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Regional Differences in Dietary Total Fat and Saturated Fatty Acid Intake and Their Associations with Metabolic Diseases among Korean Adults: Using the 2016~2019 Korea National Health and Nutrition Examination Surveys

지역에 따른 총지방 및 포화지방산의 섭취 수준, 급원식품, 대사질환과의 관련성 비교: 2016 ~ 2019년 국민건강영양조사 자료를 활용하여

  • Song, SuJin (Department of Food and Nutrition, Hannam University) ;
  • Shim, Jae Eun (Department of Food and Nutrition, Daejeon University)
  • Received : 2021.11.22
  • Accepted : 2021.12.17
  • Published : 2021.12.31

Abstract

Objectives: This study examined regional differences in the intake of dietary total fat and saturated fatty acid (SFA) and their food sources among Korean adults. We also investigated the associations of SFA intake with metabolic diseases by region. Methods: This study included 13,926 adults (≥ 19y) who participated in the 2016 ~ 2019 Korea National Health and Nutrition Examination Surveys. The regions were divided into urban and rural areas according to the administrative districts where the participants lived. Using dietary data obtained from a 24-h recall, intake of total fat and SFA and their food sources were assessed by region. Metabolic diseases included obesity, abdominal obesity, and elevated total cholesterol and their association with SFA intake by region were examined using multiple logistic regression. Results: Of the participants, 19.6% lived in rural areas. In urban areas, the total fat and SFA intakes were higher than in rural areas: 21.2% of energy (%E) came from total fat and 6.9%E from SFA in urban areas, whereas 18.0%E came from total fat and 5.8%E from SFA in rural areas. The percentage of participants who exceeded the dietary reference intakes for total fat and SFA in urban areas was 16.5% and 41.9%, respectively, but 43.4% of participants in rural areas showed lower intake levels for total fat compared to the reference level. Young adults did not show regional differences in fat intake, and the percentage of subjects who exceeded the reference for SFA was high both in urban (58.5%) and rural (55.7%) areas. Among middle-aged and older adults, intake of fatty acids except for n-3 fatty acid was significantly higher in urban areas than in rural areas. About 69% of older adults in rural areas showed a lower intake of total fat compared to the reference level. The food sources for total fat and SFA were meat, soybean oil, eggs, and milk in both areas. The intake of fat from eggs, milk, mayonnaise, and bread was higher in urban areas, but the intake of fat from white rice and coffee mix was higher in rural areas. The SFA intake was positively associated with elevated serum total cholesterol in urban areas (4th quartile vs. 1st quartile, OR: 1.22, 95% CI: 1.06-1.40, P for trend: 0.043), but not in rural areas. Conclusions: Regional differences in total fat and SFA intakes and their food sources were observed among Korean adults. Our findings may help plan nutritional strategies to ameliorate regional health disparities.

Keywords

Acknowledgement

This study was supported by the Korean Society of Community Nutrition funded by the Korea Disease Control and Prevention Agency (No. ISSN 2733-5488).

