Dairy food consumption is inversely associated with the risk of the metabolic syndrome in Korean adults

Intakes of Dairy and Soy Products and 10-Year Coronary Heart Disease Risk in Korean Adults

Dairy and soy products are healthy food. However, studies have reported conflicting results associating their intake with coronary heart disease (CHD). Thus, this study determined the association between intake of dairy or soy products and 10-year CHD risk. Participants aged 40~69 years were grouped into those who consumed dairy products (more or less than twice a week) and those who consumed soy products (more or less than twice a week). Ten-year CHD risk (%), atherogenic index (AI), and atherogenic index of plasma (AIP) were calculated. The CHD risk, according to the level of dairy and soy product intake, was expressed as an odds ratio (OR) and a confidence interval (CI). Significant differences were observed in sex, age, education, income, and living area according to dairy intake frequencies, whereas only age showed significant differences according to soy products' intake frequencies. Relative effects of Framingham Risk Score (FRS) factors on 10-year CHD risk in Korean adults were found to be significant in the order of age, high-density lipoprotein cholesterol (HDL-C), smoking, blood total cholesterol (TC), systolic blood pressure (SBP), diabetes, and sex. Overall, participants who consumed dairy products ≥2/week had a significantly lower OR of 10-year CHD risk compared to those who consumed dairy products <2/week after adjusting for confounding factors (OR: 0.742, 95% CI: 0.619 to 0.890). Otherwise, intake of soy products ≥2/week tended to decrease the OR of 10-year CHD risk, although the decrease was not statistically significant. In conclusion, Korean adults who consumed dairy products ≥2/week had higher HDL-C and lower 10-year CHD risk than those who consumed dairy products <2/week. However, these results did not appear when consuming soy products.

Higher Intake of Dairy Is Associated with Lower Cardiometabolic Risks and Metabolic Syndrome in Asian Indians

There is conflicting evidence about the association between dairy products and cardiometabolic risk (CMR). We aimed to assess the association of total dairy intake with CMR factors and to investigate the association of unfermented and fermented dairy intake with CMR in Asian Indians who are known to have greater susceptibility to type 2 diabetes and cardiovascular diseases compared to white Europeans. The study comprised 1033 Asian Indian adults with normal glucose tolerance chosen from the Chennai Urban Rural Epidemiological Study (CURES). Dietary intake was assessed using a validated open-ended semi-quantitative food frequency questionnaire. Metabolic syndrome (MS) was diagnosed based on the new harmonising criteria using central obesity, dyslipidaemia [low high-density lipoprotein cholesterol (HDL) and increased serum triglycerides (TG)], hypertension and glucose intolerance. Increased consumption of dairy (≥5 cups per day of total, ≥4 cups per day of unfermented or ≥2 cups per day of fermented dairy) was associated with a lower risk of high fasting plasma glucose (FPG) [hazards ratio (HR), 95% confidence interval (CI): 0.68, 0.48−0.96 for total dairy; 0.57, 0.34−0.94 for unfermented dairy; and 0.64, 0.46−0.90 for fermented dairy; p < 0.05 for all] compared to a low dairy intake (≤1.4 cups per day of total dairy; ≤1 cup per day of unfermented dairy; and ≤0.1 cup per day of fermented dairy). A total dairy intake of ≥5 cups per day was also protective against high blood pressure (BP) (HR: 0.65, 95% CI: 0.43−0.99, p < 0.05), low HDL (HR: 0.63, 95% CI: 0.43−0.92, p < 0.05) and MS (HR: 0.71, 95% CI: 0.51−0.98, p < 0.05) compared to an intake of ≤1.4 cups per day. A high unfermented dairy intake (≥4 cups per day) was also associated with a lower risk of high body mass index (BMI) (HR: 0.52, 95% CI: 0.31−0.88, p < 0.05) compared to a low intake (≤1 cup per day), while a reduced risk of MS was observed with a fermented dairy intake of ≥2 cups per day (HR: 0.71, 95% CI: 0.51−0.98, p < 0.05) compared to an intake of ≤0.1 cup per day. In summary, increased consumption of dairy was associated with a lower risk of MS and components of CMR.

