Association between Milk Consumption and Metabolic Syndrome among Korean Adults: Results from the Health Examinees Study

Association of milk and dairy product consumption with the incidence of cardio-cerebrovascular disease incidence in middle-aged and older Korean adults: a 16-year follow-up of the Korean Genome and Epidemiology Study

BACKGROUND/OBJECTIVES

Unhealthy dietary behaviors constitute one of risk the factors for chronic and cardiovascular diseases, which are prevalent in middle-aged and older populations. Milk and dairy products are high-quality foods and important sources of calcium. Calcium protects against osteoporosis and cardiovascular disease. Therefore, this study investigated the association of milk and dairy product consumption with cardio-cerebrovascular disease incidence in middle-aged and older Korean adults.

SUBJECTS/METHODS

Data were derived from the Ansan-Anseong cohort study, and a total of 8,009 individuals aged 40-69 years were selected and followed up biennially. Cox proportional hazard models were used to examine the association of milk and dairy product consumption with cardio-cerebrovascular disease incidence.

RESULTS

During a mean follow-up period of 96.5 person-months, 552 new cases of cardio-cerebrovascular disease were documented. Milk consumers (< 1 serving/day) exhibited a 23% lower risk of cardio-cerebrovascular disease incidence than non-milk consumers (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.61-0.97; P for trend = 0.842). High yogurt consumption was associated with a 29% lower incidence risk (≥ 0.5 servings/day vs. none: HR, 0.71; 95% CI, 0.53-0.96; P for trend = 0.049), whereas high ice cream consumption was associated with a 70% higher risk of cardio-cerebrovascular disease incidence (≥ 0.5 servings/day vs. none: HR, 1.70; 95% CI, 1.01-2.88; P for trend = 0.070).

CONCLUSIONS

This study indicates that less than one serving of milk and high yogurt consumption are associated with a lower cardio-cerebrovascular disease risk in the middle-aged and older populations.

Adherence to the World Cancer Research Fund/American Institute for Cancer Research and Korean Cancer Prevention Guidelines and cancer risk: a prospective cohort study from the Health Examinees-Gem study

OBJECTIVES

The purpose of this study was to explore the association between adherence to 2 cancer prevention recommendations and cancer risk.

METHODS

In total, 104,386 individuals aged 40-69 years old who were recruited between 2004 and 2013 in the Health Examinees-Gem study were included. Adherence scores were constructed based on 8 items from the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations, including body weight, physical activity, diet, alcohol consumption and breastfeeding, and on 6 items from the Korean cancer prevention guidelines (smoking status, eating vegetables and fruits, salty foods, alcohol intake, physical activity, and body weight). A Cox proportional hazards model was used to estimate the associations between adherence scores and the risk of total and 5 major cancers.

RESULTS

The multivariable hazard ratio (HR) for total cancer with the high adherence score versus the lowest score (4.25-7.00 vs. 0.00-3.25) for the WCRF/AICR guidelines was 0.91 (95% confidence interval [CI], 0.82 to 1.00) in men. A reduced breast cancer risk was observed among women with the highest score. Men within the highest category of the Korean cancer prevention guideline score (3.25-6.00) had an HR of 0.80 (95% CI, 0.73 to 0.88) for developing total cancer compared to men within the lowest score (0.00-2.50). The higher adherence group among men showed lower risks of developing stomach, colorectal, and lung cancers.

CONCLUSIONS

Adhering to guidelines for cancer prevention can help to reduce the risk of developing cancer in Korean men. The association might differ by cancer type and gender.

