DOI QR코드

DOI QR Code

Estimating and evaluating usual total fat and fatty acid intake in the Korean population using data from the 2019-2021 Korea National Health and Nutrition Examination Surveys: a cross-sectional study

우리 국민의 총 지방 및 지방산 일상 섭취량 추정 및 평가: 2019 - 2021년 국민건강영양조사 자료를 활용한 단면조사연구

  • Gyeong-yoon Lee (Department of Public health, Graduate School of Public Health, Seoul National University) ;
  • Dong Woo Kim (Division of Human Ecology, College of Natural Sciences, Korea National Open University)
  • 이경윤 (서울대학교 보건대학원) ;
  • 김동우 (한국방송통신대학교 자연과학대학 생활과학부)
  • Received : 2023.09.26
  • Accepted : 2023.10.26
  • Published : 2023.10.31

Abstract

Objectives: This study evaluated usual dietary intakes of total fat and fatty acids among the Korean population based on the revised Dietary Reference Intakes for Koreans 2020 (2020 KDRIs). Methods: This study utilized data from the eighth Korea National Health and Nutrition Examination Survey (KNHANES 2019-2021). We included 18,895 individuals aged 1 year and above whose 1-day 24-hour dietary recall data were available. To calculate the external variability using the National Cancer Institute 1-day method, data from the U.S. NHANES 2017-March 2020 Pre-pandemic dataset were employed. The total fat and fatty acid intake were evaluated based on the Acceptable Macronutrient Distribution Ranges (AMDRs) and Adequate intake (AI) of 2020 KDRIs for each sex and age groups. Results: Approximately 86% of the Korean population obtained an adequate amount of energy from total fat consumption (within the AMDRs), indicating an appropriate level of intake. However, the percentage of individuals consuming saturated fatty acids below the AMDR was low, with only 12% among those under 19 years of age and 52% aged 19 years and older. On a positive note, approximately 70% of the population showed adequate consumption of essential fatty acids, exceeding the AI. Nevertheless, monitoring the intake ratio of omega 3 (n-3) to omega 6 (n-6) fatty acids is essential to ensure an optimum balance. Conclusions: This study explored the possibility of estimating the distribution of nutrient intake in a population by applying the external variability ratio. Therefore, if future KNHANES conduct multiple 24-hour recalls every few years-similar to the U.S. NHANES-even for a subset of participants, this may aid in the accurate assessment of the nutritional status of the population.

Keywords

Acknowledgement

This research was supported by Korea National Open University Research Fund.