Cow's Milk Intake and Risk of Coronary Heart Disease in Korean Postmenopausal Women

Numerous studies have reported conflicting results associated with cow’s milk intake and coronary heart disease (CHD). However, studies involving postmenopausal women are very limited. This study was therefore undertaken to identify the relationship between cow’s milk intake and CHD risk in postmenopausal women, using data from the 6th period of the Korea National Health and Nutrition Examination Survey (2013−2015). A total of 1825 postmenopausal women, aged 50−64 years old, were included in the final analysis. The frequency of cow’s milk consumption for each subject was determined using the semi-quantitative food frequency questionnaire, and was classified into four groups (Q1−Q4): Q1, group that did not drink milk (no milk, n = 666); Q2, 0 < frequency of milk intake per week ≤ 1 (n = 453); Q3, 1 < frequency of milk intake per week ≤ 3 (n = 319); and Q4, frequency of milk intake >3 times per week (n = 387). General characteristics, such as education, living area, household income, and obesity level, were compared between the four groups. Percentages of daily nutrient intake compared to the dietary reference intake for Koreans (KDRIs) were determined, and the Framingham Risk Score (FRS), atherogenic index (AI), and atherogenic index of plasma (AIP) were determined as the CHD risk indicators. Except household income, no significant difference was obtained among the four groups with respect to age, education, living area, or obesity. Compared to KDRIs, the intake ratio of calcium, phosphorus, and riboflavin were significantly higher in the Q4 group than in the Q1−Q3 groups. Blood HDL-cholesterol was significantly higher in Q4 than in Q1. The CHD risk factors FRS (%), AI, and AIP were significantly lower in the Q4 group as compared to the other groups (CHD risk (%): Q1 9.4, Q4 8.5; AI: Q1 3.06, Q4 2.83; API: Q1 0.37, Q2 0.31, Q4 0.32). FRS was determined to be significantly and positively correlated to AI or AIP, and negatively correlated with the cow’s milk intake frequency and calcium intake. In conclusion, compared to women who do not consume cow’s milk, postmenopausal women who consume cow’s milk frequently have a better nutritional status of calcium, phosphorus, and vitamin B12, higher HDL levels, and a lower level of CHD risk indicators, such as FRS, AI, and AIP, contributing to decreased CHD risk in a 10-year period. Therefore, to prevent the risk of CHD in postmenopausal women, there needs to be a greater emphasis for cow’s milk consumption four or more times per week.

Association Between Dietary Patterns and Dyslipidemia in Korean Women

Background:

The prevalence of dyslipidemia among Korean women differs significantly according to menopausal status. This study aimed to identify major dietary patterns among Korean women and examine their associations with the prevalence of dyslipidemia and its components.

Methods:

This study recruited 6,166 women from the Cancer Screenee Cohort 2007–2019 from the National Cancer Center of Korea. Dietary patterns were identified using factor analysis. Multivariable logistic regression was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between dietary patterns and the prevalence of dyslipidemia and its components, including hypercholesterolemia, hypertriglyceridemia, hypo-high-density lipoprotein (HDL) cholesterol, and hyper-low-density lipoprotein (LDL) cholesterol. Stratification analyses were performed for the premenopausal and postmenopausal subgroups.

Results:

The factor analysis identified three main dietary patterns, including traditional, western, and prudent dietary patterns. Compared with those with the lowest pattern scores, those with the highest pattern scores of the traditional (OR = 1.32, 95% CI = 1.05–1.67) and western (OR = 1.40, 95% CI = 1.11–1.78) diets had a higher prevalence of hyper-LDL cholesterol. When accounting for menopausal status in the analysis, traditional (OR = 1.44, 95% CI = 1.10–1.89) and western (OR = 1.43, 95% CI = 1.09–1.88) diets were still associated with hyper-LDL cholesterol in postmenopausal women. Additionally, consumption of a traditional diet was associated with a decreased prevalence of hypertriglyceridemia (OR = 0.73, 95% CI = 0.54–0.99), and consumption of a western diet was associated with an increased prevalence of hypercholesterolemia (OR = 1.41, 95% CI = 1.11–1.79) but a reduced prevalence of hypo-HDL cholesterol (OR = 0.60, 95% CI = 0.36–0.99). However, the prudent dietary pattern was not significantly associated with dyslipidemia and its components in the group of all women or the subgroups according to menopausal status.

