Haeng-Shin Lee

Soft drink consumption is positively associated with metabolic syndrome risk factors only in Korean women: Data from the 2007–2011 Korea National Health and Nutrition Examination Survey

OBJECTIVE To examine the association between sugar-sweetened beverage consumption and metabolic syndrome risk factors in Korean adults. METHODS We used data from 13,972 participants (5432 men and 8540 women) aged ≥30 years, from the 2007-2011 Korea National Health and Nutrition Examination Survey. The subjects were divided into six groups based on their soft drink consumption levels from a food frequency questionnaire. Dietary sugar intake was compared among groups using 24-hour dietary recall data. RESULTS The highest soft drink consumption frequency category was ≥4 times per week, observed in 4.6% of men and 1.7% of women. The percentage of energy from total sugar and sugar in processed foods increased with increased soft drink consumption in both men and women. In the highest consumption group, the percentage of energy from sugar in processed foods was 8.9% in men and 11.0% in women. After adjusting for potential confounding variables, greater consumption of soft drinks was positively associated with all of the components of metabolic syndrome, except the high density lipoprotein (HDL) cholesterol level, in women only. Women who consumed soft drinks ≥4 times per week had a 74% higher risk of metabolic syndrome compared to those who consumed soft drinks infrequently (OR: 1.74; 95% CI: 1.00-3.03; P for trend <0.0001). CONCLUSION High levels of soft drink consumption might constitute an important determinant of metabolic syndrome and its components only in Korean adult women.

Association between High Blood Pressure and Intakes of Sodium and Potassium among Korean Adults: Korean National Health and Nutrition Examination Survey, 2007-2012

BACKGROUND The association between dietary sodium and potassium, the ratio of sodium to potassium, and blood pressure remains unclear. OBJECTIVE We evaluated the associations between blood pressure and dietary sodium and potassium intake in terms of the amount and ratio in Korean adults. DESIGN This cross-sectional study was based on data from the fourth and fifth Korean National Health and Nutrition Examination Survey, 2007-2012. PARTICIPANTS/SETTING A total of 24,096 adults (aged ≥19 years) without history of antihypertensive medication use were selected. The 24-hour recall method was used for dietary assessment. We categorized the subjects into four groups using median intakes of sodium and potassium, and defined the low sodium/high potassium intake group as the reference group. MAIN OUTCOME MEASURES High blood pressure (HBP) was defined as mean systolic or diastolic blood pressures of ≥140 or ≥90 mm Hg, respectively. STATISTICAL ANALYSES PERFORMED Multivariate logistic regression was performed to estimate the odds ratio and 95% CI to investigate the association between the four groups of sodium and potassium intakes and HBP. RESULTS Sodium intake was positively associated with diastolic blood pressure, with an increase of 0.21 mm Hg per 1 mg/kcal increase in sodium (P<0.001). In contrast, potassium intake was negatively associated with systolic blood pressure, with a decrease of 1.01 mm Hg per 1 mg/kcal increase in potassium (P<0.001). After adjusting for confounders, the high sodium/low potassium (odds ratio 1.21, 95% CI 1.02 to 1.44) and low sodium/low potassium intake groups (odds ratio 1.19, 95% CI 1.01 to 1.40) were at higher risk of HBP than the reference group. The risk of HBP in the high sodium/high potassium group did not differ from that in the reference group. CONCLUSIONS Low potassium intake was associated with an increased risk of hypertension. These results suggest that increasing potassium intake might be beneficial for hypertension control among populations with low-potassium diets.

Development of supplemental nutrition care program for women, infants and children in Korea: NutriPlus.

Onto the world-fastest ageing of society, the world-lowest fertility rate prompted a development of various policies and programs for a betterment of the population in Korea. Since the vulnerability of young children of low socio-economic class to malnutrition was clearly shown at the in-depth analysis of the 2001 Korea National Health and Nutrition Examination Survey data, an effort to devise supplemental nutrition care program for pregnant/breastfeeding women, infants and preschool children was initiated. The program was designed to offer nutrition education tailored to fit the needs of the participants and special supplementary foods, using USDA WIC program as a benchmark. Based on the dietary intake of those age groups, target nutrients were selected and their major food sources were searched through nutrient content of foods and dietary pattern analysis. As a result, we developed 6 kinds of food packages using combinations of 11 different food items. The amount of each item in a food package was determined to supplement the intake deficit in target nutrients. Nutrition education in NutriPlus+ aims to improve the nutrition knowledge, attitude, and dietary behaviors of the participants, and is provided through group lessons, individual counseling sessions and home visits. Breastfeeding is promoted with top priority in education for the health of both mother and baby. The eligibility guidelines were set for residency, household income, age, pregnancy/breastfeeding and nutritional risk such as anemia, stunting, underweight, and/or inadequate nutrient intake. Income eligibility was defined as household income less than 200 percent of the Korean poverty guidelines. A pilot study to examine the feasibility of program implementation was run in 3 public health centers in 2005 and expanded to 15 and 20 in the following 2 years. The result of 3-year pilot study will be reported separately along with the ultimate nationwide implementation of the NutriPlus+ in 2008.