Iodine intake from brown seaweed and the related nutritional risk assessment in Koreans.

BACKGROUND/OBJECTIVES: Although iodine is essential for thyroid hormone production and controls many metabolic processes, there are few reports on the iodine intake of the population because of the scarcity of information on the iodine content in food. This study estimated the iodine intake of Koreans from brown seaweed, the major source of iodine in nature. SUBJECTS/METHODS: The dietary intake data from the recent Korea National Health and Nutrition Examination Survey (2016-2021) and the iodine content in brown seaweed were used for the estimation. Nationwide brown seaweed samples were collected and prepared using the representative preparation/cooking methods in the Koreans' diet before iodine analysis by alkaline digestion followed by inductively coupled plasma mass spectrometry. RESULTS: The mean (± SE) iodine intake from sea mustard was 96.01 ± 2.36 µg/day in the Korean population. Although the iodine content in kelp was approximately seven times higher than that in sea mustard, the mean iodine intake from kelp (except broth) was similar to that of sea mustard, 115.58 ± 7.71 µg/day, whereas that from kelp broth was 347.57 ± 10.03 µg/day. The overall mean iodine intake from brown seaweed was 559.16 ± 13.15 µg/day, well over the Recommended Nutrient Intake of iodine for Koreans. Nevertheless, the median intake was zero because only 37.6% of the population consumed brown seaweed on the survey date, suggesting that Koreans do not consume brown seaweed daily. CONCLUSION: The distribution of the usual intake of iodine from brown seaweed in Koreans would be much tighter, resulting in a lower proportion of people exceeding the tolerable upper intake levels and possibly a lower mean intake than this study presented. Further study evaluating the iodine nutriture of Koreans based on the usual intake is warranted. Nevertheless, this study adds to the few reports on the iodine nutriture of Koreans.

Assessment of zinc, manganese, copper, and magnesium intake levels in Koreans using the Korean Total Diet Study.

This study evaluated zinc, manganese, copper, and magnesium intake levels in Koreans using the Korean Total Diet Study, targeting 92-93% of the Korean diet. Representative foods were collected from 9 cities, resulting in 1344-1368 samples. Results showed adequate intake for most minerals, but high proportions of adults and adolescents didn't meet recommended levels. Infants had high levels of zinc and manganese intake, posing possible health concerns. This is the first comprehensive assessment of these nutrients in Korea and is significant for considering all age groups, including infants, by analyzing nutrient content for table-ready (cooked) samples of foods. It is hoped that the Korean Total Diet Survey will be expanded to assess a wider range of nutrients for better nutrient intake assessment in Korea. Supplementary Information: The online version contains supplementary material available at 10.1007/s10068-023-01394-y.

Assessment of dietary exposure to heterocyclic amines based on the Korean total diet study.

Heterocyclic amines (HCAs) are contaminants in proteinaceous foods produced by cooking at high temperatures. This study was the first assessment of exposure to HCAs using the Korean total diet study. Twelve HCAs were analysed in 1,232 pooled samples using six isotope-labelled internal standards and HPLC-MS/MS. The daily intake of HCAs in the Korean population was estimated based on the concentration of HCAs in the total diet study samples and individual food consumption data from the Korean National Health and Nutrition Examination Survey. Among HCAs, the intake of ß-carbolines, such as harman and norharman, was the highest, followed by the intake of PhIP. The primary sources of HCA intake were meat, fish, shellfish, and beverages, including alcohol. The margin of exposure to PhIP was 2,349,000 at the average level and 373,000 at the 95th percentile in the Korean population. The estimated daily intake of all HCAs in the Korean population was considered safe.

Progress on sodium reduction in South Korea.