Conclusion:

There were significant associations between the traditional and western dietary patterns and hyper-LDL cholesterol in the entire group and postmenopausal subgroup of women. In the perspective of energy restriction, our findings recommend women not to eat either traditional or western diets excessively or too frequently. Menopause may induce the effect of both the traditional diet on triglyceride reduction and the western diet on increasing total cholesterol.

Macronutrient Intake in Adults Diagnosed with Metabolic Syndrome: Using the Health Examinee (HEXA) Cohort

Macronutrient intake is important in the prevention and management of metabolic syndrome (MetS). This study aimed to evaluate total energy and macronutrient intake of participants diagnosed with MetS at recruitment of the health examinees (HEXA) cohort, considering the plant and animal sources of each macronutrient. We included 130,423 participants aged 40-69 years for analysis. Odds ratios (OR) and 95% confidence intervals (CI) were estimated to evaluate the intake of macronutrients stratified by gender. Energy and macronutrient intake were estimated by linking food frequency questionnaire data to the Korean food composition database, and were calculated separately for plant and animal foods. Low energy (men: OR = 0.95, 95% CI: 0.92-0.98; women: OR = 0.97, 95% CI: 0.95-0.99), and fat intake (men: OR = 0.93, 95% CI: 0.90-0.96; women: OR = 0.80, 95% CI: 0.77-0.83) were observed. Only postmenopausal women had lower intake of total energy (OR = 0.95, 95% CI: 0.92-0.97), whereas low fat intake was observed in all women (OR = 0.80, 95% CI: 0.77-0.83). For carbohydrate intake, the OR were 1.14 (95% CI: 1.08-1.22) and 1.17 (95% CI: 1.08-1.27) among women in their 50s and 60s, respectively. Protein intake was low (OR = 0.90, 95% CI: 0.86-0.95; and OR = 0.88, 95% CI: 0.82-0.94) among women in their 50s and 60s, respectively. High intake of plant carbohydrates in women (OR = 1.16, 95% CI: 1.12-1.20), and plant protein in both genders (OR = 1.09, 95% CI: 1.05-1.13) were observed, but low intake of total energy, fat, and animal-source carbohydrates in both genders was also observed. Fat intake was low regardless of food source. In conclusion, high consumption of plant-source macronutrients, and low consumption of animal-source macronutrients was observed in Korean adults diagnosed with MetS. Attention should be directed to plant sources of carbohydrates and proteins when designing population interventions for metabolic syndrome reduction in Korea.

Dairy Consumption and Risk of Metabolic Syndrome: Results from Korean Population and Meta-Analysis

Dairy consumption has been associated with decreased risk of metabolic syndrome (MetS) in previous studies, but the association may be different according to each type of dairy products and its subgroups. Thus, we conducted an updated meta-analysis of observational studies to examine the association between various dairy products and risk of MetS. The PubMed and Web of Science databases were searched for eligible studies published up to February 2021. In addition, we included unpublished results from Korea National Health and Nutrition Examination Survey, 2013-2018, including 23,319 Korean adults and the elderly. A total of 35 studies (12 cohort studies and 25 cross-sectional studies) with 398,877 subjects were included in the meta-analysis. The pooled relative risks (RR) of MetS for the highest versus lowest categories of dairy consumption was 0.80 [95% confidence interval (CI): 0.72-0.88]. For the type of dairy products, there were also significant inverse associations with milk (RR: 0.83; 95% CI: 0.78-0.89) and yogurt consumption (RR: 0.89; 95% CI: 0.83-0.95). For cheese consumption, however, no significant association was found (RR: 0.98; 95% CI: 0.86-1.11). Our findings suggest that milk and yogurt consumption is inversely associated with the risk of MetS, but not cheese consumption.