References

  1. Meier T, Grafe K, Senn F, Sur P, Stangl GI, Dawczynski C et al. Cardiovascular mortality attributable to dietary risk factors in 51 countries in the WHO European Region from 1990 to 2016: A systematic analysis of the Global Burden of Disease Study. Eur J Epidemiol 2019; 34(1): 37-55. https://doi.org/10.1007/s10654-018-0473-x
  2. Hu FB, Willett WC. Optimal diets for prevention of coronary heart disease. JAMA 2002; 288(20): 2569-2578. https://doi.org/10.1001/jama.288.20.2569
  3. Siri-Tarino PW, Sun Q, Hu FB, Krauss RM. Meta-analysis of prospective cohort studies evaluating the association of saturated fat with cardiovascular disease. Am J Clin Nutr 2010; 91(3): 535-546. https://doi.org/10.3945/ajcn.2009.27725
  4. Estruch R, Ros E, Salas-Salvado J, Covas MI, Corella D, Aros F et al. Primary prevention of cardiovascular disease with a mediterranean diet supplemented with extra-virgin olive oil or nuts. N Engl J Med 2018; 378(25): e34.
  5. DiNicolantonio JJ, O'Keefe JH. Importance of maintaining a low omega-6/omega-3 ratio for reducing inflammation. Open Heart 2018; 5(2): e000946.
  6. 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
  7. Ministry of Health and Welfare, The Korean Nutrition Society. Dietary reference intakes for Koreans 2020. Sejong: Ministry of Health and Welfare. 2020.
  8. Arab L, Tseng CH, Ang A, Jardack P. Validity of a multipass, web-based, 24-hour self-administered recall for assessment of total energy intake in blacks and whites. Am J Epidemiol 2011; 174(11): 1256-1265. https://doi.org/10.1093/aje/kwr224
  9. Dodd KW, Guenther PM, Freedman LS, Subar AF, Kipnis V, Midthune D et al. Statistical methods for estimating usual intake of nutrients and foods: A review of the theory. J Am Diet Assoc 2006; 106(10): 1640-1650. https://doi.org/10.1016/j.jada.2006.07.011
  10. Qin Y, Cowan AE, Bailey RL, Jun S, Eicher-Miller HA. Usual nutrient intakes and diet quality among United States older adults participating in the Supplemental Nutrition Assistance Program compared with income-eligible nonparticipants. Am J Clin Nutr 2023; 118(1): 85-95. https://doi.org/10.1016/j.ajcnut.2023.03.013
  11. Luo H, Dodd KW, Arnold CD, Engle-Stone R, A new statistical method for estimating usual intakes of nearly-daily consumed foods and nutrients through use of only one 24-hour dietary recall. J Nutr 2019; 149(9): 1667-1673. https://doi.org/10.1093/jn/nxz070
  12. Tooze JA, Midthune D, Dodd KW, Freedman LS, Krebs-Smith SM, Subar AF et al. A new statistical method for estimating the usual intake of episodically consumed foods with application to their distribution. J Am Diet Assoc 2006; 106(10): 1575-1587. https://doi.org/10.1016/j.jada.2006.07.003
  13. Harika RK, Eilander A, Alssema M, Osendarp SJ, Zock PL. Intake of fatty acids in general populations worldwide does not meet dietary recommendations to prevent coronary heart disease: A systematic review of data from 40 countries. Ann Nutr Metab 2013; 63(3): 229-238. https://doi.org/10.1159/000355437
  14. Linseisen J, Bergstrom E, Gafa L, Gonzalez CA, Thiebaut A, Trichopoulou A et al. Consumption of added fats and oils in the European Prospective Investigation into Cancer and Nutrition (EPIC) centres across 10 European countries as assessed by 24-hour dietary recalls. Public Health Nutr 2002; 5(6B): 1227-1242. https://doi.org/10.1079/PHN2002401
  15. Shen X, Fang A, He J, Liu Z, Guo M, Gao R et al. Trends in dietary fat and fatty acid intakes and related food sources among Chinese adults: A longitudinal study from the China Health and Nutrition Survey (1997-2011). Public Health Nutr 2017; 20(16): 2927-2936. https://doi.org/10.1017/S1368980017001781
  16. Kris-Etherton PM, Taylor DS, Yu-Poth S, Huth P, Moriarty K, Fishell V et al. Polyunsaturated fatty acids in the food chain in the United States. Am J Clin Nutr 2000; 71(1 S): 179S-188S. https://doi.org/10.1093/ajcn/71.1.179S
  17. Raatz SK, Conrad Z, Jahns L. Trends in linoleic acid intake in the United States adult population: NHANES 1999-2014. Prostaglandins Leukot Essent Fatty Acids 2018; 133: 23-28. https://doi.org/10.1016/j.plefa.2018.04.006
  18. Pizzino G, Irrera N, Cucinotta M, Pallio G, Mannino F, Arcoraci V et al. Oxidative stress: Harms and benefits for human health. Oxid Med Cell Longev 2017; 2017: 8416763.
  19. DiNicolantonio JJ, O'Keefe J. The importance of maintaining a low omega-6/omega-3 ratio for reducing the risk of autoimmune diseases, asthma, and allergies. Mo Med 2021; 118(5): 453-459.
  20. Song S, Shim JE. 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. Korean J Community Nutr 2021; 26(6): 495-507. https://doi.org/10.5720/kjcn.2021.26.6.495
  21. Jahns L, Arab L, Carriquiry A, Popkin BM. The use of external within-person variance estimates to adjust nutrient intake distributions over time and across populations. Public Health Nutr 2005; 8(1): 69-76. https://doi.org/10.1079/PHN2005671