Relationship between the Prevalence of Metabolic Disease and Impaired Mobility, Diet, Physical Activity, and Socio-Demographic Characteristics in the Polish Elderly-A Cross-Sectional Study

Maintaining good health for as long as possible presents a great challenge for the elderly. As the elderly population is growing, there is an ongoing need to identify health risk factors affecting older individuals. The study aimed to explore relationships between sociodemographic characteristics, diet, physical activity, and prevalence of metabolic diseases and impaired mobility in the Polish elderly. A cross-sectional study was carried out on 417 elderlies in May-July 2021. Cluster analysis was applied to separate four homogeneous clusters based on the prevalence of metabolic disease and impaired mobility. Logistic regression analysis was used to verify associations between variables. Being overweight or having obesity, as well as following a diet, increased the probability of being affected by metabolic disease. Being well educated, having a better financial situation, positive perception of own health, and having at least moderate physical activity decreased the probability of suffering from mobility impairments. Eating behaviors were not found to be predictors of the disease. However, they differentiated the selected clusters. The results confirmed the heterogeneity of factors that may impact healthy aging. Thus, they should be taken into account by public health authorities to develop health promotion actions adjusted to the needs of specific subgroups.

Association of Tibetan Habitual Food and Metabolic Syndrome Among Tibetan People in China: A Cross-Sectional Study

Background

The association between habitual food intake in Tibet and metabolic syndrome (MetS) is largely unclear.

Objective

To examine the association between Tibetan habitual food intake and MetS among Tibetan adults.

Methods

A population-based cross-sectional study, named the China Multi-Ethnic Cohort (CMEC) study, was conducted between 2018 and 2019. We used data from all Tibetans in the CMEC in the current study. The participants, 1,954 men and 3,060 women aged 18–79 years, were from Lhasa, Tibet Autonomous Region, Tibet. The habitual dietary intake was assessed using a food frequency questionnaire (FFQ). MetS was defined according to ATP III guidelines. Multivariate logistic regression was used to estimate the association between five Tibetan habitual foods and MetS.

Results

Tsampa, butter tea, and Qing cha intake were associated with reduced prevalence of MetS. Compared with the lowest quartile of each food, odds ratios (ORs) and their 95% confidence intervals (95% CIs) of medium and high Tsampa intake were 0.59 (0.41–0.85) and 0.53 (0.36–0.77), ORs (95% CIs) of butter tea were 0.67 (0.52–0.88) and 0.61 (0.46–0.81), and Qing cha were 0.85 (0.71–1.03) and 0.75 (0.60–0.93), respectively. When exploring the joint effects of these three foods on MetS, the adjusted ORs and their 95% CIs were 0.65 (0.49–0.87) for the middle intake group and 0.59 (0.42–0.83) for the high intake group as compared with the never/rarely group (p = 0.022 for trend). Associations of MetS with Tibetan noodles and raw beef were not observed.

Conclusion

Tsampa, butter tea, and Qing cha were negatively associated with MetS. The recommendation of increasing the intake of these foods may be beneficial for MetS prevention.

Association Between Dietary Patterns and Dyslipidemia in Korean Women

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.

Higher Animal Protein Intake During the Second Trimester of Pregnancy Is Associated With Risk of GDM

Background and Aims: This study aimed to examine the associations between the total protein intake as well as types and sources of proteins with the gestational diabetes mellitus (GDM) risk. Method and Results: This was a prospective cohort study of the pregnant women in Malaysia. In this study, the total, animal, and plant protein intakes were assessed using a semi-quantitative food frequency questionnaire. Of the 452 women, 48 (10.62%) were diagnosed with GDM. From pre-pregnancy to second trimester, most of the women had 10-20% of energy intake from protein (88.9-90.3%) and ≥75% of recommended protein intake (74.6-86.5%). The women in the highest tertile (T3) of total animal protein intake [adjusted odds ratio (AOR) = 2.76, 95% CI = 1.27-6.04] and red meat protein (AOR = 2.69, 95% CI = 1.27-5.70), specifically in the second trimester, had significantly higher GDM risk compared with the women in the middle tertile of intake (T2). Interestingly, the women in the T3 of egg protein in the second trimester were significantly at lower GDM risk (AOR = 0.43, 95% CI = 0.18-0.91) compared with those in T2. Conclusion: The highest tertile of animal protein (≥42.15 g/day) intake, particularly red meat protein in the second trimester was positively associated with the GDM risk, whereas the highest tertile of egg protein was inversely associated with the GDM risk. Protein intake before or during early pregnancy was not associated with the GDM risk. These findings underscore the importance of sources and types of protein intake, particularly after the first trimester of pregnancy, in relation to GDM risk.