INTRODUCTION: High dietary sodium is a leading contributor to hypertension, and hypertension is the leading underlying cause of death globally. There is a robust body of evidence supporting the health benefits of sodium reduction. Sodium intake in South Korea is high, with about half the population consuming >4000 mg/day, twice the recommended upper limit. METHODS: In 2012, South Korea implemented its National Plan to Reduce Sodium Intake, with a goal of reducing population sodium consumption by 20%, to 3900 mg/day, by 2020. The plan included five key components: (1) a consumer awareness campaign designed to change food consumption behaviours; (2) increased availability of low-sodium foods at schools and worksites; (3) increased availability of low-sodium meals in restaurants; (4) voluntary reformulation of processed foods to lower sodium content; and (5) development of low-sodium recipes for food prepared at home. Monitoring and evaluation included tracking sodium intake and sources of dietary sodium using the Korea National Health and Nutrition Examination Survey. RESULTS: By 2014, South Korea had reduced dietary sodium consumption among adults by 23.7% compared to a survey conducted in 2010 prior to implementation of a nationwide salt reduction campaign that used this comprehensive, multipronged approach. The reductions in sodium intake were accompanied by reductions in population blood pressure and hypertension prevalence. Although causal associations between the sodium reduction programme and reduced sodium intake cannot be made, the declines occurred with the introduction of the programme. CONCLUSION: Multicomponent interventions have great potential to reduce population sodium intake. Lessons learnt from South Korea could be applied to other countries and are likely very relevant to other Asian countries with similar food sources and consumption profiles.

Validation of analytical methods for heterocyclic amines in seven food matrices using high-performance liquid chromatography-tandem mass spectrometry.

Heterocyclic amines (HCAs) are potent mutagens generated by the high temperatures of the cooking process. The purpose of this study was to develop and validate analytical methods for HCAs determination using high-performance liquid chromatography-tandem mass spectrometry in seven food matrices: corn oil, milk, 20% ethanol, pork, flat fish, sea mustard (Undaria pinnatifida), and radish. Six isotopically labelled internal standards were used for quantitation, and Chem Elut and Oasis hydrphilic-liphophilic balance cartridges were applied for sample preparation to remove interferences. Calibration curves showed good linearity (R2 > 0.99) in all matrices. The ranges of the method detection limit and method quantitation limit were 0.009-2.35 ng g-1 and 0.025-7.13 ng g-1, respectively. The recoveries ranged from 67.5% to 119.6%. The coefficients of variation ranged from 0.3% to 15.1% for intra-day and ranged from 0.8% to 19.1% for inter-day. The methods were applied to 24 total diet study samples for HCAs quantitation. These results indicate that the established methods are reliable for determining HCAs in various foods.

Analytical Method of Multi-Mycotoxins in Table-Ready Foods for a Total Diet Study Using Stable Isotope Dilution Liquid Chromatography-Tandem Mass Spectrometry.

Background: Determining the multi-mycotoxins present in table-ready foods is necessary for a total diet study. However, so far, most methods of analyzing multi-mycotoxins apply to raw foods. Therefore, a reliable method for analyzing multi-mycotoxins in table-ready foods is needed. Objective: We developed and validated methods of multi-mycotoxin analysis that employed stable isotope dilution with LC-tandem MS (LC-MS/MS) using two representative matrices. Methods: Samples were fortified with [13C]-labeled mycotoxins as internal standards and extracted with 50% acetonitrile in water for high-carbohydrate foods and 3% formic acid in acetonitrile for high-protein and/or high-fat foods, cleaned up with n-hexane and the quick, easy, cheap, effective, rugged, and safe (QuEChERS) method, and followed up by LC-MS/MS. Results: Validation of the methods was performed, and the results were as follows: the correlation coefficient, R², was 0.99; method detection limit, 0.01-2.4 µg/kg; recoveries, 83.6-114%; precision, 0.8-10 (intraday) and 3.1-22% (interday); interlaboratory reproducibility, ≤15%; and uncertainty, 3.5-19%error. The applicability of the methods was evaluated by analyzing table-ready foods spiked with standards. Conclusions: These methods were successfully evaluated and deemed appropriate for determining the multi-mycotoxins in table-ready foods. Highlights: This work demonstrates that stable isotope dilution with LC-MS/MS can be effectively used to analyze multi-mycotoxins simultaneously in a total diet study.

Preconceptional use of folic acid and knowledge about folic acid among low-income pregnant women in Korea.

