Dataset Information

Association of Cardiometabolic Multimorbidity Pattern with Dietary Factors among Adults in South Korea.

ABSTRACT: Globally, cardiometabolic multimorbidity pattern (CMP) is a complex chronic health status that negatively effects the life expectancy of adults globally, even more than single diseases. We aimed to identify multimorbidity patterns in Korean adults to clarify the associations between dietary factors and CMP. Nationally representative data of 9011 Korean adults aged 19-64 years were obtained from the Korean National Health and Nutrition Examination Survey (KNHANES) from the period 2013 to 2015. Multimorbidity patterns for CMP, inflammatory disease, cancer and other disease patterns were identified by exploratory factor analysis. Dietary factors including food and nutrient intake and dietary habits were evaluated. Multivariable-adjusted logistic regression models examined the associations between dietary factors and CMP. More than half of the multimorbidity patterns were CMP (n = 4907, 54.5%); CMP subjects were more likely to be older, male, less educated, lower income, laborers, smokers, and high-risk consumers of alcohol than those of non-CMP subjects. A higher intake of calcium (OR = 0.809, 95% CI = 0.691-0.945), potassium (OR = 0.838, 95% CI = 0.704-0.998), and fruits (OR = 0.841, 95% CI = 0.736-0.960) were inversely associated with the prevalence of CMP, while the consumption of irregular meals (OR = 1.164, 95% CI = 1.034-1.312) and skipping breakfast (OR = 1.279, 95% CI = 1.078-1.518) was positively related to a 16% and 28% higher likelihood of CMP, respectively. CMP accounts for more than half of the multimorbidity patterns in the Korean population, and lower intake of calcium, potassium, fruits, and skipping meals have strong associations with CMP.

SUBMITTER: Jeong D

PROVIDER: S-EPMC7551044 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Association of Cardiometabolic Multimorbidity Pattern with Dietary Factors among Adults in South Korea.

Jeong Dawoon D Kim Jieun J Lee Hansongyi H Kim Do-Yeon DY Lim Hyunjung H

Nutrients 20200907 9

Globally, cardiometabolic multimorbidity pattern (CMP) is a complex chronic health status that negatively effects the life expectancy of adults globally, even more than single diseases. We aimed to identify multimorbidity patterns in Korean adults to clarify the associations between dietary factors and CMP. Nationally representative data of 9011 Korean adults aged 19-64 years were obtained from the Korean National Health and Nutrition Examination Survey (KNHANES) from the period 2013 to 2015. Mu ...[more]

PMID: 32906713

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Project description:ImportanceThe prevalence of cardiometabolic multimorbidity is increasing.ObjectiveTo estimate reductions in life expectancy associated with cardiometabolic multimorbidity.Design, setting, and participantsAge- and sex-adjusted mortality rates and hazard ratios (HRs) were calculated using individual participant data from the Emerging Risk Factors Collaboration (689,300 participants; 91 cohorts; years of baseline surveys: 1960-2007; latest mortality follow-up: April 2013; 128,843 deaths). The HRs from the Emerging Risk Factors Collaboration were compared with those from the UK Biobank (499,808 participants; years of baseline surveys: 2006-2010; latest mortality follow-up: November 2013; 7995 deaths). Cumulative survival was estimated by applying calculated age-specific HRs for mortality to contemporary US age-specific death rates.ExposuresA history of 2 or more of the following: diabetes mellitus, stroke, myocardial infarction (MI).Main outcomes and measuresAll-cause mortality and estimated reductions in life expectancy.ResultsIn participants in the Emerging Risk Factors Collaboration without a history of diabetes, stroke, or MI at baseline (reference group), the all-cause mortality rate adjusted to the age of 60 years was 6.8 per 1000 person-years. Mortality rates per 1000 person-years were 15.6 in participants with a history of diabetes, 16.1 in those with stroke, 16.8 in those with MI, 32.0 in those with both diabetes and MI, 32.5 in those with both diabetes and stroke, 32.8 in those with both stroke and MI, and 59.5 in those with diabetes, stroke, and MI. Compared with the reference group, the HRs for all-cause mortality were 1.9 (95% CI, 1.8-2.0) in participants with a history of diabetes, 2.1 (95% CI, 2.0-2.2) in those with stroke, 2.0 (95% CI, 1.9-2.2) in those with MI, 3.7 (95% CI, 3.3-4.1) in those with both diabetes and MI, 3.8 (95% CI, 3.5-4.2) in those with both diabetes and stroke, 3.5 (95% CI, 3.1-4.0) in those with both stroke and MI, and 6.9 (95% CI, 5.7-8.3) in those with diabetes, stroke, and MI. The HRs from the Emerging Risk Factors Collaboration were similar to those from the more recently recruited UK Biobank. The HRs were little changed after further adjustment for markers of established intermediate pathways (eg, levels of lipids and blood pressure) and lifestyle factors (eg, smoking, diet). At the age of 60 years, a history of any 2 of these conditions was associated with 12 years of reduced life expectancy and a history of all 3 of these conditions was associated with 15 years of reduced life expectancy.Conclusions and relevanceMortality associated with a history of diabetes, stroke, or MI was similar for each condition. Because any combination of these conditions was associated with multiplicative mortality risk, life expectancy was substantially lower in people with multimorbidity.

