Association between dietary diversity and metabolic syndrome in Korean adults

Abstract

Dietary diversity is public health recommendation to encourage a nutritionally appropriate diet and it has protective effect against chronic diseases. This prospective study was conducted to investigate the association between dietary diversity score (DDS) and the risk of developing metabolic syndrome among Korean population during 12-years follow-up. This study hypothesized that DDS may be associated with lower risk of metabolic syndrome in Korean. To demonstrate this hypothesis, it was examined whether DDS was associated with the risk of metabolic syndrome. Study subjects were obtained from community-based cohort (Ansan and Ansung cohort) which is a sub-cohort of the Korean Genome and Epidemiology Study (KoGES). We selected 5,468 participants (2,824: men; 2,644: women) aged 40-69 years without metabolic syndrome at baseline. Foods are classified as five major food groups (grains, meat and alternatives, vegetables, fruits, and dairy products). When a subject consumes foods in each group at least per week, dietary diversity scored 1. According to the DDS from 0 to 5, we divided subjects into three groups (≤3, 4, or 5). During the 12-years follow-up period, the cumulative incidences of metabolic syndrome were respectively 32.8% (925 cases) in men and 35.9% (950 cases) in women. DDS was associated with reduced risk of metabolic syndrome [hazard ratio (HR) = 0.76, 95% confidence interval (CI): 0.63-0.92, P-trend = 0.006] after adjustment for all covariables in men. Subjects with higher DDS had lower intake of grain, and higher intake of meat and alternatives, vegetable, fruits and dairy products (P-trend < 0.0001) compared with those with lower DDS. In addition, subjects with higher dairy intake had lower risk of metabolic syndrome (HR = 0.75, 95% CI: 0.62-0.91, P-trend = 0.018) in men after adjustment for all potential covariables. These results suggested that diverse diets composed with five major food groups may have preventive effect against the risk of metabolic syndrome among Korean men.;섭취 식품의 다양성은 영양학적 불균형을 개선함으로써 만성질환을 예방하는 요인으로 알려져 있다. 본 연구는 한국의 성인에서 섭취 식품의 다양성과 대사증후군의 상관성을 규명하고자 수행되었다. 본 연구는 한국인 유전체 역학 조사 사업(The Korean Genome and Epidemiology Study, KoGES)의 지역사회 기반 코호트(안산∙안성)에 참여한 40-69세 성인 5,468명을 대상으로 하였다. 식이 다양성 점수를 구성하는 식품군은 곡류, 육류, 채소류, 과일류, 유제품을 포함한 5가지로 분류하였다. 각 식품군에 해당되는 식품을 일주일에 1-2회 이상 섭취하였을 때 대상자에게 식품군 점수(Dietary diversity score, DDS)를 1점 부여하였다. 식품군 점수에 따라 대상자를 3그룹(3점 미만, 4점, 5점)으로 나누었다. 12년의 추적기간 동안 남성의 32.8%, 여성의 35.9%에게서 대사증후군이 발병한 것으로 나타났다. 남성 대상자에게서 DDS가 증가할수록 대사증후군의 위험비는 유의적으로 감소하였다. [hazard ratio (HR) = 0.76; 95% confidence interval (CI): 0.63-0.92; P-trend = 0.006] DDS에 따른 식품군별 섭취량을 분석하였을 때 DDS가 증가될수록 곡류의 섭취가 감소하고 채소, 과일, 유제품의 섭취가 증가하는 것으로 나타났다. 특히 남성의 경우 유제품 섭취가 증가할수록 대사증후군의 위험비는 유의하게 감소하였다. (HR = 0.75; 95% CI: 0.62-0.91; P-trend = 0.018) 이와 같은 결과를 종합하면, 섭취식품의 다양성을 나타내는 식품군점수가 증가할수록 대사증후군의 발생률이 감소하였으며, 다섯가지 식품군을 골고루 섭취하는 것이 대사증후군 예방에 효과가 있는 것으로 사료된다.