BACKGROUND/OBJECTIVES: Folic acid supplementation before pregnancy is known to significantly reduce the risk of having a baby with neural tube defects (NTDs). Therefore, it is important for women to be aware of the effects of folic acid supplementation before pregnancy. The purpose of this study was to investigate the awareness and preconceptional use of folic acid and to assess the current knowledge about folic acid among low-income pregnant women in Korea. SUBJECTS/METHODS: A questionnaire survey was conducted in 2012. Five hundred pregnant women were selected from the waiting list for the Nutriplus program implemented in public health centers using a multistage clustered probability sampling design. Data from 439 women were analyzed after excluding ones with incomplete answers. RESULTS: Among women who responded to the questionnaire, 65.6% had heard of folic acid before pregnancy, and 26.4% reported on the preconceptional use of folic acid. Women with a university degree or higher education were more likely to be aware of folic acid and to take folic acid in the preconception period. In a multivariate logistic regression, when age, education level, household income, employment status, gravidity, parity, and folic acid awareness were included in the model, folic acid awareness was a strong predictor of preconceptional folic acid use. As of interview, 85.4% and 77.7% of women were aware of the NTD-preventive role of folic acid and the appropriate time to take folic acid, respectively. The main sources of information on folic acid were healthcare professionals (41.2%), friends and family members (31.2%), and the media (26.5%). CONCLUSIONS: Our results suggest that public health strategies are needed to increase the preconceptional use of folic acid among Korean women.

Association of Dietary Sugars and Sugar-Sweetened Beverage Intake with Obesity in Korean Children and Adolescents.

Few studies have examined the association between dietary sugar intake and obesity in Asian children and adolescents. We evaluated the association of dietary sugar intake and its food source with obesity in Korean children and adolescents. In this cross-sectional analysis, data were obtained from five studies conducted between 2002 and 2011. The study included 2599 children and adolescents who had completed more than three days of dietary records and had anthropometric data. Total sugar intake was higher in girls than in boys (54.3 g for girls and 46.6 g for boys, p < 0.0001). Sugar intake from milk and fruits was inversely associated with overweight or obesity in girls only (OR for overweight, 0.52; 95% CI, 0.32-0.84; p for trend = 0.0246 and OR for obesity, 0.42; 95% CI, 0.23-0.79; p for trend = 0.0113). Sugar-sweetened beverage (SSB) consumption was not associated with obesity in girls, while boys had lower odds ratios for obesity (OR for obesity, 0.52; 95% CI, 0.26-1.05; p for trend = 0.0310). These results suggest that total sugars and SSB intake in Asian children and adolescents remains relatively low and sugar intake from milk and fruits is associated with a decreased risk of overweight or obesity, especially in girls.

Total Diet Study: For a Closer-to-real Estimate of Dietary Exposure to Chemical Substances.

Recent amendment on the Food Sanitation Act in Korea mandated the Minister of Food & Drug Safety to secure the scientific basis for management and reevaluation of standards and specifications of foods. Especially because the current food safety control is limited within the scope of 'Farm to Market' covering from production to retail in Korea, safety control at the plane of true 'Farm to Fork' scope is urgently needed and should include 'total diet' of population instead of individual food items. Therefore, 'Total Diet Study (TDS)' which provides 'closer-to-real' estimates of exposure to hazardous materials through analysis on table-ready (cooked) samples of foods would be the solution to more comprehensive food safety management, as suggested by World Health Organization and Food and Agriculture Organization of the United Nations. Although the protection of diets from hazards must be considered as one of the most essential public health functions of any country, we may need to revisit the value of foods which has been too much underrated by the meaningless amount of some hazardous materials in Korea. Considering the primary value of foods lies on sustaining life, growth, development, and health promotion of human being, food safety control should be handled not only by the presence or absence of hazardous materials but also by maximizing the value of foods via balancing with the preservation of beneficial components in foods embracing total diet. In this regard, this article aims to provide an overview on TDS by describing procedures involved except chemical analysis which is beyond our scope. Also, details on the ongoing TDS in Korea are provided as an example. Although TDS itself might not be of keen interest for most readers, it is the main user of the safety reference values resulted from toxicological research in the public health perspective.

Determination of Heterocyclic Amines and Acrylamide in Agricultural Products with Liquid Chromatography-Tandem Mass Spectrometry.

