Dietary patterns derived by reduced rank regression are associated with lipid disorders among Korean adults: a cross-sectional analysis.

BACKGROUND: Lipid disorders are a potent risk factor for cardiovascular diseases. Moreover, the intake of dietary fatty acids has been closely related to blood lipid levels. Therefore, this cross-sectional study examined the associations between dietary patterns related to fatty acid intake and lipid disorders in Korean adults. METHODS: From the 2013-2019 Korea National Health and Nutrition Examination Surveys data, 8399 men and 11404 women (aged ≥ 19 years) were selected. Reduced rank regression was employed to identify dietary patterns from 26 food groups, aiming to explain the maximum variation in the intake of saturated fatty acids (SFA), polyunsaturated fatty acids (PUFA), omega-3 fatty acids, and the PUFA/SFA ratio. Associations of quintiles (Q) of dietary pattern scores with lipid disorders were examined using multiple logistic regression stratified by sex. RESULTS: Three dietary patterns were identified: dietary pattern 1 showed positive factor loadings for vegetable oils, seasonings, legumes, nuts, and fish; dietary pattern 2 was high in consumption of red meat, bread and snacks, and milk and dairy products; and dietary pattern 3 was rich in fish and milk and dairy products. In men, dietary pattern 3 was inversely associated with elevated triglycerides (Q5 vs. Q1: odds ratio [OR] = 0.82, 95% confidence interval [CI] = 0.69-0.97, P-trend = 0.008). In women, dietary pattern 2 was positively associated with elevated total cholesterol (OR = 1.31, 95% CI = 1.12-1.52, P-trend < 0.001) but inversely associated with low HDL-cholesterol (OR = 0.70, 95% CI = 0.59-0.83, P-trend < 0.001). CONCLUSION: In this study, dietary patterns explaining the intake of various types of fatty acids were differentially associated with lipid disorders in Korean adults. Dietary pattern characterized by higher intakes of red meat, bread and snacks and milk and dairy products were positively associated with elevated total cholesterol, whereas dietary pattern rich in fish consumption showed an inverse association with elevated triglycerides. These findings could be instrumental in developing dietary guidelines and strategies for preventing and managing lipid disorders in this population.

Dietary vitamin D intake in low ultraviolet irradiation seasons is associated with a better nutritional status of vitamin D in Korean adults according to the 2013-2014 National Health and Nutrition Examination Survey.

Vitamin D deficiency poses a global public health burden; however, there are limited studies on the relationship between vitamin D intake and serum 25-hydroxyvitamin D (25(OH)D) concentration in Koreans with a special focus on seasonal variables. We hypothesized that the relationship between serum 25(OH)D and vitamin D intake levels in Korean adults would change with the seasons, and that the distribution of food sources for vitamin D would vary according to sex and age. We established a new version of the food vitamin D database, analyzed the Korean National Health and Nutrition Examination Survey 2013 to 2014 data (n = 3257), and calculated the vitamin D intake of Koreans using a complex sample model. We found that the daily vitamin D intakes of men and women were 4.09 ± 0.26 µg and 2.87 ± 0.17 µg and their 25(OH)D levels were 16.98 ± 0.24 ng/mL and 15.62 ± 0.21 ng/mL, respectively. A significant positive correlation was observed between vitamin D intake and serum 25(OH)D levels in all participants. Serum 25(OH)D levels in the spring and winter (low ultraviolet irradiation seasons) were significantly higher in the 3rd tertile of vitamin D intake than in the first tertile. Fish and shellfish were the main sources of vitamin D for Koreans, the consumption of which was the least in the 19- to 29-year-old group; additionally, their serum 25(OH)D level was the lowest. In conclusion, insufficient vitamin D intake during low ultraviolet irradiation seasons is associated with lower levels of serum 25(OH)D.

Food behaviors accounting for the recent trends in dietary fatty acid profiles among Korean adults.

