SuJin Song

Consumption of red and processed meat and esophageal cancer risk: Meta-analysis

To summarize the evidence about the association between red and processed meat intake and the risk of esophageal cancer, we systematically searched the PubMed and EMBASE databases up to May 2012, with a restriction to English publications, and the references of the retrieved articles. We combined the study-specific relative risks (RRs) and 95%CI, comparing the highest with the lowest categories of consumption by using a random-effects model. A total of 4 cohort studies and 23 case-control studies were included in the meta-analysis. The combined RRs (95%CI) of the cohort studies comparing the highest and lowest categories were 1.26 (1.00-1.59) for red meat and 1.25 (0.83-1.86) for processed meat. For the case-control studies, the combined RRs (95%CI) comparing the highest and lowest categories were 1.44 (1.16-1.80) for red meat and 1.36 (1.07-1.74) for processed meat. Findings from this meta-analysis suggest that a higher consumption of red meat was associated with a greater risk of esophageal cancer.

Carbohydrate Intake and Refined-Grain Consumption Are Associated with Metabolic Syndrome in the Korean Adult Population

BACKGROUND Metabolic syndrome is prevalent in the Asian population, but little is known about its associations with sources or types of dietary carbohydrates. OBJECTIVE We examined relationships between metabolic syndrome prevalence and dietary carbohydrate intake, including total carbohydrate, energy from carbohydrates, dietary glycemic index, dietary glycemic load, total grains, refined grains, and white rice in Korean men and women. DESIGN This cross-sectional study was based on data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES 2007-2009) and a nationally representative sample. PARTICIPANTS/SETTING A total of 6,845 adults (2,631 men, 4,214 women) aged 30 to 65 years with no diagnosed diabetes, hypertension, or dyslipidemia were selected. Dietary intake data were obtained using the 24-hour recall method and all dietary carbohydrate intakes were divided into quintiles by sex. MAIN OUTCOME MEASURES Metabolic syndrome and its components were defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. STATISTICAL ANALYSES PERFORMED All statistical analyses accounted for the complex sampling design effect and used appropriate sample weights. Multivariate adjusted logistic regression was used to estimate odds ratios and 95% CIs for metabolic syndrome across quintiles of dietary carbohydrate intake. RESULTS After controlling for potential confounding variables, the determinants of metabolic syndrome were the percentage of energy from carbohydrates in men and intakes of refined grains, including white rice, in women. Triglyceride, high-density lipoprotein cholesterol, and fasting blood glucose levels were associated with the percentage of energy from carbohydrates in men and white rice intake in women. CONCLUSIONS Our findings suggest that the sources and types of carbohydrates were differentially associated with metabolic syndrome according to sex in the Korean adult population. The percentage of energy from carbohydrates in men and intake of refined grains, including white rice, in women were associated with metabolic syndrome.

High carbohydrate intake was inversely associated with high-density lipoprotein cholesterol among Korean adults.

The traditional Asian diet, which is characterized as being high in carbohydrate with an abundance of vegetables, may be beneficial for preventing metabolic syndrome abnormalities within the Asian population. However, the prevalence of metabolic syndrome is increasing in Asian countries. This study explored the association between dietary carbohydrates and low high-density lipoprotein cholesterol (HDL-C) prevalence, one of the abnormalities of metabolic syndrome in Korean adults. We used the data from the Fourth Korea National Health and Nutrition Examination Survey and evaluated a total of 9947 Korean adults older 20 years. To measure carbohydrate quality and quantity, total carbohydrate intake (g/d), percentage of energy from carbohydrate, glycemic index, and glycemic load were divided into quintiles. Mean levels of HDL-C significantly decreased across the quintiles for all types of dietary carbohydrate intake except glycemic index after adjusting for potential variables in both men and women. Odds ratios for having low HDL-C in the highest quintile were 1.66 (95% confidence interval, 1.24-2.22) for total carbohydrate, 1.34 (1.02-1.75) for percentage of energy from carbohydrate, and 1.54 (1.17-2.03) for glycemic load in men as compared with the second quintile as a reference. Odds ratio for low HDL-C was 1.38 (1.12-1.71) for percentage of energy from carbohydrate in women. In conclusion, our study indicates that low HDL-C is associated with high carbohydrate intake without regard to energy or fat intake. Further studies would be necessary to optimize carbohydrate intake quantitatively on dyslipidemia for Asian population.