Heterocyclic amines (HCAs) and acrylamide are unintended hazardous substances generated by heating or processing of foods and are known as carcinogenic and mutagenic agents by the animal experiments. A simple method was established for a rapid and accurate determination of 12 types of HCAs (IQ, MeIQ, Glu-P-1, Glu-P-2, MeIQx, Trp-P-1, Trp-P-2, PhIP, AαC, MeAαC, Harman and Norharman) and acrylamide in three food matrices (non-fat liquid, non-fat solid and fat solid) by isotope dilution liquid chromatography-tandem mass spectrometry (LC-MS/MS). In every sample, a mixture of internal standards including IQ-d3, MeIQx-d3, PhIP-d3, Trp-P-2-(13)C2-(15)N and MeAαC-d3 was spiked for quantification of HCAs and (13)C3-acrylamide was also spiked for the analysis of acrylamide. HCAs and acrylamide in sample were extracted with acetonitrile and water, respectively, and then two solid-phase extraction cartridges, ChemElut: HLB for HCAs and Accucat: HLB for acrylamide, were used for efficiently removing interferences such as pigment, lipid, polar, nonpolar and ionic compounds. Established method was validated in terms of recovery, accuracy, precision, limit of detection, limit of quantitation, and linearity. This method showed good precision (RSD < 20%), accuracy (71.8~119.1%) and recovery (66.0~118.9%). The detection limits were < 3.1 ng/g for all analytes. The correlation coefficients for all the HCAs and acrylamide were > 0.995, showing excellent linearity. These methods for the detection of HCAs and acrylamide by LC-MS/MS were applied to real samples and were successfully used for quantitative monitoring in the total diet study and this can be applied to risk assessment in various food matrices.

Validation and Determination of the Contents of Acetaldehyde and Formaldehyde in Foods.

The aim of this study was to develop an efficient quantitative method for the determination of acetaldehyde (AA) and formaldehyde (FA) contents in solid and liquid food matrices. The determination of those compounds was validated and performed using gas chromatography-mass spectrometry combined by solid phase micro-extraction after derivatization with O-(2,3,4,5,6-pentafluoro-benzyl)-hydroxylamine hydrochloride. Validation was carried out in terms of limit of detection, limit of quantitation, linearity, precision, and recovery. Then their contents were analyzed in various food samples including 15 fruits, 22 milk products, 31 alcohol-free beverages, and 13 alcoholic beverages. The highest contents of AA and FA were determined in a white wine (40,607.02 ng/g) and an instant coffee (1,522.46 ng/g), respectively.

Determination of Ethyl Carbamate in Alcoholic Beverages and Fermented Foods Sold in Korea.

Ethyl carbamate (EC) classified as a probable human carcinogen (Group 2A) is naturally formed in alcoholic beverages and fermented foods during fermentation process and/or during storage. The objective of this study was to analyze EC in 34 food items including 14 alcoholic beverages and 20 fermented foods sold in Korea. Each food was collected from 18 supermarkets in 9 metropolitan cities in Korea, and then made into composite. According to food composition and alcohol content, samples were divided into four matrices such as apple juice, milk, Soju (liquor containing about 20% alcohol), and rice porridge. The maximum EC value of 151.06 µg/kg was found in Maesilju (liquor made from Maesil and Soju). Whisky and Bokbunjaju (Korean black raspberry wine) contained 9.90 µg/kg and 6.30 µg/kg, respectively. EC was not detected in other alcoholic beverages. Of 20 fermented foods, Japanese-style soy sauce had highest level of 15.59 µg/kg and traditional one contained 4.18 µg/kg. Soybean paste had 1.18 µg/kg, however, EC was not found in other fermented foods.

Analysis of Trans Fat in Edible Oils with Cooking Process.

Trans fat is a unsaturated fatty acid with trans configuration and separated double bonds. Analytical methods have been introduced to analyze trans fat content in foods including infrared (IR) spectroscopy, gas chromatography (GC), Fourier transform-infrared (FT-IR) spectroscopy, reverses-phase silver ion high performance liquid chromatography, and silver nitrate thin layer chromatography. Currently, FT-IR spectroscopy and GC are mostly used methods. Trans fat content in 6 vegetable oils were analyzed and processing effects including baking, stir-frying, pan-frying, and frying on the formation of trans fat in corn oil was evaluated by GC. Among tested vegetable oils, corn oil has 0.25 g trans fat/100 g, whereas other oils including rapeseed, soybean, olive, perilla, and sesame oils did not have detectable amount of trans fat content. Among cooking methods, stir-frying increased trans fat in corn oil whereas baking, pan-frying, and frying procedures did not make changes in trans fat content compared to untreated corn oils. However, the trans fat content was so low and food label can be declared as '0' trans based on the regulation of Ministry of Food ad Drug Safety (MFDS) (< 2 g/100 g edible oil).

Progressive risk assessment of polychlorinated biphenyls through a Total Diet Study in the Korean population.