BACKGROUND/OBJECTIVES: This study examined the changes in food behaviors of dietary fatty acids over 2007-2018 among Korean adults. SUBJECTS/METHODS: This study used data from the 4th (2007-2009), 5th (2010-2012), 6th (2013-2015), and 7th (2016-2018) Korea National Health and Nutrition Examination Surveys. A total of 46,307 adults aged 19-64 yrs were selected and dietary data were obtained from a single 24-h recall. In the 4th and 7th data, the major food sources for each fatty acid based on the contributing percentage of the food item were compared. The consumption trends in the major food sources were presented as grams per day over 2007-2018 and compared across the survey periods using the multiple regression model. RESULTS: From 2007 to 2018, for total fat, saturated fatty acid (SFA), and monounsaturated fatty acid, the contribution of animal food sources, including beef, chicken, and eggs increased but plant food sources (e.g., tofu, soybean, and plant oil) decreased. As polyunsaturated fatty acid sources, mayonnaise, eggs, and bread showed higher contributions, whereas soybean and tofu showed lower contributions in the 7th data compared to the 4th data. For n-3 fatty acids, the contribution of fish decreased between the 4th and 7th data. Over 12 yrs, the significant increases in the absolute amount of consumption from animal sources were observed. In contrast, decreases in the consumption from plant sources and fish were seen across the survey periods. CONCLUSIONS: In Korean adults, increases in the intake of dietary fatty acids along with changes in the food behaviors during 2007-2018 have evoked great concern for SFA intake, which is a cardiovascular disease risk factor. Healthy food sources of dietary fatty acids should be emphasized in this population.

Trends in Dietary Intake of Total Fat and Fatty Acids Among Korean Adolescents from 2007 to 2017.

We analyzed the trends in dietary intake of total fat and fatty acids among Korean adolescents during 2007-2017. A total of 6406 adolescents from the 2007-2017 Korea National Health and Examination Surveys were selected. Total fat and fatty acids intakes were calculated based on single 24-hour recall data and presented as grams (g) and percentage of energy intake (% kcal) across the survey period. Linear trends in intake across the survey period were compared using the multiple regression model. Total fat intake increased during the 11-year period from 54.3 g (21.7% kcal) to 61.8 g (25.2% kcal). Saturated fatty acids (SFA) and monounsaturated fatty acids (MUFA) intakes changed from 17.8 g (7.1% kcal) and 17.2 g (6.8% kcal) to 20.6 g (8.4% kcal) and 20.7 g (8.4% kcal) over time, respectively. For polyunsaturated fatty acids (PUFA), n-3 fatty acid intake did not change during the survey period. The proportions of individuals who had total fat and SFA above the recommendations increased across the survey period: 13.7% to 27.5% for total fat and 36.0% to 49.7% for SFA. Among Korean adolescents, dietary fat intake increased over time and the increases in SFA and MUFA intake were prominent. Monitoring dietary fat intake is helpful to suggest dietary guidelines and health policies.

Compliance to Prenatal Iron and Folic Acid Supplement Use in Relation to Low Birth Weight in Lilongwe, Malawi.

Prenatal iron and folic acid (IFA) supplements are offered free to all pregnant women in Malawi to reduce maternal anemia and improve birth outcomes. We investigated the association between self-reported compliance to IFA intake and risk of low birth weight (LBW). Pregnant women who attended Bwaila Maternity Wing of Lilongwe District Hospital for delivery were recruited (n = 220). We used a questionnaire to collect self-reported information on IFA use and maternal sociodemographic data. Before delivery, blood samples for maternal hemoglobin (Hb) and folate status, and upon delivery, birth weight, and other newborn anthropometrics were measured. We used multivariable logistic regression to determine risk of LBW by prenatal IFA intake. The self-reported number of IFA pills taken during pregnancy was positively associated with Hb, but not serum and RBC folate concentration: <45, 45⁻89 and ≥90 pills taken corresponded with mean (SD) Hb 10.7 (1.6), 11.3 (1.8), and 11.7 (1.6) g/dL, respectively (p = 0.006). The prevalence of LBW was 20.1%, 13.5% and 5.6% for those who reported taking IFA pills <45, 45⁻89, and ≥90 pills, respectively (p = 0.027). Taking >60 IFA pills reduced risk of LBW delivery (OR (95% CI) = 0.15 (0.03⁻0.70), p = 0.033) than taking ≤30 pills. Self-reported compliance to IFA use is valid for assessing prenatal supplement program in Malawi, especially Hb status, and can reduce the rate of LBW.