Association between Carbohydrate Intake and the Prevalence of Metabolic Syndrome in Korean Women

Carbohydrates consist of a large proportion of calories in the Asian diet. Therefore, we aimed to investigate the association between carbohydrate intake and metabolic syndrome in Korean women. A cross-sectional analysis was conducted with a total of 4294 Korean women aged 40–69 years from the Korean Genomic and Epidemiology Study (KoGES). Carbohydrate intake was calculated based on a validated food frequency questionnaire. Metabolic syndrome was defined by using the National Cholesterol Education Program, Adult Treatment Panel III (NCEPIII). Logistic regression was used to estimate the association of carbohydrate intake with metabolic syndrome and its components. In this study, high carbohydrate intake seemed to be associated with low socioeconomic status and an imbalanced diet. After adjusting for confounding factors, subjects with higher carbohydrate intake showed an increased risk of metabolic syndrome (odds ratio (OR) 1.34, 95% confidence interval (CI) 1.08–1.66, p-trend = 0.004, highest vs. lowest quartile [≥75.2 vs. <67.0% of energy]), particularly elevated waist circumference. This association was stronger among those with low levels of C-reactive protein (CRP) and those with low dairy intake. In conclusion, higher carbohydrate intake is associated with a higher risk of metabolic syndrome, particularly abdominal obesity, in Korean women. This association may differ according to individuals’ CRP level and dairy intake.

Dairy Consumption and Risk of Metabolic Syndrome: Results from Korean Population and Meta-Analysis

Dairy consumption has been associated with decreased risk of metabolic syndrome (MetS) in previous studies, but the association may be different according to each type of dairy products and its subgroups. Thus, we conducted an updated meta-analysis of observational studies to examine the association between various dairy products and risk of MetS. The PubMed and Web of Science databases were searched for eligible studies published up to February 2021. In addition, we included unpublished results from Korea National Health and Nutrition Examination Survey, 2013-2018, including 23,319 Korean adults and the elderly. A total of 35 studies (12 cohort studies and 25 cross-sectional studies) with 398,877 subjects were included in the meta-analysis. The pooled relative risks (RR) of MetS for the highest versus lowest categories of dairy consumption was 0.80 [95% confidence interval (CI): 0.72-0.88]. For the type of dairy products, there were also significant inverse associations with milk (RR: 0.83; 95% CI: 0.78-0.89) and yogurt consumption (RR: 0.89; 95% CI: 0.83-0.95). For cheese consumption, however, no significant association was found (RR: 0.98; 95% CI: 0.86-1.11). Our findings suggest that milk and yogurt consumption is inversely associated with the risk of MetS, but not cheese consumption.

Dietary patterns and their associations with the metabolic syndrome and predicted 10-year risk of CVD in northwest Chinese adults

The impact of diet on the metabolic syndrome (MetS) and CVD has been investigated widely, but few studies have investigated the association between dietary patterns (DP) and the predicted CVD, derived from reduced rank regression (RRR). The objectives of this study were to derive DP using RRR and principal component analysis (PCA) and investigate their associations with the MetS and estimated 10-year atherosclerotic CVD (ASCVD). We used the baseline dataset from the Xinjiang multi-ethnic cohort study in China, collected from June 2018 to May 2019. A total of 14 982 subjects aged 35-74 years from Urumqi, Huo Cheng and Mo Yu were included in the analysis. The 10-year ASCVD risk was estimated using the Chinese ASCVD risk equations. The associations of DP with the MetS and 10-year ASCVD were determined using multivariable logistic regression models. In Urumqi and Mo Yu, the increased RRR DP score was associated with a higher OR of having the MetS and with a higher OR of elevated 10-year ASCVD risk. However, only the first DP determined by PCA in Urumqi was inversely associated with the MetS and elevated 10-year ASCVD risk. The prevalence of the MetS and elevated ASCVD risk in urban population is higher than that in rural areas. Our results may help nutritionists develop more targeted dietary strategies to prevent the MetS and ASCVD in different regions in China.