High intake of whole grains and beans pattern is inversely associated with insulin resistance in healthy Korean adult population

We investigated the association between dietary patterns and insulin resistance in the 3871 healthy Korean adults from the 2007 to 2008 Korea National Health and Nutrition Examination Survey. The whole grains and beans pattern was associated with lower prevalence of insulin resistance (OR for highest quintile=0.80, 95% CI=0.61-1.03, P for trend=0.013).

Low consumption of fruits and dairy foods is associated with metabolic syndrome in Korean adults from outpatient clinics in and near Seoul.

BACKGROUND/OBJECTIVES The aim of this study was to examine differences in nutrient intake and food consumption by the presence of metabolic syndrome in Korean adults. SUBJECTS/METHODS Study subjects in this cross-sectional study were recruited from four outpatient clinics in and near the Seoul metropolitan area of South Korea between 2006 and 2012. A total of 668 subjects (413 men and 255 women) aged ≥ 30 y were included in the final data analyses. For each subject, daily nutrient intake and food consumption were calculated using three days of dietary intake data obtained from a combination of 24-hour recalls and dietary records. To evaluate food consumption, mean number of servings consumed per day and percentages of recommended number of servings for six food groups were calculated. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. The general linear model was performed to examine differences in nutrient intake and food consumption by sex and the presence of metabolic syndrome after adjustment for potential confounding variables. RESULTS Nutrient intake did not differ by the presence of metabolic syndrome in both men and women. Men with metabolic syndrome had lower consumption and percentage of the recommendation for fruits compared with those without metabolic syndrome (1.6 vs. 1.1 servings/day, P-value = 0.001; 63.5 vs. 49.5%, P-value = 0.013). Women with metabolic syndrome showed lower consumption and percentage of the recommendation for dairy foods than those without metabolic syndrome (0.8 vs. 0.5 servings/day, P-value = 0.001; 78.6 vs. 48.9%, P-value = 0.001). CONCLUSIONS Low intakes of fruits and dairy foods might be associated with the risk of having metabolic syndrome among Korean adults. Dietary advice on increasing consumption of these foods is needed to prevent and attenuate the risk of metabolic syndrome.

Sex Differences in the Risk of Metabolic Syndrome and its Diagnostic Components in Korean Adults

Objective: We examined sex differences in the risk of metabolic syndrome (MetS) and its diagnostic components among Korean adults. Methods: A total of 17,826 adults (7,061 men, 10,765 women) aged 19+ years with no diagnosed chronic diseases, such as diabetes, hypertension, or dyslipidemia were selected from the 2008-2012 Korea National Health and Nutrition Examination Survey data. MetS was classified by the National Cholesterol Education Program Adult Treatment Panel III criteria with the Asia-Pacific specific cut-off for excessive waist circumference. All statistical analyses accounted for the complex sampling design effect and used appropriate sample weights. Results: The overall prevalence of MetS was slightly higher in men (19.0%) than in women (14.8%). The prevalent diagnostic components were elevated triglycerides (33.2%) in men whereas low HDL-cholesterol (44.9%) and excessive waist circumference (31.3%) in women. The prevalence of MetS increased with age only in women. Women < 60 years had a lower prevalence of MetS than men in the same age category but the prevalence in women surpassed that in men after 60 years. There were differences in common combinations of MetS diagnostic components between men and women. Conclusion: The MetS risk differed by sex in Korean adults and was markedly high in older women. Our findings warrant specific preventive strategies and clinical managements for MetS according to sex, especially for middleaged and elderly women.

Three distinct clustering patterns in metabolic syndrome abnormalities are differentially associated with dietary factors in Korean adults.

Dietary factors are not consistently associated with metabolic syndrome abnormalities. In this cross-sectional study, we hypothesized that distinct clustering patterns exist in metabolic syndrome abnormalities and that those patterns are differentially associated with dietary factors. To test this hypothesis, we examined distinct clustering patterns of metabolic syndrome abnormalities and their association with dietary factors in Korean adults. A total of 141 subjects were recruited through the Family Medicine Division of the General Hospital in Seoul. Subjects who had complete data on waist circumference, blood pressure, blood glucose and lipid indicators, and no medication usage were included in this study. Dietary intake data were obtained by multiple 24-hour recalls (2-4 days) through on-site or telephone interviews. To identify clustering patterns of metabolic syndrome abnormalities, factor analysis was used for waist circumference, systolic and diastolic blood pressure, blood glucose, triglycerides, and high-density lipoprotein cholesterol. Three distinct clustering patterns were identified: (1) high blood pressure, (2) dyslipidemia, and (3) high blood glucose. The high blood pressure pattern was significantly associated with higher alcohol intake and lower carbohydrate intake. The dyslipidemia pattern was significantly associated with a diet of high glycemic index and glycemic load. The high blood glucose pattern was associated with lower carbohydrate intake. Metabolic syndrome abnormalities had 3 distinct clustering patterns independently associated with dietary factors. Diets with high glycemic index and glycemic load were strongly linked with the dyslipidemia pattern, and high alcohol intake was linked with the high blood pressure pattern in Korean adults.

