Nutr Res Pract.  2015 Oct;9(5):554-562. 10.4162/nrp.2015.9.5.554.

Low consumption of fruits and dairy foods is associated with metabolic syndrome in Korean adults from outpatient clinics in and near Seoul

• Song S
• Kim EK
• Hong S
• Shin S
• Song Y
• Baik HW
• Joung H
• Paik HY

• KMID: 2313878
• DOI: http://doi.org/10.4162/nrp.2015.9.5.554

Abstract

BACKGROUND/OBJECTIVES
The aim of this study was to examine differences in nutrient intake and food consumption by the presence of metabolic syndrome in Korean adults.
SUBJECTS/METHODS
Study subjects in this cross-sectional study were recruited from four outpatient clinics in and near the Seoul metropolitan area of South Korea between 2006 and 2012. A total of 668 subjects (413 men and 255 women) aged > or = 30 y were included in the final data analyses. For each subject, daily nutrient intake and food consumption were calculated using three days of dietary intake data obtained from a combination of 24-hour recalls and dietary records. To evaluate food consumption, mean number of servings consumed per day and percentages of recommended number of servings for six food groups were calculated. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. The general linear model was performed to examine differences in nutrient intake and food consumption by sex and the presence of metabolic syndrome after adjustment for potential confounding variables.
RESULTS
Nutrient intake did not differ by the presence of metabolic syndrome in both men and women. Men with metabolic syndrome had lower consumption and percentage of the recommendation for fruits compared with those without metabolic syndrome (1.6 vs. 1.1 servings/day, P-value = 0.001; 63.5 vs. 49.5%, P-value = 0.013). Women with metabolic syndrome showed lower consumption and percentage of the recommendation for dairy foods than those without metabolic syndrome (0.8 vs. 0.5 servings/day, P-value = 0.001; 78.6 vs. 48.9%, P-value = 0.001).
CONCLUSIONS
Low intakes of fruits and dairy foods might be associated with the risk of having metabolic syndrome among Korean adults. Dietary advice on increasing consumption of these foods is needed to prevent and attenuate the risk of metabolic syndrome.

Keyword

Fruits; dairy foods; food consumption; metabolic syndrome; Korean adults

MeSH Terms

Adult*
Ambulatory Care Facilities*
Cholesterol
Confounding Factors (Epidemiology)
Cross-Sectional Studies
Diet Records
Education
Female
Fruit*
Humans
Korea
Linear Models
Male
Outpatients*
Seoul*
Statistics as Topic
Cholesterol

Reference

1. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F. American Heart Association. National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005; 112:2735–2752.

2. Ford ES, Schulze MB, Pischon T, Bergmann MM, Joost HG, Boeing H. Metabolic syndrome and risk of incident diabetes: findings from the European Prospective Investigation into Cancer and Nutrition-Potsdam Study. Cardiovasc Diabetol. 2008; 7:35.

3. Mottillo S, Filion KB, Genest J, Joseph L, Pilote L, Poirier P, Rinfret S, Schiffrin EL, Eisenberg MJ. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol. 2010; 56:1113–1132.

4. Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol. 2008; 28:629–636.

5. Lim S, Shin H, Song JH, Kwak SH, Kang SM, Won Yoon J, Choi SH, Cho SI, Park KS, Lee HK, Jang HC, Koh KK. Increasing prevalence of metabolic syndrome in Korea: the Korean National Health and Nutrition Examination Survey for 1998-2007. Diabetes Care. 2011; 34:1323–1328.

6. Yoo S, Nicklas T, Baranowski T, Zakeri IF, Yang SJ, Srinivasan SR, Berenson GS. Comparison of dietary intakes associated with metabolic syndrome risk factors in young adults: the Bogalusa Heart Study. Am J Clin Nutr. 2004; 80:841–848.