Human exposure to polychlorinated biphenyls (PCBs) from foods was investigated through a Total Diet Study (TDS) for the first time in Korea. A representative food list was developed from food intake data. Non-selected foods were also included in the TDS through the mapping process to anticipate practical risk assessment. For better representativeness, data (2008-2011) from the Korea National Health and Nutrition Examination Survey (KNHANES) were combined with the TDS data set. And also, we estimated the dietary exposure to PCBs from various food items using a 'best-fit' mapping process and assessed the differences in PCB exposures by sex and age. In this study, we examined total PCBs (62 congeners) including dioxin-like PCBs (DL-PCBs) and indicator PCBs, which are congeners that are mainly detected in various environmental matrices. The average dietary exposure (3.94 ng/kg body weight/day) that was estimated through food intake was 19.7% of the World Health Organization (WHO) recommendation.

Soft drink consumption is positively associated with metabolic syndrome risk factors only in Korean women: Data from the 2007-2011 Korea National Health and Nutrition Examination Survey.

OBJECTIVE: To examine the association between sugar-sweetened beverage consumption and metabolic syndrome risk factors in Korean adults. METHODS: We used data from 13,972 participants (5432 men and 8540 women) aged ≥30 years, from the 2007-2011 Korea National Health and Nutrition Examination Survey. The subjects were divided into six groups based on their soft drink consumption levels from a food frequency questionnaire. Dietary sugar intake was compared among groups using 24-hour dietary recall data. RESULTS: The highest soft drink consumption frequency category was ≥4 times per week, observed in 4.6% of men and 1.7% of women. The percentage of energy from total sugar and sugar in processed foods increased with increased soft drink consumption in both men and women. In the highest consumption group, the percentage of energy from sugar in processed foods was 8.9% in men and 11.0% in women. After adjusting for potential confounding variables, greater consumption of soft drinks was positively associated with all of the components of metabolic syndrome, except the high density lipoprotein (HDL) cholesterol level, in women only. Women who consumed soft drinks ≥4 times per week had a 74% higher risk of metabolic syndrome compared to those who consumed soft drinks infrequently (OR: 1.74; 95% CI: 1.00-3.03; P for trend <0.0001). CONCLUSION: High levels of soft drink consumption might constitute an important determinant of metabolic syndrome and its components only in Korean adult women.

Intakes of dairy products and calcium and obesity in Korean adults: Korean National Health and Nutrition Examination Surveys (KNHANES) 2007-2009.

BACKGROUND: The possible effects of dairy product intake against obesity have been suggested in animal studies; however, the association is still not well established in epidemiological studies. Few studies in Asian countries with relatively low intake of dairy products exist. OBJECTIVE: We investigated the association between dairy products and calcium intake and obesity in Korean population with relatively low intake of dairy products. SUBJECTS AND METHODS: Our study population consisted of adults (n = 7173) aged 19-64 among participants of the 2007, 2008 and 2009 Korean National Health and Nutrition Examination Survey who had not made any attempt of intentional weight loss. Dietary intake data from food frequency questionnaire (FFQ) and 24-hour recall were used. Dairy products included milk and yogurt in the FFQ. Obesity was defined as BMI≥25 kg/m². RESULTS: Higher frequency of dairy product intake was associated with a reduced prevalence of obesity (OR = 0.63; 95% CI = 0.45-0.89 for ≥2 times/day vs. ≤1 time/month; p for trend = 0.003) using the intake data from FFQ. Similarly, high frequency of milk or yogurt intake had an inverse association with obesity. The association between milk and yogurt intake and obesity was similar when the intake from 24-hour recall was examined. Higher calcium intake from dairy products as well as total dietary calcium intake was associated with a decreased prevalence of obesity (OR = 0.83; 95% CI = 0.71-0.98 for highest vs. lowest quintile of dairy calcium intake; p for trend = 0.02, OR = 0.78; 95% CI = 0.64-0.94 for highest vs. lowest quintile of total calcium intake; p for trend = 0.04). The associations appeared to be stronger in women than in men. CONCLUSION: These results suggest that high consumption of dairy products is associated with a lower prevalence of obesity and that calcium in dairy products may be one of the components contributing to the association. Further longitudinal studies are warranted to replicate our findings.

Weight misperception and its association with dieting methods and eating behaviors in South Korean adolescents.