Prevalence and Determinants of Overweight and Obesity in Children and Adolescents from Migrant and Seasonal Farmworker Families in the United States—A Systematic Review and Qualitative Assessment

Overweight and obesity (OW/OB) is a pressing health concern among migrant and seasonal farmworker (MSFW) families in the US. The limited number of previously reported research on MSFW families suggests that their unique sociodemographic characteristics and lifestyle predispose them to poor health outcomes including OW/OB. We aimed to synthesize and assess available data on the prevalence and modifiable health determinants of OW/OB in MSFW children and adolescents. Literature search, study selection, data extraction and synthesis, and qualitative assessment of selected studies were performed independently by two authors. Ten cross-sectional studies met the inclusion criteria: articles or dissertations investigating prevalence and association between health determinants and OW/OB in MSFW children and adolescents (<20 years) in the US. The prevalence of OW, OB, and OW/OB ranged from 10%–33%, 15%–37%, and 31%–73%, respectively. Children’s education, household food insecurity, parents’ weight status, parents’ distorted perception of their children’s weight status, and parents’ participation in the federal nutrition assistance program were significantly associated with the children’s and adolescents’ risk of OW/OB. Promotion of culturally relevant public health programs and implementation of a systematic health surveillance plan for MSFWs and their children should be emphasized to combat OW/OB among MSFW children and adolescents.

Compliance to Prenatal Iron and Folic Acid Supplement Use in Relation to Low Birth Weight in Lilongwe, Malawi

Prenatal iron and folic acid (IFA) supplements are offered free to all pregnant women in Malawi to reduce maternal anemia and improve birth outcomes. We investigated the association between self-reported compliance to IFA intake and risk of low birth weight (LBW). Pregnant women who attended Bwaila Maternity Wing of Lilongwe District Hospital for delivery were recruited (n = 220). We used a questionnaire to collect self-reported information on IFA use and maternal sociodemographic data. Before delivery, blood samples for maternal hemoglobin (Hb) and folate status, and upon delivery, birth weight, and other newborn anthropometrics were measured. We used multivariable logistic regression to determine risk of LBW by prenatal IFA intake. The self-reported number of IFA pills taken during pregnancy was positively associated with Hb, but not serum and RBC folate concentration: <45, 45–89 and ≥90 pills taken corresponded with mean (SD) Hb 10.7 (1.6), 11.3 (1.8), and 11.7 (1.6) g/dL, respectively (p = 0.006). The prevalence of LBW was 20.1%, 13.5% and 5.6% for those who reported taking IFA pills <45, 45–89, and ≥90 pills, respectively (p = 0.027). Taking >60 IFA pills reduced risk of LBW delivery (OR (95% CI) = 0.15 (0.03–0.70), p = 0.033) than taking ≤30 pills. Self-reported compliance to IFA use is valid for assessing prenatal supplement program in Malawi, especially Hb status, and can reduce the rate of LBW.

Snack patterns are associated with biomarkers of glucose metabolism in US men

Abstract Few studies have made distinctions between dietary intake from meals and snacks in relating them to biomarkers. We aimed to examine if snack patterns are associated with biomarkers of glucose metabolism, specifically hemoglobin A1c and HOMA-IR in US adults. Using 24-h dietary recall data from National Health and Nutrition Examination Survey (NHANES) in 2007–2008, we derived snack patterns using factor analyses. Multivariate logistic regressions were performed to estimate adjusted odds ratios (AOR) for biomarkers of glucose metabolism by quintiles of snack pattern scores. Men in the highest quintile of dairy and sugary snack pattern had higher risk of having hemoglobin A1c ≥ 6.5% (AOR: 2.06; 95% CI: 1.20–3.51) and HOMA-IR > 3.0 (AOR: 1.73; 95% CI: 1.01–2.95) than did those in the lowest quintile. No significant association was found in women between snack patterns and biomarkers of glucose metabolism. Dairy and sugary snack patterns of US men had the greatest association with poor control of glucose metabolism.