Adherence to the Recommended Intake of Calcium and Colorectal Cancer Risk in the HEXA Study

Purpose

Dietary calcium intake has been suggested to be protective against the development of colorectal cancer. The mean dietary calcium intake of Koreans is 490 mg/day, which is far below the recommended calcium intake of 700-800 mg/day. In this study, we explored the relationship between dietary calcium intake and colorectal cancer development in Koreans with relatively low calcium intake compared with individuals in Western countries.

Materials and Methods

The Health Examinees Study, a large-scale genomic community-based prospective cohort study, was designed to identify the general characteristics of major chronic diseases in Koreans. A total of 119,501 participants aged 40-69 years recruited between 2004 and 2013 were included in this analysis. The calcium intake level was categorized using the Dietary Reference Intakes for Koreans (KDRIs). The Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and the corresponding 95% confidence intervals (CIs) for colorectal cancer risk, adjusting for potential confounders.

Results

In the multivariable-adjusted model, compared with the group that consumed less than the recommended amount of calcium, the group that consumed more than the recommended intake of calcium showed a significant reduction in the risk of colorectal cancer in women. (HR, 0.54; 95% CI, 0.31 to 0.95). Among men, however, no significant association was observed between dietary calcium intake and colorectal cancer risk (HR, 0.89; 95% CI, 0.54 to 1.45).

Conclusion

Korean women who adhere to the recommended intake of calcium showed a reduced risk of colorectal cancer.

Effect of Dairy Protein Intake on Muscle Mass among Korean Adults: A Prospective Cohort Study

This cohort study aimed to identify the associations of dairy protein intake with the risk of developing a low muscle mass during a 12-year follow-up period, using data from 4412 middle-aged Korean Genome and Epidemiology Study participants with a normal baseline muscle mass. Dairy protein intake at baseline was assessed using a semi-quantitative Food Frequency Questionnaire. Skeletal muscle mass index (SMI), defined as the weight-adjusted skeletal muscle mass, was measured biennially using multi-frequency bioelectrical impedance analyses. Cox proportional hazards regression analysis was used to calculate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Overall, 395 subjects developed a low SMI (%) during an average follow-up of 141 (19-152) months. The average consumption of milk and other dairy products was 73.6 and 104.1 g/day, respectively. In men, a higher dairy protein intake was associated with a decreased risk of developing a low SMI (tertile 3 [T3] vs. T1, HR: 0.63; 95% CI: 0.42, 0.94; p for trend = 0.029). In a stratified analysis according to a total protein intake, this association was stronger in the lower-protein intake group (HR: 0.59; 95% CI: 0.35, 0.99; p for trend = 0.036) but not detected in the higher-protein intake group. Men who consumed milk ≥1 time/day had a significantly lower risk of developing a low SMI (HR: 0.62; 95% CI: 0.39, 0.98; p for trend = 0.023). No significant associations were observed in women. In summary, dairy consumption appears to be beneficial for decreasing the risk of developing a low muscle mass in middle-aged Korean men.

Evaluation of risk factors for insulin resistance: a cross sectional study among employees at a private university in Lebanon

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.

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

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.

Association between dairy product intake and hypertriglyceridemia in Korean adults

BACKGROUND/OBJECTIVES

Hypertriglyceridemia may be a more important predictor of cardiovascular disease in Asian population consuming carbohydrate-rich foods than in Western populations. Dairy products are known to play a beneficial role in obesity, dyslipidemia, and metabolic syndrome, but the results vary depending on gender and obesity. In this study, we investigated the associations between dairy product intake and hypertriglyceridemia in Korean adults.

SUBJECTS/METHODS

The participants were selected from the Korea National Health and Nutrition Examination Survey 2007–2012 (KNHANES IV and V). A total of 22,836 participants aged 19–64 years were included in the analysis. A food frequency questionnaire used to determine the frequency of consumption of products (milk and yogurt). Multivariable logistic regression was used to assess the associations between dairy product intake and hypertriglyceridemia.

