Background and Objectives: There is growing evidence supporting the association between ultra-processed food (UPF) consumption and metabolic disease risk. However, little is known about the association between UPF consumption and blood pressure (BP). Thus, this study examined the association between UPF consumption and elevated BP in Korean adults. Methods: This study used data from the Korea National Health and Nutrition Examination Survey (2016–2018) and included 9,188 participants aged 30–79 years without a history of hypertension diagnosis. Food items reported in a one-day 24-hour recall were categorized on the basis of the NOVA (not an acronym) food classification criteria. UPF consumption was estimated as the contribution to total energy intake. Elevated BP was defined as systolic BP ≥120 mmHg or diastolic BP ≥80 mmHg. The independent association between UPF consumption and elevated BP was assessed by multivariable logistic regression analysis. Results: The upper tertile of UPF consumption was significantly associated with elevated BP compared with the lower tertile, after adjusting for potential confounders. A linear trend was observed for elevated BP across the tertiles of the dietary energy contribution of UPF. Similar results were found in stratified analyses by age group, smoking, obesity, and overall dietary quality. However, a marginal level of association was found in some subgroups, current smokers, and non-obese adults. Conclusions The dietary energy contribution of UPF consumption was positively associated with increased prevalence of elevated BP, and these findings suggest that lowering UPF consumption might help prevent BP elevation.

Beverage consumption is one of the most habitual dietary behaviors. Beverages such as coffee, tea, and juice are among the most widely and commonly consumed food. Recently, consumption of sugar-sweetened beverages has been steadily increasing across the globe. Beverages, particularly sugar-sweetened beverages, are the primary source of added sugars and contribute to energy overconsumption. A number of studies have shown positive associations of sugar-sweetened beverage consumption with weight gain, obesity, diabetes, hypertension, and cardiovascular diseases. This review presents consumption of diabetic patients, impact of beverage consumption on metabolic and cardiovascular health, and much healthier beverage choices for diabetic patients.
Beverages ; Carbohydrates ; Cardiovascular Diseases ; Coffee ; Diabetes Mellitus ; Humans ; Hypertension ; Obesity ; Tea ; Weight Gain

BACKGROUND/OBJECTIVES: Dietary sugars intake worldwide is stable or decreasing, but overall sugars intake remains above the recommended level. Some studies suggest that ultraprocessed foods (UPFs) drive excessive sugars intake. However, UPF consumption in Korea and its association with sugars intake have not yet been studied. This study aimed to estimate the contribution of UPF consumption to total sugars intake and to investigate the association between UPF consumption and total sugars intake in Koreans. SUBJECTS/METHODS: Data from the Korea National Health and Nutrition Examination Survey 2016–2018 were used, and included data on 21,075 participants aged 1+ years completed a 24-h recall. Food items reported in the 24-h recall were classified according to the NOVA system as UPFs, processed foods, processed culinary ingredients, or unprocessed or minimally processed foods. RESULTS: The average daily energy intake was 1,996 kcal, and UPFs accounted for 26.2% of the total energy intake (% TE). The average total sugars intake was 63.1 g (13.0% TE), and 44.9% of total sugars intake came from UPFs. Among the entire population, 15.8% exceeded the recommended limit for total sugars within 20% TE, and excessive total sugars intake was more prevalent among females (19.5%) and children (21.1%). The prevalence of excessive total sugars intake showed a significantly increasing tendency across the quartiles of UPF energy contribution, ranging from 11.9% in the lowest quartile to 23.2% in the highest quartile. Even after adjustment for sociodemographic variables, UPF consumption was positively associated with the prevalence of excessive total sugars intake (P for trend < 0.001). This association was similar in subgroup analyses by sex and age. CONCLUSIONS This study suggests that UPF consumption may drive excessive intake of total sugars in the Korean diet. Our findings conclusively establish that restricting UPF consumption may be an efficient way to reduce sugars intake in Korean population.