Project description:Background and aimsAging accompanied by cardiometabolic multimorbidity (CM) promotes chronic low-grade inflammation, increased oxidative stress, and insulin resistance (IR), which result in loss of muscle mass and functional impairment. Better quality diets have been directly associated with muscle health and decreased risk of all-cause mortality. However, no study has investigated the relationship of dietary factors with grip strength, body composition, and prevalence of sarcopenic obesity (SO) in Korean rural residents according to their CM pattern. Therefore, we aimed to examine this association among this population.Materials and methodsThis cross-sectional study utilized data from 932 rural residents aged ≥ 65 years. An exploratory tetrachoric factor analysis revealed four multimorbidity patterns: CM, inflammatory disease, respiratory disease, and cancer and other diseases. All participants were categorized into the CM and non-CM groups. Skeletal muscle mass and the prevalence of sarcopenia were estimated using bioelectrical impedance analysis (BIA). Dietary assessment was analyzed using a validated 106-item food frequency questionnaire. Adjusted multiple linear regression and multivariate logistic regression were employed to examine the association of dietary factors with muscle strength, quality, and SO prevalence ratio in elderly participants.ResultsThe mean age of the participants was 71.8 ± 0.1 years (65.8% women). Dietary fat and protein intake were positively correlated with handgrip strength in women with CM, after adjusting for covariates (p = 0.001). Similarly, protein intake (g/kg) was positively associated with appendicular skeletal muscle mass (ASM; kg/m2) and ASM (%) in both sexes in the CM and non-CM groups. Regarding the tertiles of wheat intake (g/d), 2.1-fold increase in SO prevalence ratios [prevalence ratio (PR): 2.149, confidence intervals (CIs): 1.134-4.071] was observed in the highest tertile (T3: 269.1 g/d), compared to the lowest tertile (Q1: 8.6 g/d) in the CM group. Higher tertile of meat intake (T2: 34.8 g/d, T3: 99.5 g/d) had a 2-fold increase in SO (PR: 1.932, CIs: 1.066-3.500) compared to the lowest tertile (T1: 9.2 g/d) in the CM group.ConclusionOverconsumption of wheat and meat negatively impacted the development of SO, while protein intake was positively associated with grip strength and skeletal muscle mass in elderly Koreans with CM.

Project description:BackgroundCardiometabolic multimorbidity (CMM) and obesity represent two major health problems. The relationship between adiposity indices and CMM, however, remains understudied. This study aimed to investigate the associations of body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), and conicity index (CI) with CMM among Chinese adults.MethodsData of 101,973 participants were collected from a population-based screening project in Southern China. CMM was defined as having two or more of the following diseases: coronary heart disease, stroke, hypertension, and diabetes. The relationship between the six adiposity indices and CMM was investigated by multivariate logistic regression and restricted cubic splines. Receiver operator characteristic curve, C-statistic and net reclassification index were used to estimate the discriminative and incremental values of adiposity indices on CMM.ResultsLogistic regression models showed the six adiposity indices were all significantly associated with the odds of CMM with non-linear relationships. For per SD increment, WC (Odds ratio [OR]: 1.66; 95% confidence interval (CI): 1.62-1.70) and WHtR (OR, 1.61; 95% CI, 1.58-1.65) were more significantly associated with a higher prevalence of CMM than BMI (OR, 1.55; 95% CI, 1.52-1.58) (all P < 0.05). In addition, WC, WHtR, and BRI displayed significantly better performance in detecting CMM compared with BMI (all P < 0.05). Their respective area under the curve (AUC) values were 0.675 (95% CI: 0.670-0.680), 0.679 (95% CI: 0.675-0.684), and 0.679 (95% CI: 0.675-0.684), while BMI yielded an AUC of 0.637 (95% CI: 0.632-0.643). These findings hold true across all subgroups based on sex and age. When Adding WC, WHtR, or BRI to a base model, they all provided larger incremental values for the discrimination of CMM compared with BMI (all P < 0.05).ConclusionsAdiposity indices were closely associated with the odds of CMM, with WC and WHtR demonstrating stronger associations than BMI. WC, WHtR, and BRI were superior to BMI in discriminative ability for CMM. Avoidance of obesity (especially abdominal obesity) may be the preferred primary prevention strategy for CMM while controlling for other major CMM risk factors.