RESULTS

A significantly decreased risk of hypertriglyceridemia was detected in the highest dairy product intake frequency group (≥ 1 time/day) (odd ratio [OR] = 0.79; 95% confidence interval [CI] 0.64–0.97, P for trend = 0.022) compared to that for the lowest dairy product intake frequency group. Among obese participants, the group with the highest intakes of milk (in men, OR = 0.64; 95% CI: 0.46–0.91, P for trend = 0.036) and yogurt (in women; OR = 0.53; 95% CI: 0.29–0.94, P for trend = 0.019) showed inverse associations with hypertriglyceridemia. No associations were detected in normal weight participants.

CONCLUSION

The association between dairy product intake and hypertriglyceridemia differed by gender and obesity status. Further prospective studies are needed to confirm these associations.

The association between milk consumption and the metabolic syndrome: a cross-sectional study of the residents of Suzhou, China and a meta-analysis

The association between milk consumption and the metabolic syndrome remains inconclusive, and data from Chinese populations are scarce. We conducted a cross-sectional study to investigate the association between milk consumption and the metabolic syndrome and its components among the residents of Suzhou Industrial Park, Suzhou, China. A total of 5149 participants were included in the final analysis. A logistic regression model was applied to estimate the OR and 95 % CI for the prevalence of the metabolic syndrome and its components according to milk consumption. In addition, the results of our study were further meta-analysed with other published observational studies to quantify the association between the highest v. lowest categories of milk consumption and the metabolic syndrome and its components. There was no significant difference in the odds of having the metabolic syndrome between milk consumers and non-milk consumers (OR 0·86, 95 % CI 0·73, 1·01). However, milk consumers had lower odds of having elevated waist circumference (OR 0·78, 95 % CI 0·67, 0·92), elevated TAG (OR 0·83, 95 % CI 0·70, 0·99) and elevated blood pressure (OR 0·85, 95 % CI 0·73, 0·99). When the results were pooled together with other published studies, higher milk consumption was inversely associated with the risk of the metabolic syndrome (relative risk 0·80, 95 % CI 0·72, 0·88) and its components (except elevated fasting blood glucose); however, these results should be treated with caution as high heterogeneity was observed. In summary, the currently available evidence from observational studies suggests that higher milk consumption may be inversely associated with the metabolic syndrome.

Associations of Dietary Intake with Cardiovascular Disease, Blood Pressure, and Lipid Profile in the Korean Population: a Systematic Review and Meta-Analysis

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.

Association between egg consumption and elevated fasting glucose prevalence in relation to dietary patterns in selected group of Polish adults

Background

The safety of high egg intake in view of its impact on glucose metabolism remains inconclusive. The aim of the study was to assess the relationship between egg intake, dietary patterns and elevated fasting glucose (FG) level in a selected group of Polish adults.

Methods

The study group consisted of 1630 adults who participated in the Polish arm of the Prospective Urban Rural Epidemiological Study. Dietary intake, including egg intake, was assessed based on the data from the Additional file 2 Food Frequency Questionnaire previously validated for the population of Lower Silesia. DPs were derived using principal component analysis. FG levels ≥100 mg/dl were considered elevated. Subjects who used antidiabetic drugs were included in the group with elevated FG levels.

Results

Egg consumption increased in higher quartiles of “Western” and “traditional” DPs in both men and women (p < 0.0001). In a crude model each 10 g of eggs consumed per day was associated with 7% increased risk (OR 1.07; 95% CI: 1.01–1.15) of elevated glucose level in the overall group and 10% increased risk (OR 1.10; 95% CI: 1.01–1.21) of elevated glucose level in the group of men. Men who consumed at least five eggs per week had higher risk for elevated FG level compared to men who consumed at most one egg per week (OR 1.79; 95% CI 1.13–2.84), but this relationship became insignificant when the data were adjusted for DPs. In the group of women no association between egg intake and elevated FG level was observed.

