J Nutr Health.  2024 Feb;57(1):88-104. 10.4163/jnh.2024.57.1.88.

Association between Korean Healthy Eating Index and abdominal obesity in Korean adults: the mediating effect of high-sensitivity C-reactive protein

• Yoon J
• Shin D

• KMID: 2553708
• DOI: http://doi.org/10.4163/jnh.2024.57.1.88

Abstract

Purpose
High-sensitivity C-reactive protein (hs-CRP) is primarily synthesized in the liver upon stimulation of infectious disease cytokines, such as interleukin-6 (IL-6), and is used as a biological marker of systemic inflammation. Previous studies reported that hs-CRP is closely related to diet and abdominal obesity. Furthermore, a dietary score favoring the consumption of vegetables, fruits, and whole grains over meat and saturated fat reduced inflammation and decreased the prevalence of obesity and abdominal obesity. Nevertheless, no studies have examined whether hs-CRP mediates the relationship between dietary scores and abdominal obesity, and research on the Korean Healthy Eating Index (KHEI) is lacking. Therefore, the present study examined the association between the KHEI and abdominal obesity and the mediating effect of hs-CRP.
Methods
In total, 17,770 adults aged ≥19 years were included in the study using the Korea National Health and Nutrition Examination Survey 2015–2018. KHEI was developed to assess the overall diet quality of Korean adults. Multivariable linear and logistic regression analyses assessed the relationship between KHEI, hs-CRP, and abdominal obesity. The mediation analysis with the bootstrapping method was performed using SAS MACRO.
Results
Among women, the odds ratio (OR) of abdominal obesity prevalence was lower in the highest KHEI compared to the lowest KHEI after adjusting for age, body mass index, educational level, income level, occupational status, marital status, household type, region type, alcohol consumption, smoking status, physical activity, total energy intake, and hsCRP (OR 0.744, 95% confidence interval 0.598–0.926). The association between KHEI and abdominal obesity was partially mediated via hs-CRP, and the mediated proportion was 68.7% in men and 38.1% in women.
Conclusion
A substantial relationship was observed between the KHEI and abdominal obesity among females. Moreover, according to the KHEI, abdominal obesity may be mediated partially by hs-CRP.

Keyword

Healthy Eating Index; abdominal obesity; waist circumference; C-reactive protein; mediating