7. Kouki R, Schwab U, Hassinen M, Komulainen P, Heikkilä H, Lakka TA, Rauramaa R. Food consumption, nutrient intake and the risk of having metabolic syndrome: the DR's EXTRA Study. Eur J Clin Nutr. 2011; 65:368–377.

8. Lutsey PL, Steffen LM, Stevens J. Dietary intake and the development of the metabolic syndrome: the Atherosclerosis Risk in Communities study. Circulation. 2008; 117:754–761.

9. Liu S, Song Y, Ford ES, Manson JE, Buring JE, Ridker PM. Dietary calcium, vitamin D, and the prevalence of metabolic syndrome in middle-aged and older U.S. women. Diabetes Care. 2005; 28:2926–2932.

10. Fumeron F, Lamri A, Abi Khalil C, Jaziri R, Porchay-Baldérelli I, Lantieri O, Vol S, Balkau B, Marre M. Data from the Epidemiological Study on the Insulin Resistance Syndrome (DESIR) Study Group. Dairy consumption and the incidence of hyperglycemia and the metabolic syndrome: results from a French prospective study, Data from the Epidemiological Study on the Insulin Resistance Syndrome (DESIR). Diabetes Care. 2011; 34:813–817.

11. Elwood PC, Pickering JE, Fehily AM. Milk and dairy consumption, diabetes and the metabolic syndrome: the Caerphilly prospective study. J Epidemiol Community Health. 2007; 61:695–698.

12. Beydoun MA, Gary TL, Caballero BH, Lawrence RS, Cheskin LJ, Wang Y. Ethnic differences in dairy and related nutrient consumption among US adults and their association with obesity, central obesity, and the metabolic syndrome. Am J Clin Nutr. 2008; 87:1914–1925.

13. Aleixandre A, Miguel M. Dietary fiber in the prevention and treatment of metabolic syndrome: a review. Crit Rev Food Sci Nutr. 2008; 48:905–912.

14. Puchau B, Zulet MA, de Echávarri AG, Hermsdorff HH, Martínez JA. Dietary total antioxidant capacity is negatively associated with some metabolic syndrome features in healthy young adults. Nutrition. 2010; 26:534–541.

15. Mattei J, Bhupathiraju S, Tucker KL. Higher adherence to a diet score based on American Heart Association recommendations is associated with lower odds of allostatic load and metabolic syndrome in Puerto Rican adults. J Nutr. 2013; 143:1753–1759.

16. Kesse-Guyot E, Ahluwalia N, Lassale C, Hercberg S, Fezeu L, Lairon D. Adherence to Mediterranean diet reduces the risk of metabolic syndrome: a 6-year prospective study. Nutr Metab Cardiovasc Dis. 2013; 23:677–683.

17. Fogli-Cawley JJ, Dwyer JT, Saltzman E, McCullough ML, Troy LM, Meigs JB, Jacques PF. The 2005 Dietary Guidelines for Americans and risk of the metabolic syndrome. Am J Clin Nutr. 2007; 86:1193–1201.

18. Babio N, Bulló M, Basora J, Martínez-González MA, Fernández-Ballart J, Márquez-Sandoval F, Molina C, Salas-Salvadó J. Nureta-PREDIMED Investigators. Adherence to the Mediterranean diet and risk of metabolic syndrome and its components. Nutr Metab Cardiovasc Dis. 2009; 19:563–570.

19. Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC. Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome. Am J Clin Nutr. 2006; 84:1489–1497.

20. Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi F. Dairy consumption is inversely associated with the prevalence of the metabolic syndrome in Tehranian adults. Am J Clin Nutr. 2005; 82:523–530.

21. Park MH, Kim D, Park MS, Kim MY, Paik HY, Kim OS, Oh SY, Lee SS, Ok SH. Cultural Life in Korea. Seoul: Kyomunsa;2003.

22. Song S, Jung HJ, Shim JE, Paik HY. Assessment of food group intake in Korean population with a newly developed food group database. J Food Compost Anal. 2014; 36:72–78.