Dairy Consumption and Risk of Metabolic Syndrome in Korean Adults and Elderly People

Background: To investigate the association of dairy consumption with metabolic syndrome (MetS) in a representative sample of Korean adult and elderly population. Methods: We used data from the Korea National Health and Nutrition Examination Survey, 2013-2018. A total of 18,206 adults (19-64 years) and 5113 elderly people (≥65 years) were included in the analysis. Dairy product consumption was assessed with a 24-hr dietary recall, and the subjects were divided into three groups based on their total dairy consumption (0, <1, ≥1 serving/day). The primary outcome, MetS, was defined according to the National Cholesterol Education Program Adult Treatment Panel III and the Korean Society for the Study of Obesity. Results: After adjusting for covariates, high dairy consumption was associated with 12% lower odds of MetS in adults compared with no dairy consumption [odds ratio (OR) 0.88, 95% confidence interval (CI) 0.78-0.998, P for trend = 0.048]. A similar inverse association was found in adult men (OR 0.84, 95% CI 0.71-0.99), but no significant association was found in adult women (OR 0.93, 95% CI 0.78-1.11). For the elderly, high dairy consumption was associated with 20% lower odds of MetS (OR 0.80, 95% CI 0.65-0.98, P for trend = 0.020); a significant inverse association was shown in elderly women (OR 0.72, 95% CI 0.56-0.94) but not in elderly men (OR 0.93, 95% CI 0.68-1.28). Conclusion: Our findings suggest that one or more servings/day of dairy products were associated with lower prevalence of MetS in Korean adult men and elderly women.

Alleviation of Metabolic Endotoxemia by Milk Fat Globule Membrane: Rationale, Design, and Methods of a Double-Blind, Randomized, Controlled, Crossover Dietary Intervention in Adults with Metabolic Syndrome

BACKGROUND

Milk fat globule membrane (MFGM) is a phospholipid-rich component of dairy fat that might explain the benefits of full-fat dairy products on cardiometabolic risk. Preclinical studies support that MFGM decreases gut permeability, which could attenuate gut-derived endotoxin translocation and consequent inflammatory responses that impair cardiometabolic health.

OBJECTIVES

To describe the rationale, study design, and planned outcomes that will evaluate the efficacy of MFGM-enriched milk compared with a comparator beverage on health-promoting gut barrier functions in persons with metabolic syndrome (MetS).

METHODS

We plan a double-blind, randomized, crossover trial in which people with MetS will receive a rigorously controlled eucaloric diet for 2 wk that contains 3 daily servings of an MFGM-enriched bovine milk beverage or a comparator beverage that is formulated with nonfat dairy powder, coconut and palm oils, and soy phospholipids. Compliance will be monitored by assessing urinary para-aminobenzoic acid that is added to all test beverages. After the intervention, participants will ingest a high-fat/high-carbohydrate meal challenge to assess metabolic excursions at 30-min intervals for 3 h. Nondigestible sugar probes also will be ingested prior to collecting 24-h urine to assess region-specific gut permeability. Intervention efficacy will be determined based on circulating endotoxin (primary outcome) and glycemia (secondary outcome). Tertiary outcomes include: gut and systemic inflammatory responses, microbiota composition and SCFAs, gut permeability, and circulating insulin and incretins.

EXPECTED RESULTS

MFGM is expected to decrease circulating endotoxin and glycemia without altering body mass. These improvements are anticipated to be accompanied by decreased gut permeability, decreased intestinal and circulating biomarkers of inflammation, increased circulating incretins, and beneficial antimicrobial and prebiotic effects in the gut microbiome.