BACKGROUND AND OBJECTIVES: Cigarette smoking has been reported to be associated with arterial stiffness. However, the clinical relevance of smoking cessation on arterial stiffness is debatable. Thus, we evaluated whether smoking cessation is associated with arterial stiffness.METHODS: A total of 1,169 male participants aged 30–64 years with absence of cardiovascular diseases in 2013–2017 were selected from the Cardiovascular and Metabolic Disease Etiology Research Center cohort study. The subjects were classified into the following 5 groups based on self-reporting: non-smokers, former smokers (<1, 1 to <10, and ≥10, years after cessation), and current smokers. Arterial stiffness was assessed using the augmentation index (AIx). The radial artery AIx was obtained from the peripheral artery waveform. The association was explored cross-sectionally.RESULTS: The AIx of former smokers did not differ from that of non-smokers (p=0.089). However, after former smokers were stratified by duration of smoking cessation, we noted a linear trend according to the smoking status (p<0.001). Men who quit smoking <1 year ago showed an elevated AIx (β=3.94, standard error=1.54, p=0.011) as much as ones of current smokers (β=4.39, standard error=0.74, p<0.001), while those who quit more than a decade ago showed an AIx similar to that of non-smokers (β=0.35, standard error=0.82, p=0.670) after controlling covariates.CONCLUSIONS: A dose-response association between smoking cessation and AIx was revealed, which implies the possibility of a reversible effect of smoking cessation on arterial stiffness. Therefore, our findings may motivate current smokers to modify their smoking habits to delay or reverse disease progression.
Arteries ; Cardiovascular Diseases ; Cohort Studies ; Disease Progression ; Health Behavior ; Humans ; Male ; Metabolic Diseases ; Radial Artery ; Smoke ; Smoking Cessation ; Smoking ; Vascular Stiffness

BACKGROUND AND OBJECTIVES: Cigarette smoking has been reported to be associated with arterial stiffness. However, the clinical relevance of smoking cessation on arterial stiffness is debatable. Thus, we evaluated whether smoking cessation is associated with arterial stiffness. METHODS: A total of 1,169 male participants aged 30–64 years with absence of cardiovascular diseases in 2013–2017 were selected from the Cardiovascular and Metabolic Disease Etiology Research Center cohort study. The subjects were classified into the following 5 groups based on self-reporting: non-smokers, former smokers (<1, 1 to <10, and ≥10, years after cessation), and current smokers. Arterial stiffness was assessed using the augmentation index (AIx). The radial artery AIx was obtained from the peripheral artery waveform. The association was explored cross-sectionally. RESULTS: The AIx of former smokers did not differ from that of non-smokers (p=0.089). However, after former smokers were stratified by duration of smoking cessation, we noted a linear trend according to the smoking status (p<0.001). Men who quit smoking <1 year ago showed an elevated AIx (β=3.94, standard error=1.54, p=0.011) as much as ones of current smokers (β=4.39, standard error=0.74, p<0.001), while those who quit more than a decade ago showed an AIx similar to that of non-smokers (β=0.35, standard error=0.82, p=0.670) after controlling covariates. CONCLUSIONS A dose-response association between smoking cessation and AIx was revealed, which implies the possibility of a reversible effect of smoking cessation on arterial stiffness. Therefore, our findings may motivate current smokers to modify their smoking habits to delay or reverse disease progression.

OBJECTIVES: This study explored the association between dietary and suicidal behaviors of Korean adolescents and investigated differences in this association in children of immigrant parents. METHODS: The sample (n=368,138) was collected from the Korea Youth Risk Behavior Survey from 2015 to 2020. Participants who agreed to provide family information (n=313,689) were classified according to their parents’ nationality. The study variables were 11 self-reported dietary behaviors, and their composite dietary behaviors (i.e., nutrient deprivation and unhealthy food consumption) that resulted from principal component analysis. The association between study variables and suicide-related outcomes (i.e., suicidal ideation, suicide planning, and suicide attempts) was analyzed by multiple logistic regression with adjustment for covariates. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. RESULTS: Participants who skipped key meals and foods were more likely to have attemped suicide (aOR [95% CI]: skipping breakfast ≥5 days/wk, 1.28 [1.21 to 1.35]; consuming fruits <1 times/wk: 1.42 [1.32 to 1.52]; consuming vegetables <1 times/wk: 1.72 [1.53 to 1.93]; consuming milk <3 times/wk: 1.07 [0.99 to 1.16]). The associations were prominent in third culture kids (TCKs) (aOR [95% CI]: 2.23 [1.61 to 3.09]; 2.32 [1.61 to 3.35]; 2.63 [1.50 to 4.60]; 1.69 [1.09 to 2.63], respectively). Participants who consumed unhealthy foods (fast food, caffeinated and sugary drinks) more frequently were more likely to have attempted suicide (aOR, 1.55; 95% CI, 1.38 to 1.73). This association was also more prominent in TCKs (aOR, 2.08; 95% CI, 1.08 to 4.01). CONCLUSIONS Our findings indicate a positive association between unfavorable dietary behaviors and outcomes related to suicide, and this association appears to be notable in adolescents with immigrant parents.

We examined the associations between thigh muscle area (TMA) and insulin resistance (IR) according to body mass index (BMI) in middle-aged Korean general population.