23. Kim J. Dairy food consumption is inversely associated with the risk of the metabolic syndrome in Korean adults. J Hum Nutr Diet. 2013; 26:Suppl 1. 171–179.

24. Lee CJ, Joung H. Milk intake is associated with metabolic syndrome: using data from the Korea National Health and Nutrition Examination Survey 2007-2010. Korean J Community Nutr. 2012; 17:795–804.

25. Cho GJ, Park HT, Shin JH, Hur JY, Kim YT, Kim SH, Lee KW, Kim T. Calcium intake is inversely associated with metabolic syndrome in postmenopausal women: Korea National Health and Nutrition Survey, 2001 and 2005. Menopause. 2009; 16:992–997.

26. Jung HJ, Han SN, Song S, Paik HY, Baik HW, Joung H. Association between adherence to the Korean Food Guidance System and the risk of metabolic abnormalities in Koreans. Nutr Res Pract. 2011; 5:560–568.

27. Jung HJ, Lee SE, Kim D, Noh H, Song S, Kang M, Song Y, Paik HY. Development and feasibility of a web-based program 'Diet Evaluation System (DES)' in urban and community nutrition survey in Korea. Korean J Health Promot. 2013; 13:107–115.

28. Jung HJ, Lee SE, Kim D, Noh H, Song S, Kang M, Song YJ, Paik HY. Improvement in the technological feasibility of a web-based dietary survey system in local settings. Asia Pac J Clin Nutr. 2015; 24:308–315.

29. Rural Resources Development Institute (KR). Food Composition Table. 7th rev. ed. Suwon: Rural Development Administration;2006.

30. The Korean Nutrition Society. Dietary Referece Intakes for Koreans. 1st rev. ed. Seoul: The Korean Nutrition Society;2010.

31. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, Kim DY, Kwon HS, Kim SR, Lee CB, Oh SJ, Park CY, Yoo HJ. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract. 2007; 75:72–80.

32. Shin H, Yoon YS, Lee Y, Kim CI, Oh SW. Dairy product intake is inversely associated with metabolic syndrome in Korean adults: Anseong and Ansan cohort of the Korean Genome and Epidemiology Study. J Korean Med Sci. 2013; 28:1482–1488.

33. Hosseinpour-Niazi S, Mirmiran P, Sohrab G, Hosseini-Esfahani F, Azizi F. Inverse association between fruit, legume, and cereal fiber and the risk of metabolic syndrome: Tehran Lipid and Glucose Study. Diabetes Res Clin Pract. 2011; 94:276–283.

34. Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. 2002; 13:3–9.

35. Otsuka R, Imai T, Kato Y, Ando F, Shimokata H. Relationship between number of metabolic syndrome components and dietary factors in middle-aged and elderly Japanese subjects. Hypertens Res. 2010; 33:548–554.

36. Shin SK, Kim MK, Lee YH, Shin DH, Shin MH, Chun BY, Choi BY. The cross-sectional relationship between dietary calcium intake and metabolic syndrome among men and women aged 40 or older in rural areas of Korea. Nutr Res Pract. 2015; 9:328–335.

37. Dugan CE, Barona J, Fernandez ML. Increased dairy consumption differentially improves metabolic syndrome markers in male and female adults. Metab Syndr Relat Disord. 2014; 12:62–69.

38. Shin A, Lim SY, Sung J, Shin HR, Kim J. Dietary intake, eating habits, and metabolic syndrome in Korean men. J Am Diet Assoc. 2009; 109:633–640.

39. Cohen DA, Sturm R, Lara M, Gilbert M, Gee S. Discretionary calorie intake a priority for obesity prevention: results of rapid participatory approaches in low-income US communities. J Public Health (Oxf). 2010; 32:379–386.

40. Malik VS, Popkin BM, Bray GA, Després JP, Hu FB. Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation. 2010; 121:1356–1364.