Epidemiology and Health

Original Articles

Associations of cumulative average dietary total antioxidant capacity and intake of antioxidants with metabolic syndrome risk in Korean adults aged 40 years and older: a prospective cohort study (KoGES_CAVAS): Ji-Sook Kong, Jiseon Lee, Youngjun Kim, Hye Won Woo, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Yu-Mi Kim, Mi Kyung Kim; Epidemiol Health. 2023;45:e2023067. Published online July 28, 2023; DOI: https://doi.org/10.4178/epih.e2023067

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Abstract

OBJECTIVES
Limited and inconsistent prospective evidence exists regarding the relationship of dietary total antioxidant capacity (dTAC) and antioxidant intake with metabolic syndrome (MetS) risk. We evaluated the associations of the cumulative averages of dTAC and antioxidant intake (in 5 classes: retinol, vitamin C, vitamin E, carotenoids, and flavonoids, as well as 7 flavonoid subclasses) with the risk of MetS.

METHODS

This study included 11,379 participants without MetS, drawn from the Korean Genome and Epidemiology Study_CArdioVascular disease Association Study (KoGES_CAVAS). The cumulative average consumption was calculated using repeated food frequency questionnaires. Incidence rate ratios were estimated using a modified Poisson regression model with a robust error estimator.

RESULTS

The median follow-up period was 5.16 years, and 2,416 cases of MetS were recorded over 58,750 person-years. In men, significant inverse associations were observed in all 5 antioxidant classes, except for the highest quartile of dTAC. In women, dTAC and total flavonoids were not significantly associated with MetS; however, significant L-shaped associations were found for the remaining 4 antioxidant classes. Of the 7 flavonoid subclasses, only flavones in the highest quartile for men and flavan-3-ols in women lacked significant associations with MetS. The inverse associations were not sex-specific, but they were particularly pronounced among participants with a body mass index (BMI) of 23 kg/m<sup>2</sup> or higher.

CONCLUSIONS

The findings suggest that most antioxidant classes and flavonoid subclasses, unlike dTAC, exhibit a clear beneficial association with MetS in an L-shaped pattern in both men and women, particularly those with a high BMI.

Summary

Korean summary
농촌코호트 조사 참여자를 대상으로 식이 총항산화능, 총항산화능 하위분류, 플라보노이드 하위분류와 대사증후군 발생 위험의 전향적 연관성을 평가한 결과, 대부분의 항산화물(5개항산화물 분류:4개 항산화 비타민과 플라보노이드; 플라보노이드 7개 하부분류)에서 대사증후군과 음의 상관성을 확인할 수 있었으며 총항산화능(남자와 여자)과 플라보노이드(여자)에서 약한 연관성을 보였다. 남녀간 유의한 상호작용은 없었고 특히 BMI가 높은 집단에서 두드러졌다. 이 연구의 결과는 특히 식이 총항산화능을 구성하는 하위 유형을 적절히 섭취하는 것이 특히 비만한 성인에서 대사증후군 위험을 낮추는 예방전략으로 효과가 있을 수 있음을 시사한다.

Key Message
We observed that the cumulative average of dietary antioxidant vitamins and most flavonoids may be have pivotal roles in prevention of MetS, although there may be weak associations of dTAC and flavonoids in women. Moreover, these inverse associations were more pronounced in high BMI individuals. Our results suggest that the consumption of antioxidants and flavonoid may mitigate the MetS risk, particularly in overweight/obese individuals at high risk of developing chronic diseases.

Citations

Citations to this article as recorded by

The association of dietary total flavonoids and their subclasses with the risk of type 2 diabetes: a prospective cohort study
Hye Won Woo, Mi Kyung Kim, Kong Ji-Sook, Jiseon Lee, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Yu-Mi Kim
European Journal of Nutrition.2024;[Epub] CrossRef
A Systematized Review of the Relationship Between Obesity and Vitamin C Requirements
Julia K Bird, Edith JM Feskens, Alida Melse-Boonstra
Current Developments in Nutrition.2024; 8(5): 102152. CrossRef

The association between fruit and vegetable consumption and metabolic syndrome in Korean adults: does multivitamin use matter?: Jihae Kim, Li-Juan Tan, Hyein Jung, Yumi Roh, Kyungjoon Lim, Sangah Shin; Epidemiol Health. 2022;44:e2022039. Published online April 19, 2022; DOI: https://doi.org/10.4178/epih.e2022039

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Metabolic syndrome (MetS) is closely associated with dietary intake; however, few studies have investigated whether the consumption of fruits and vegetables and multivitamin use affect MetS in the Korean population. This study aimed to examine these effects in Korean adults.