References

  1. Song S, Shim JE. Evaluation of total fat and fatty acids intakes in the Korean adult population using data from the 2016-2017 Korea National Health and Nutrition Examination Surveys. Korean J Community Nutr 2019; 24(3): 223-231. https://doi.org/10.5720/kjcn.2019.24.3.223
  2. Song S, Shim JE, Song WO. Trends in total fat and fatty acid intakes and chronic health conditions in Korean adults over 2007-2015. Public Health Nutr 2019; 22(8): 1341-1350. https://doi.org/10.1017/s1368980018003701
  3. Korea Disease Control and Prevention Agency. Korea Health Statistics 2019: Korea National Health and Nutrition Examination Survey (KNHANES VIII-1). Cheongju: Korea Disease Control and Prevention Agency; 2020.
  4. Van Gaal LF, Mertens IL, De Block CE. Mechanisms linking obesity with cardiovascular disease. Nature 2006; 444(7121): 875-880. https://doi.org/10.1038/nature05487
  5. Arnold M, Leitzmann M, Freisling H, Bray F, Romieu I, Renehan A et al. Obesity and cancer: An update of the global impact. Cancer Epidemiol 2016; 41: 8-15. https://doi.org/10.1016/j.canep.2016.01.003
  6. Cannon CP. Mixed dyslipidemia, metabolic syndrome, diabetes mellitus, and cardiovascular disease: Clinical implications. Am J Cardiol 2008; 102(12A): 5L-9L. https://doi.org/10.1016/j.amjcard.2008.09.067
  7. Statistics Korea. Causes of Death [Internet]. 2020 [cited 2021 Nov 02]. Available from: https://kosis.kr/index/index.do.
  8. Ministry of Health and Welfare. Health Plan 2030, 2021~2030. Sejong: Ministry of Health and Welfare; 2021.
  9. Ministry of Health and Welfare, Korea Health Promotion Institute. Health Plan 2020, 2016~2020. Sejong: Ministry of Health and Welfare, Korea Health Promotion Institute; 2015.
  10. Korea Health Promotion Institute. Health plan 2020 quantitative evaluation report. Seoul: Korea Health Promotion Institute; 2020.
  11. Korea Health Promotion Institute. HP 2020 annual report. Seoul: Korea Health Promotion Institute; 2020.
  12. Kim HJ, Kim K. Effect of geographic area on dietary quality across different age groups in Korea. Korean J Community Nutr 2019; 24(6): 453-464. https://doi.org/10.5720/kjcn.2019.24.6.453
  13. Ha K, Song Y, Kim HK. Regional disparities in the associations of cardiometabolic risk factors and healthy dietary factors in Korean adults. Nutr Res Pract 2020; 14(5): 519-531. https://doi.org/10.4162/nrp.2020.14.5.519
  14. Choi E, Cho HN, Seo DH, Park B, Park S, Cho J et al. Socioeconomic inequalities in obesity among Korean women aged 19-79 years: The 2016 Korean Study of Women's Health-Related Issues. Epidemiol Health 2019; 41: e2019005. https://doi.org/10.4178/epih.e2019005
  15. Lee Y, Choi Y, Park HR, Song KH, Lee KE, Yoo CH et al. Comparative analysis of dietary behavior and nutrient intake of elderly in urban and rural areas for development of "Village Lunch Table" program: Based on 2014 Korea National Health and Nutrition Examination Survey data. J Nutr Health 2017; 50(2): 171-179. https://doi.org/10.4163/jnh.2017.50.2.171
  16. The Korean Nutrition Society. Dietary reference intakes for Koreans 2015. Seoul: The Korean Nutrition Society; 2016.
  17. International Obesity Taskforce. The Asia-Pacific perspective: Redefining obesity and its treatment. Sydney: WHO Western Pacific Region; 2000.
  18. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ et al. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract 2007; 75(1): 72-80. https://doi.org/10.1016/j.diabres.2006.04.013
  19. Rhee EJ, Kim HC, Kim JH, Lee EY, Kim BJ, Kim EM et al. 2018 Guidelines for the management of dyslipidemia in Korea. J Lipid Atheroscler 2019; 8(2): 78-131. https://doi.org/10.12997/jla.2019.8.2.78
  20. Park S, Kim HJ, Kim K. Do where the elderly live matter? Factors associated with diet quality among Korean elderly population living in urban versus rural areas. Nutrients 2020; 12(5): 1314. https://doi.org/10.3390/nu12051314
  21. Lee JH. The regional health inequity, and individual and neighborhood level health determinants. Health Soc Welf Rev 2016; 36(2): 345-384. https://doi.org/10.15709/HSWR.2016.36.2.345
  22. Kim Y, Seo S, Kwon O, Cho MS. Comparisons of dietary behavior, food intake, and satisfaction with food-related life between the elderly living in urban and rural areas. Korean J Nutr 2012; 45(3): 252-263. https://doi.org/10.4163/kjn.2012.45.3.252
  23. Song S, Shim JE. Trends in dietary intake of total fat and fatty acids among Korean adolescents from 2007 to 2017. Nutrients 2019; 11(12): 3073. https://doi.org/10.3390/nu11123073
  24. Guasch-Ferre M, Babio N, Martinez-Gonzalez MA, Corella D, Ros E, Martin-Pelaez S et al. Dietary fat intake and risk of cardiovascular disease and all-cause mortality in a population at high risk of cardiovascular disease. Am J Clin Nutr 2015; 102(6): 1563-1573. https://doi.org/10.3945/ajcn.115.116046
  25. Yamagishi K, Iso H, Kokubo Y, Saito I, Yatsuya H, Ishihara J et al. Dietary intake of saturated fatty acids and incident stroke and coronary heart disease in Japanese communities: The JPHC Study. Eur Heart J 2013; 34(16): 1225-1232. https://doi.org/10.1093/eurheartj/eht043
  26. de Souza RJ, Mente A, Maroleanu A, Cozma AI, Ha V, Kishibe T et al. Intake of saturated and trans unsaturated fatty acids and risk of all cause mortality, cardiovascular disease, and type 2 diabetes: Systematic review and meta-analysis of observational studies. BMJ 2015; 351: h3978.
  27. Song S, Song WO, Song Y. Dietary carbohydrate and fat intakes are differentially associated with lipid abnormalities in Korean adults. J Clin Lipidol 2017; 11(2): 338-347. https://doi.org/10.1016/j.jacl.2017.01.016
  28. Mente A, Dehghan M, Rangarajan S, McQueen M, Dagenais G, Wielgosz A et al. Association of dietary nutrients with blood lipids and blood pressure in 18 countries: A cross-sectional analysis from the PURE study. Lancet Diabetes Endocrinol 2017; 5(10): 774-787. https://doi.org/10.1016/S2213-8587(17)30283-8
  29. Praagman J, Beulens JW, Alssema M, Zock PL, Wanders AJ, Sluijs I et al. The association between dietary saturated fatty acids and ischemic heart disease depends on the type and source of fatty acid in the European Prospective Investigation into Cancer and Nutrition-Netherlands cohort. Am J Clin Nutr 2016; 103(2): 356-365. https://doi.org/10.3945/ajcn.115.122671
  30. Vissers LET, Rijksen J, Boer JMA, Verschuren WMM, van der Schouw YT, Sluijs I. Fatty acids from dairy and meat and their association with risk of coronary heart disease. Eur J Nutr 2019; 58(7): 2639-2647. https://doi.org/10.1007/s00394-018-1811-1
  31. Kim HJ, Cho S, Jacobs DR, Jr., Park K. Instant coffee consumption may be associated with higher risk of metabolic syndrome in Korean adults. Diabetes Res Clin Pract 2014; 106(1): 145-153. https://doi.org/10.1016/j.diabres.2014.07.007
  32. Lee J, Kim HY, Kim J. Coffee consumption and the risk of obesity in Korean women. Nutrients 2017; 9(12): 1340. https://doi.org/10.3390/nu9121340