Identification of interactions between genetic risk scores and dietary patterns for personalized prevention of kidney dysfunction in a population-based cohort.

BACKGROUND & AIM: Chronic kidney disease (CKD) is a heterogeneous disorder that affects the kidney structure and function. This study investigated the effect of the interaction between genetic factors and dietary pattern on kidney dysfunction in Korean adults. METHODS: Baseline data were obtained from the Ansan and Ansung Study of the Korean Genome and Epidemiology Study involving 8230 participants aged 40-69 years. Kidney dysfunction was defined as an estimated glomerular filtration rate < 90 mL/minute/1.73 m2. Genomic DNAs genotyped on the Affymetrix® Genome-Wide Human SNP array 5.0 were isolated from peripheral blood. A genome-wide association study using a generalized linear model was performed on 1,590,162 single-nucleotide polymorphisms (SNPs). To select significant SNPs, the threshold criterion was set at P-value < 5 × 10-8. Linkage disequilibrium clumping was performed based on the R2 value, and 94 SNPs had a significant effect. Participants were divided into two groups based on their generic risk score (GRS): the low-GR group had GRS > 0, while the high-GR group had GRS ≤ 0. RESULTS: Three distinct dietary patterns were extracted, namely, the "prudent pattern," "flour-based and animal food pattern," and "white rice pattern," to analyze the effect of dietary pattern on kidney function. In the "flour-based and animal food pattern," higher pattern scores were associated with a higher prevalence of kidney dysfunction in both the low and high GR groups (P for trend < 0.0001 in the low-, high-GR groups of model 1; 0.0050 and 0.0065 in the low-, high-GR groups of model 2, respectively). CONCLUSIONS: The results highlight a significant association between the 'flour-based and animal food pattern' and higher kidney dysfunction prevalence in individuals with both low and high GR. These findings suggest that personalized nutritional interventions based on GR profiles may become the basis for presenting GR-based individual dietary patterns for kidney dysfunction.

Association between traditional Korean fermented vegetables (kimchi) intake and serum lipid profile: using the Korean Genome and Epidemiology Study (KoGES) cohort.

PURPOSE: Dyslipidemia is a major health issue worldwide. There is growing interest in understanding the potential role of kimchi consumption on serum lipid profiles. However, there are limited epidemiological studies available on this topic. Therefore, this study aims to investigate the association between kimchi intake and serum lipid profiles. METHODS: We conducted an epidemiological study on participants (aged 40-69 years old) selected from the Health Examinees (HEXA) cohort study (n = 61,761). Four types of kimchi, including Baechu kimchi (cabbage kimchi), Kkakdugi (radish kimchi), Nabak kimchi/Dongchimi (a type of water kimchi made with fermented vegetables), and other kimchi, were assessed by a 106-food item semi-quantitative validated food frequency questionnaire (FFQ). Each kimchi intake is the average value calculated from the FFQ of the baseline and follow-up surveys. Fasting blood data were obtained at baseline and follow-up visits. Linear regression was used to examine the relationship between the intake of kimchi and the change in serum lipid profiles. RESULTS: The mean years between the baseline survey and a follow-up survey was 4.97 years. In this study, compared to the lowest category (< 1 serving/day), Baechu kimchi intake (2- < 3 servings/day) had more negative correlations with the change in values of total cholesterol (ß: -1.600, 95% confidence interval [CI, -2.744, -0.456]), triglycerides (ß: -3.372, 95% CI [-5.414, -1.330]), and low-density lipoprotein cholesterol (ß: -1.155, 95% CI [-2.214, -0.095]) in women. In men, Baechu kimchi intake (2- < 3 servings/day) had a more positive correlation associated with the changes in values of high-density lipoprotein cholesterol (ß: 0.049, 95% CI [0.031, 0.907]) compared to the lowest intake category (< 1 serving/day). CONCLUSIONS: Among Korean adults, consumption of kimchi, particularly Baechu kimchi, was found to be associated with improvements in serum lipid profiles. Further studies are required to conduct additional interventions to confirm the association between kimchi and serum lipid profiles.

Association between plant-based diets and the risk of coronary heart disease predicted using the Framingham Risk Score in Korean men: data from the HEXA cohort study.

OBJECTIVES: This study investigated the potential correlation between 4 plant-based diet indices and the predicted risk of coronary heart disease (CHD) in Korean men using the Framingham Risk Score. METHODS: The study included 12,356 men participants (aged ≥40 years) from the Health Examinees Study. Dietary intake was estimated using a validated food frequency questionnaire. Four plant-based diet indices were measured, including the overall plant-based diet index, the healthy plant-based diet index (hPDI), the unhealthy plant-based diet index (uPDI), and the pro-vegetarian diet index. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for the predicted 10-year risk of CHD. RESULTS: The study found that individuals in the highest hPDI quintile had a 19% lower risk score for CHD based on the Framingham Risk Score (model 3: HR, 0.80; 95% CI, 0.69 to 0.93; p for trend=0.010). In stratified analyses, the highest pro-vegetarian diet index was associated with a lower risk score for CHD in physically active individuals (HR, 0.74; 95% CI, 0.59 to 0.93; p for interaction=0.020). Conversely, the highest uPDI was associated with the highest risk score for CHD in those with a body mass index of ≥25 kg/m2 and a waist circumference ≥90 cm. CONCLUSIONS: This prospective cohort study highlights the positive role of adhering to a high hPDI diet in the prevention of CHD in Korean men. Further prospective studies are needed to determine the association between various plant-based diet indices and the risk of CHD in Asian populations with different dietary habits.

Association of hypertension with noodle consumption among Korean adults based on the Health Examinees (HEXA) study.