BACKGROUND/OBJECTIVES: Food composition databases are necessary for assessing dietary intakes. Developing and maintaining a high quality database is difficult because of the high cost of analyzing nutrient profiles and the recent fast-changing food marketplace. Thus, priorities have to be set for developing and updating the database. We aimed to identify key foods in the Korean diet to set priorities for future analysis of foods. SUBJECTS/METHODS: modified the US Department of Agriculture's key food approach. First, major foods were analyzed, contributing to 75%, 80%, 85%, or 90% of each nutrient intake. Second, the cumulative contributions to nutrient intakes were compared before and after excluding the foods least commonly consumed by individuals. Third, total nutrient score for each food was calculated by summing all percent contributions times 100 for nutrients. To set priorities among the foods in the list, we sorted the score in descending order and then compared total percent contributions of foods, within the 100, 90, 85, 80, and 75 percentiles of the list. Finally, we selected the minimum list of foods contributing to at least 90% of the key nutrient intake as key items for analysis. RESULTS: Among the 1,575 foods consumed by individuals, 456 were selected as key foods. Those foods were chosen as items above the 80 percentile of the total nutrient score, among the foods contributing at least 85% of any nutrient intake. On an average, the selected key foods contributed to more than 90% of key nutrient intake. CONCLUSIONS: In total, 456 foods, contributing at least 90% of the key nutrient intake, were selected as key foods. This approach to select a minimum list of key foods will be helpful for systematically updating and revising food composition databases.
Diet ; Food Analysis ; Nutrition Surveys

BACKGROUND AND OBJECTIVES: We investigated the inter-arm difference in blood pressure of the general Korean population to identify associated factors. SUBJECTS AND METHODS: A total of 806 participants aged 30 to 64 years without history of major cardiovascular disease were analyzed in this cross-sectional study. They participated in the Cardiovascular and Metabolic Disease Etiology Research Center cohort study that began in 2013. Brachial blood pressure was measured simultaneously for both arms using an automated oscillometric device equipped with two cuffs in seated position. After five minutes of rest, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured three times. The average of the three measurements was used for analysis. Multivariate logistic regression models were used to identify factors associated with inter-arm differences in blood pressure. RESULTS: The mean inter-arm difference was 3.3 mmHg for SBP and 2.0 mmHg for DBP. Large inter-arm differences (≥10 mmHg) in SBP and in DBP were found in 3.7% and 0.9% of subjects, respectively. A large inter-arm difference in SBP was associated with mean SBP (p=0.002) and C-reactive protein (p=0.014) while a large inter-arm different in DBP was only associated with body mass index (p=0.015). Sex, age, and anti-hypertensive medication use were not associated with differences in inter-arm blood pressure. CONCLUSION: Large inter-arm difference in blood pressure is only present in a small portion of healthy Korean adults. Our findings suggest that high SBP, chronic inflammation, and obesity may be associated with larger difference in inter-arm blood pressure.
Adult ; Arm ; Blood Pressure* ; Body Mass Index ; C-Reactive Protein ; Cardiovascular Diseases ; Cohort Studies ; Cross-Sectional Studies ; Humans ; Inflammation ; Logistic Models ; Metabolic Diseases ; Obesity ; Posture

OBJECTIVES: Many recent studies have suggested that several systemic conditions, such as obesity, hypertension, hyperlipidemia, and diabetes, are related to periodontitis. The aim of this study was to investigate whether any particular metabolic syndrome component correlates with the periodontal status. METHODS: This study analyzed data from 501 adults (age range, 30 to 64 years) who completed a general physical examination and an oral-health-related questionnaire between January 2014 and June 2014. Periodontitis was already used by the validity and reliability has been proven questionnaire. Multiple logistic regression analysis was used to assess the association between metabolic syndrome and the presence of chronic periodontitis. RESULTS: Among the 501 participants, 81 (16.2%) had metabolic syndrome and 91 (18.2%) had chronic periodontitis. The prevalence of chronic periodontitis was 28.40% (23/81) and 16.19% (68/420) in the participants with and without metabolic syndrome, respectively. The association remained significant after adjusting for sex, age, education, income, occupation, and smoking status; the adjusted odds ratio was 2.03 (95% confidence interval, 1.11 to 3.71). CONCLUSIONS: A significant association exists between metabolic syndrome components and the periodontal status.
Adult ; Chronic Periodontitis ; Education ; Humans ; Hyperlipidemias ; Hypertension ; Logistic Models ; Obesity ; Occupations ; Odds Ratio ; Periodontitis ; Physical Examination ; Prevalence ; Reproducibility of Results ; Smoke ; Smoking