Project description:ObjectivesCardiometabolic diseases are increasing disproportionately in South Asia compared with other regions of the world despite high levels of vegetarianism. This unexpected discordance may be explained by differences in the healthfulness of vegetarian and non-vegetarian diets in South Asia compared with the United States. The aim of this study was to compare the food group intake of vegetarians with non-vegetarians in South Asia and the United States and to evaluate associations between vegetarianism and cardiometabolic disease risk factors (overweight/obesity, central obesity, diabetes, hypertension, high triacylglycerols, high low-density lipoprotein, low high-density lipoprotein, and high Framingham Heart Score).MethodsUsing cross-sectional data from adults (age 20-69 y) in South Asia (Centre for Cardiometabolic Risk Reduction in South-Asia [CARRS] 2010-2011; N = 15 665) and the United States (National Health and Nutrition Examination Survey 2003-2006; N = 2159), adherence to a vegetarian diet was assessed using food propensity questionnaires. Multivariable logistic regression was used to estimate odds ratios and predicted margins (e.g., adjusted prevalence of the outcomes).ResultsOne-third (33%; n = 4968) of adults in the South Asian sample were vegetarian compared with only 2.4% (n = 59) in the US sample. Among South Asians, vegetarians more frequently ate dairy, legumes, vegetables, fruit, desserts, and fried foods than non-vegitarians (all P < 0.05). Among Americans, vegetarians more frequently ate legumes, fruit, and whole grains, and less frequently ate refined cereals, desserts, fried foods, fruit juice, and soft drinks than non-vegetarians (all P < 0.05). After adjustment for confounders (age, sex, education, tobacco, alcohol, and also city in CARRS), South Asian vegetarians were slightly less frequently overweight/obese compared with non-vegetarians: 49% (95% confidence interval [CI], 45%-53%) versus 53% (95% CI, 51%-56%), respectively; whereas US vegetarians were considerably less frequently overweight/obese compared with non-vegetarians: 48% (95% CI, 32%-63%) versus 68% (95% CI, 65%-70%), respectively. Furthermore, US vegetarians were less likely to exhibit central obesity than non-vegetarians: 62% (95% CI, 43%-78%) versus 78% (95% CI, 76%-80%), respectively.ConclusionsThere is greater divergence between vegetarian and non-vegetarian diets in the United States than in South Asia, and US vegetarians have more consistently healthier food group intakes than South Asian vegetarians. Vegetarians in both populations have a lower probability of overweight/obesity compared with non-vegetarians. The strength of this association may be stronger for US vegetarian diets, which were also protective against central obesity.

Project description:BackgroundIncreasing trends in global obesity have been attributed to a nutrition transition where healthy foods are replaced by ultra-processed foods. It remains unknown if this nutrition transition has occurred in Venezuela, a country undergoing a socio-political crisis with widespread food shortages.MethodsWe described dietary intake of Venezuelans from a nationally representative study conducted between 2014 and 2017. We conducted a cross-sectional analysis of dietary, sociodemographic, and clinical data from Venezuelans ≥20 years of age (n = 3420). Dietary intake was assessed using a semi-quantitative food frequency questionnaire. Standardized clinical and anthropometric measurements estimated obesity, type 2 diabetes, and hypertension. A Dietary Diversity Score (DDS) was calculated using an amended Minimum Dietary Diversity for Women score where the range was 0 to 8 food groups, with 8 being the most diverse. Analyses accounted for complex survey design by estimating weighted frequencies of dietary intake and DDS across sociodemographic and cardiometabolic risk-based subgroups.ResultsThe prevalence of obesity was 24.6% (95% CI: 21.6-27.7), type 2 diabetes was 13.3% (11.2-15.7), and hypertension was 30.8% (27.7-34.0). Western foods were consumed infrequently. Most frequently consumed foods included coffee, arepas (a salted corn flour cake), and cheese. Mean DDS was 2.3 food groups (Range: 0-8, Standard Error: 0.07) and this score did not vary among subgroups. Men, younger individuals, and those with higher socioeconomic status were more likely to consume red meat and soft drinks once or more weekly. Women and those with higher socioeconomic status were more likely to consume vegetables and cheese once or more daily. Participants with obesity, type 2 diabetes, and hypertension had lower daily intake of red meat and arepas compared to participants without these risk factors.ConclusionsDespite high prevalence of cardiometabolic risk factors, adults in Venezuela have not gone through a nutrition transition similar to that observed elsewhere in Latin America. Dietary diversity is low and widely consumed food groups that are considered unhealthy are part of the traditional diet. Future studies are needed in Venezuela using more comprehensive measurements of dietary intake to understand the effect of the socio-political crisis on dietary patterns and cardiometabolic risk factors.

Dataset Information

Association of Cardiometabolic Multimorbidity Pattern with Dietary Factors among Adults in South Korea.

Publications

Association of Cardiometabolic Multimorbidity Pattern with Dietary Factors among Adults in South Korea.

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