Conclusions

Higher egg intake may be associated with the overall unhealthy dietary habits, which is why the number of eggs consumed daily should not be considered an independent risk factor for elevated fasting glucose level.

Association between the prevalence of metabolic syndrome and coffee consumption among Korean adults: results from the Health Examinees study

The aim of this study was to evaluate the association between the frequency and quantity of coffee consumption and metabolic syndrome (MetS) in the Health Examinees study. A total of 130 420 participants (43 682 men and 86 738 women) were included in our study. Coffee consumption was categorized into 5 categories (0, <1, 1, 2-3, and ≥4 cups/day). We calculated odds ratios (ORs) and 95% confidence intervalS (CIs) using multivariate logistic regression. In this study population, the prevalence of MetS was 12 701 (29.1%) in men and 21 338 (24.6%) in women. High coffee consumption (≥4 cups/day) was associated with a lower prevalence of MetS compared with non-coffee consumers (OR = 0.79, 95% CI = 0.70-0.90, p for trend <0.0001 in men; OR = 0.70, 95% CI = 0.62-0.78, p for trend <0.0001 in women). The multivariable-adjusted ORs for high fasting glucose decreased with increasing levels of coffee consumption in men (OR = 0.60, 95% CI = 0.54-0.67, p for trend <0.0001) and women (OR = 0.70, 95% CI = 0.63-0.79, p for trend <0.0001). For women, the multivariable-adjusted ORs for hypertriglyceridemia (OR = 0.84, 95% CI = 0.75-0.93, p for trend = 0.0007) decreased with increasing levels of coffee consumption. We found that coffee consumption was inversely associated with the prevalence of metabolic syndrome among Korean men and women. Our study warrants further prospective cohort studies.

Technical position on milk and its derivatives in adult health and disease from the Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría

Milk is a liquid food that possesses an important quantity of highly bioavailable macronutrients. In addition, it is readily accessible, as well as relatively inexpensive. Given that the knowledge of physicians about nutrition and food composition is deficient, in general, many of the dietary interventions recommended in diverse clinical settings lack a scientific basis. The aim of the present review was to produce a technical opinion that serves as a frame of reference to best sustain recommendations for consuming milk and dairy products as daily nutrition in the adult and older adult. The effects of milk and dairy products during the pediatric stage are not addressed in the present work. The Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Gerontología y Geriatría jointly discussed and analyzed topics dealing with the legal designation of milk, the classification and nutritional profile of cow's milk, its nutritional characteristics, its consumption in the adult, intolerance to cow's milk, and associations of milk consumption with digestive tract alterations and other conditions. Finally, certain aspects of milk consumption in the older adult and its relation to overall health are briefly discussed.

Cis-9, Trans-11 Conjugated Linoleic Acid Reduces Phosphoenolpyruvate Carboxykinase Expression and Hepatic Glucose Production in HepG2 Cells

Dysregulated hepatic gluconeogenesis is a hallmark of insulin resistance and type 2 diabetes mellitus (T2DM). Although existing drugs have been proven to improve gluconeogenesis, achieving this objective with functional food is of interest, especially using conjugated linoleic acid (CLA) found in dairy products. Both cis-9, trans-11 (c9,t11) and trans-10, cis-12 (t10,c12) isomers of CLA were tested in human (HepG2) and rat (H4IIE) hepatocytes for their potential effects on gluconeogenesis. The hepatocytes exposed for 24 h with 20 μM of c9,t11-CLA had attenuated the gluconeogenesis in both HepG2 and H4IIE by 62.5% and 80.1%, respectively. In contrast, t10,c12-CLA had no effect. Of note, in HepG2 cells, the exposure of c9,t11-CLA decreased the transcription of gluconeogenic enzymes, cytosolic phosphoenolpyruvate carboxykinase (PCK1) by 87.7%, and glucose-6-phosphatase catalytic subunit (G6PC) by 38.0%, while t10,c12-CLA increased the expression of G6PC, suggesting the isomer-specific effects of CLA on hepatic glucose production. In HepG2, the peroxisome proliferator-activated receptor (PPAR) agonist, rosiglitazone, reduced the glucose production by 72.9%. However, co-administration of c9,t11-CLA and rosiglitazone neither exacerbated nor attenuated the efficacy of rosiglitazone to inhibit glucose production; meanwhile, t10,c12-CLA abrogated the efficacy of rosiglitazone. Paradoxically, PPARγ antagonist GW 9662 also led to 70.2% reduction of glucose production and near undetectable PCK1 expression by abrogating CLA actions. Together, while the precise mechanisms by which CLA isomers modulate hepatic gluconeogenesis directly or via PPAR warrant further investigation, our findings establish that c9,t11-CLA suppresses gluconeogenesis by decreasing PEPCK on hepatocytes.