BACKGROUND/OBJECTIVES: The prevalence of hypertension is increasing, and noodles have a high sodium content, so noodle consumption might be associated with a higher prevalence of hypertension. This study aimed to analyze the association between total and types of noodle intake and the risk of hypertension among Korean adults. Subjects aged 40-69 years were selected for this study. SUBJECTS/METHODS: This study included 56,580 participants (18,246 men and 38,334 women) aged 40-69 years old from the Health Examinees study. Noodle and nutrient intakes were assessed using the food frequency questionnaire. Hypertension was diagnosed as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg or antihypertensive medication use. Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for hypertension. RESULTS: Higher noodle consumption was associated with increased hypertension among men (HR, 1.273; 95% CI, 1.166-1.390) and women (HR, 1.116; 95% CI, 1.038-1.199). CONCLUSION: We recommended reducing noodle intake and consuming vegetables and fruits to increase potassium intake, which can prevent vascular diseases.

Effect of alcohol consumption on risk of hypertension based on alcohol-related facial flushing response: From the health examinees study.

BACKGROUND: Alcohol consumption is a significant public health concern in Korea, with many individuals engaging in risky drinking behaviors. This study aims to analyze the association between facial flushing responses and the progression of hypertension in Korean adults, stratified by gender, using a large-scale prospective cohort study. METHODS: This study included 39,868 participants (males 10,868 and females 29,000) from the health examinees cohort. Participants were divided into two groups according to their weekly drinking patterns (moderate and heavy) and facial flushing responses (non-flusher and flusher) for statistical analysis. A multivariate Cox proportional hazards regression model was used to calculate hazard ratios and 95% confidence intervals between flushing response after alcohol consumption and hypertension risk. RESULTS: In males, the flusher group with a moderate alcohol intake pattern had a decreased risk of incident hypertension compared with non-flushers. In females, the flusher group had relatively higher risk of pre-hypertension and hypertension compared to the non-flusher group. CONCLUSION: The association between facial flushing and hypertension varies depending on the level of alcohol consumption and should be considered in relation to gender differences. Further research is needed to understand the relationship between facial flushing response and the risk of hypertension based on alcohol consumption levels.

Association between kimchi consumption and obesity based on BMI and abdominal obesity in Korean adults: a cross-sectional analysis of the Health Examinees study.

OBJECTIVE: Previous animal studies have shown the anti-obesity effect of kimchi-derived probiotic lactic acid bacteria. However, only a few epidemiological studies have investigated the association between kimchi consumption and obesity. Therefore, we aim to assess this relationship in Korean adults. DESIGN: Cross-sectional study. SETTING: The Health Examinees study was conducted from 2004 to 2013. PARTICIPANTS: This study analysed 115 726 participants aged 40-69 years enrolled in the Health Examinees study in Korea. PRIMARY AND SECONDARY OUTCOME MEASURES: Obesity was defined as body mass index ≥25 kg/m2, and abdominal obesity was defined as waist circumference ≥90 cm in men and ≥85 cm in women. Kimchi consumption was assessed by the validated food frequency questionnaire. RESULTS: In men, total kimchi consumption of 1-3 servings/day was related to a lower prevalence of obesity (OR: 0.875 in 1-2 servings/day and OR: 0.893 in 2-3 servings/day) compared with total kimchi consumption of <1 serving/day. Also, men with the highest baechu kimchi (cabbage kimchi) consumption had 10% lower odds of obesity and abdominal obesity. Participants who consumed kkakdugi (radish kimchi) ≥median were inversely associated with 8% in men and 11% in women with lower odds of abdominal obesity compared with non-consumers, respectively. CONCLUSIONS AND RELEVANCE: Consumption of 1-3 servings/day of total kimchi was associated with a lower risk of obesity in men. Baechu kimchi was associated with a lower prevalence of obesity in men, and kkakdugi was associated with a lower prevalence of abdominal obesity in both men and women. However, since all results showed a 'J-shaped' association, it is recommended to limit excessive kimchi intake.

Blood Pb levels are associated with prostate cancer prevalence among general adult males: Linking National Cancer Registry (2002-2017) and KNHANES (2008-2017) databases of Korea.

BACKGROUND: Exposure to heavy metals may increase the risk of developing prostate cancer. However, these observations are often inconsistent and not based on clinically diagnosed cases. OBJECTIVE: To investigate the association of lead (Pb), cadmium (Cd), and mercury (Hg) exposure with clinically determined prostate cancer cases among adult males in South Korea. METHODS: Metal biomonitoring data and cancer information from the general Korean population were extracted by linking National Cancer Center (NCC) cancer registration data (2002-2017) with Korea National Health and Nutrition Examination Survey (KNHANES) data (2008-2017). Among them, 46 prostate cancer cases (designated as 'all-prostate'), including 25 diagnosed after heavy metal measurement (designated as 'post-prostate'), and 93 matching controls were chosen. Logistic regression analysis was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) between the heavy metal levels and prostate cancer. RESULTS: Post-prostate patients exhibited higher blood Pb levels than controls (median 3.1 µg/dL vs. 2.38 µg/dL, p = 0.01). For all-prostate cancer, the OR of prostate cancer increased by 2.04-fold for every doubling of Pb levels (95% CI = 1.08-3.87, p = 0.03). The OR was also significantly elevated when comparing the third quartile (Q3) to the lowest quartile (Q1), with ORs ranging from 3.38 to 7.95, depending on model (p < 0.05). Blood Pb levels maintained a positive association with inconsistent significance for post-prostate cancer patients. For Cd and Hg, no statistically significant association was established. SIGNIFICANCE: By linking two national health databases for the first time, we constructed an unbiased database of prostate cancer cases and matching controls. We found that blood Pb concentrations were associated with the risk of prostate cancer in Korean men at the current level of exposure.