BACKGROUND/OBJECTIVES: There is little information on the association between weight misperception and eating behavior in Korean adolescents. Therefore, we investigated the association of food intake habits and dieting method and disturbed eating behavior (DEB) in relation to weight misperception. SUBJECTS/METHODS: Data was collected by using a nationwide online panel survey from 6,943 adolescents enrolled in middle/high school. DEB was measured with the Eating Attitudes Test (EAT-26) and those who scored ≥ 20 on the EAT-26 were considered to have eating disorder. Logistic regressions were conducted to examine the association between weight misperception based on self-reported weight status and dieting method and eating behaviors. RESULTS: The proportion of weight underestimation was 23.5% and that of overestimation was 24.0%. Weight overestimating girls were more likely to engage in various unhealthy dieting practices (OR = 1.69 for fasting; OR = 1.88 for laxative or diuretic use; OR = 2.05 for self-induced vomiting after meals; P < 0.05). Moreover, there was a strong association between overestimation and undesirable eating behaviors, especially among girls, e.g.: having breakfast (OR = 0.85), high consumption of fast foods (OR = 1.28) and regular sodas (OR = 1.39), but not among boys. In both genders, weight overestimation appears to be a major risk factor for DEB (OR = 1.34 for boys and OR = 1.41 for girls; P < 0.05). CONCLUSIONS: [corrected] Weight overestimation is associated with unhealthy weight control practices and eating behaviors. We particularly found a significant association between weight overestimation and DEB among nationwide Korean adolescents.

Food ingestion factors of the Korean exposure factors handbook.

The purpose of this study was to establish food ingestion factors needed to assess exposure to contaminants through food ingestion. The study reclassified the raw data of the Korean National Health and Nutrition Examination Survey in 2001 into 12 subcategories including grain products, meat products, fish and shellfish, and vegetables for international comparability of exposure evaluation. The criteria for food intake calculation were unified according to the characteristics of food groups, and recommended values for food ingestion factors were calculated through moisture correction and recategorization of cooked, processed, and mixed foods for each group. The average intake rate for grain and grain products was 6.25 g/kg-d per capita and the men's intake rate was approximately 8% higher than that of the women. The average intake rate of meat and meat products was 1.62 g/kg-d per capita and the men's intake rate was 30% higher than that of the women, on average. The average intake rate of fish and shellfish was 1.53 g/kg-d per capita, and the age groups of 1 to 2 and 3 to 6 recorded higher capita intake rates than other age groups, 2.62 g/kg-d and 2.25 g/kg-d, respectively. The average intake rate of vegetables was 6.47 g/kg-d per capita, with the age group of 1 to 2 recording the highest per capita intake rate of 9.79 g/kg-d and that of 13 to 19 recording the lowest mean. The study also offers recommended values for food ingestion factors of other food groups by gender, age, and region. The food ingestion exposure factors will need future updates in consideration of ongoing changes in food consumption behavior.

Dairy product intake is inversely associated with metabolic syndrome in Korean adults: Anseong and Ansan cohort of the Korean Genome and Epidemiology Study.

The objective of this study was to examine the relationship between dairy product intake and the incidence of metabolic syndrome (MetS) and its components among middle-aged Koreans. We examined 7,240 adults aged 40-69 yr without MetS at baseline over a 45.5-month follow-up period. They were taken from the Anseong and Ansan cohort of the Korean Genome and Epidemiology Study. Dairy product intake including milk, yogurt, and cheese was assessed with food frequency questionnaire. At the follow-up, the incidence of MetS was 17.1%. The incidences of MetS components were as follows: low HDL cholesterol (16.2%), abdominal obesity (14.0%), hypertriglyceridemia (13.8%), hyperglycemia (13.3%), and hypertension (13.1%). Adjusting for potential confounders, dairy product consumption frequency was inversely associated with the risk of MetS and abdominal obesity. Hazard ratio (HR) (95% confidence interval) for dairy product consumption more than 7 times/week compared to never was 0.75 (0.64-0.88, P for trend < 0.001) for MetS and 0.73 (0.61-0.88, P for trend < 0.001) for abdominal obesity. HR for milk intake was 0.79 for MetS and 0.82 for abdominal obesity. The results of this study suggest that daily intake of dairy products protects against the development of MetS, particularly abdominal obesity, in middle-aged Koreans.