Dietary Patterns in Relation to Components of Dyslipidemia and Fasting Plasma Glucose in Adults with Dyslipidemia and Elevated Fasting Plasma Glucose in Taiwan

Dietary patterns have been proposed to be related to dyslipidemia and hyperglycemia. This study investigated the correlation of dietary patterns with components of dyslipidemia and fasting plasma glucose (FPG) among young and middle-aged adults (aged between 20 and 50 years) with dyslipidemia and abnormal FPG in Taiwan. This cross-sectional study used the database compiled in Taiwan between 2001 to 2010. A total of 13,609 subjects aged between 20 and 50 years were selected. Dyslipidemia was defined primarily according to the National Cholesterol Education Program Adult Treatment Panel III guidelines with minor modification. Elevated FPG level was defined according to the American Diabetes Association. The factor analysis was conducted to identify three dietary patterns. Higher scores of the meat-convenience dietary pattern (high intake of deep-fried and processed food, sauces, sugar-added beverages, meat and organ meats, instant noodles, rice or flour cooked in oil, and eggs) had no association with components of dyslipidemia and abnormal FPG. Higher scores of the vegetables-fruits-seafood dietary pattern (high intake of vegetables, vegetables with oil or dressing, fruits, seafood, legumes, soy products, and rice or flour products) was inversely associated with hypercholesterolemia and positively associated with hyperglycemia. Higher scores of the dairy-complex carbohydrate dietary pattern (high intake of dairy products, milk, root crops, jam or honey, and whole grains) was inversely correlated with hypertriglycemia and low high-density lipoprotein cholesterol level. Our results support that the dietary pattern may have a role in the prevention and management of dyslipidemia and abnormal fasting plasma glucose.

Trends and Correlates of High-Risk Alcohol Consumption and Types of Alcoholic Beverages in Middle-Aged Korean Adults: Results From the HEXA-G Study

Background

We aimed to report the prevalence and correlates of high-risk alcohol consumption and types of alcoholic beverages.

Methods

The baseline data of the Health Examinees-Gem (HEXA-G) study participants, including 43,927 men and 85,897 women enrolled from 2005 through 2013, were used for analysis. Joinpoint regression was performed to estimate trends in the age-standardized prevalence of alcohol consumption. Associations of demographic and behavioral factors, perceived health-related effects, social relationships, and the diagnostic history of diseases with alcohol consumption were assessed using multinomial logistic regression.

Results

The prevalence of alcohol consumption remained higher in men during the study period and increased in women. The amount of alcohol consumed has increased in women, especially that from beer and makgeolli, a traditional Korean fermented rice wine. Older participants were less likely to be high-risk drinkers (men and women who drink more than 40 or 20 g/day of alcohol, respectively) and drink Soju, a distilled liquor, and beer, and more likely to drink makgeolli. Educational level was negatively associated with high-risk drinking. However, it was positively associated with the consumption of strong spirits and wine. Smoking was associated with high-risk drinking and the consumption of soju and strong spirits. Engaging in regular exercise and having stress were associated with drinking all types of beverages except for soju.

Conclusions

Sex-specific trends in alcohol consumption were influenced by demographic, behavioral, and perceived health-related factors. The findings will help improve the understanding of alcohol-related problems and provide evidence for establishing country-specific policies and campaigns in Korea.