METHODS

This was a cross-sectional study of 89,548 participants aged between 40 years and 69 years selected from the baseline data of the Health Examinees study conducted in Korea. Fresh vegetable and fruit consumption was assessed using a validated 106-item food frequency questionnaire. MetS and its components were defined using the National Cholesterol Education Program, Adult Treatment Panel III criteria. Multivariate logistic regression analyses were conducted to identify associations of fresh vegetable, fruit, and fresh vegetable+fruit consumption and multivitamin use with the prevalence of MetS.

RESULTS

Female in the highest quartile of fresh vegetable, fruit, and fresh vegetable + fruit consumption exhibited a lower prevalence of MetS than those in the lowest quartile. An inverse association with the prevalence of MetS was observed among male with only fresh vegetable consumption. The interaction between the 3 categories and multivitamin intake on the prevalence of MetS was not significant (all p<sub>interaction</sub>>0.05), regardless of sex.

CONCLUSIONS

Multivitamin use and consumption of fresh vegetables and fruits had no significant synergistic effects. Although fresh vegetable and fruit consumption showed an inverse association with the prevalence of MetS, this relationship was not altered by multivitamin use.

Summary

Korean summary
본 연구는 한국인 유전체역학조사사업의 도시코호트 조사에 참여한 40-69세 한국 성인 89 548명의 과일과 채소의 섭취와 종합비타민 섭취가 대사증후군에 미치는 영향을 분석하였다. 본 연구에서는 매일 다양한 과일과 채소를 섭취하면, 종합비타민의 섭취와 상관없이 대사증후군 유병 위험도를 낮추는 것을 확인하였다. 따라서, 대사증후군 예방을 위해서는 일상적인 식사에서 충분한 과일과 채소를 섭취하는 것이 권장된다.

Key Message
This study aimed to examine whether the consumption of fruits and vegetables and multivitamin use affect MetS among Korean middle-aged adults. Data was from the Health Examinees Study among 89 548 subjects. Results suggested that fruits and vegetables consumption was related with a decreased prevalence of MetS. However, there was no significant synergistic effect between the consumption of fruits and vegetables and multivitamin use in further reducing MetS prevalence.

Citations

Citations to this article as recorded by

Association of serum water-soluble vitamin exposures with the risk of metabolic syndrome: results from NHANES 2003-2006
Xun Pei, Junjie Yao, Simiao Ran, Haifei Lu, Shuo Yang, Yini Zhang, Miyuan Wang, Heyuan Shi, Aihua Tan
Frontiers in Endocrinology.2023;[Epub] CrossRef

A Case-Control Study on dietary Factors of Colorectal Adenomatous Polyps by Sites.: Mi Kyung Kim, Won Chul Lee, Kyu Yong Choi, Su Kil Kim, Se Young Lee, Yang Cha Lee-Kim, Kwang Ho Meng; Korean J Epidemiol. 1998;20(1):154-166.

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Abstract PDF: Abstract
Colorectal adenomas are benign neoplasm in the large bowel that are thought to be precursors lesion to colorectal cancer. So, studying adenomatous polyps instead of cancer might allow one to measure the diet of relatively asymptomatic subjects closer to the time of the initial neoplastic process. Some dietary factor, or set of factors, apparently plays an impotant role in the etiology of colorectal adenomatous polyps. The difference of the possible association of colorectal adenomatous polyps with dietary risk factors by anatomic subsite and gender was investigated in this case-control study. Between July 1994 and April 1998, 314 cases of patients with pathologically confirmed incident colorectal adenomatous polyps and 88 control subjects were collected from Our Lady of Mercy Hospital, The Catholic University. After colonoscopy, infor-mation on exposure was obtained by the interviewers. Also, subjects were interviewed using the semiquantitative food frequency questionnaire, and average daily nutrient intakes were calculated. Site- and gender-specific odds ratio relative to the lowest tertile of intake for each nutrient were determined using unconditional logistic regression after adjusting for a number of potential confounders. In females, significant odds ratio were found for b-carotene(0.31, 95% CI, 0.10~0.95), vitamin C(0.11, 95% CI, 0.02~0.61), vitamin-E(0.11, 95% CI, 0.02~0.78) in right colon but only the odds ratio of vitamin E(0.17, 95% CI, 0.03~0.90) was statistically significant in left colon. Among food groups, the odds ratio of green yellow vegetables was significant(OR=0.21, 95% CI, 0.05~0.96) in right colon. In males, almost all the above dietary factors were statistically not significant. In males, cigarette smoking appears to be a signigicant risk factor(OR=8.86, 95% CI, 1.10~71.5) in left colon, it was statistically not signigicant(OR=1.63, 95% CI, 0.42~4.76) in the right colon. Findings fron this study show that many associations of the nutrients with colorectal adenomatous polyps risk are different by anatomic subsite and gender and support the hypothesis that high intake of antioxidant vitamins and green yellow vagetables decreases the risk of polyps.; Summary

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