CONCLUSIONS

Demonstration of improvements in gut barrier functions that limit endotoxemia and glycemia could help to establish direct evidence that full-fat dairy lowers cardiometabolic risk, especially in people with MetS.The clinical trial associated with this article has been registered at clinicaltrials.gov (NCT03860584).

Traditional plain yogurt: a therapeutic food for metabolic syndrome?

Dairy products have an important role in a healthy diet due to their high-quality protein and rich micronutrients. Yogurt, a fermented milk product, has a similar composition to milk but is a more concentrated product in terms of group B vitamins, minerals, and proteins. It is known that bioactive metabolites and live enzymes that occur by fermentation and digestion, affect the health positively by improving gut microbiota. In recent years, the prevalence of metabolic syndrome, which threatens public health, is increasing rapidly. As with other noninfectious diseases, the diet has an important effect on the prevention and treatment of metabolic syndrome. It has been demonstrated that yogurt has a high-quality amino acid pattern, reduces energy intake by stimulating satiety, and regulates blood glucose level. In addition to the rich protein variety, yogurt also contains peptides that positively affect blood pressure. Unlike milk, increased acidity during the fermentation of yogurt positively affects calcium absorption. Calcium plays an important role in the control of blood glucose and energy metabolism through insulin-dependent and non-insulin-dependent routes. In addition to reducing inflammation, calcium has a positive effect on the regulation of the blood lipid profile by increasing fecal fat excretion. There are many lipid and lipoid nutrients such as saturated fatty acids, phospholipids, sphingolipids, and conjugated linoleic acid that may affect the blood lipid profile in yogurt positively or negatively. There are seen very few randomized controlled studies that are focused on the relationship between yogurt and metabolic syndrome, and these are based on contradictory results. In this review, based on the clinical studies conducted to date, and the nutrient content of yogurt, possible mechanisms of these contradictory results are investigated.

The association between milk consumption and the metabolic syndrome: a cross-sectional study of the residents of Suzhou, China and a meta-analysis

The association between milk consumption and the metabolic syndrome remains inconclusive, and data from Chinese populations are scarce. We conducted a cross-sectional study to investigate the association between milk consumption and the metabolic syndrome and its components among the residents of Suzhou Industrial Park, Suzhou, China. A total of 5149 participants were included in the final analysis. A logistic regression model was applied to estimate the OR and 95 % CI for the prevalence of the metabolic syndrome and its components according to milk consumption. In addition, the results of our study were further meta-analysed with other published observational studies to quantify the association between the highest v. lowest categories of milk consumption and the metabolic syndrome and its components. There was no significant difference in the odds of having the metabolic syndrome between milk consumers and non-milk consumers (OR 0·86, 95 % CI 0·73, 1·01). However, milk consumers had lower odds of having elevated waist circumference (OR 0·78, 95 % CI 0·67, 0·92), elevated TAG (OR 0·83, 95 % CI 0·70, 0·99) and elevated blood pressure (OR 0·85, 95 % CI 0·73, 0·99). When the results were pooled together with other published studies, higher milk consumption was inversely associated with the risk of the metabolic syndrome (relative risk 0·80, 95 % CI 0·72, 0·88) and its components (except elevated fasting blood glucose); however, these results should be treated with caution as high heterogeneity was observed. In summary, the currently available evidence from observational studies suggests that higher milk consumption may be inversely associated with the metabolic syndrome.

Associations of Dietary Intake with Cardiovascular Disease, Blood Pressure, and Lipid Profile in the Korean Population: a Systematic Review and Meta-Analysis

OBJECTIVE

Previous studies have separately reported the contributions of dietary factors to the risk of cardiovascular disease (CVD) and its markers, including blood pressure (BP) and lipid profile. This study systematically reviewed the current evidence on this issue in the Korean population.

METHODS

Sixty-two studies from PubMed and Embase were included in this meta-analysis. We performed a random-effects model to analyze pooled odds ratios (ORs) and hazard ratios (HRs) and their 95% confidence intervals (CIs) for the consumption of 14 food items, three macro- and eight micro-nutrients, two dietary patterns, and three dietary indices.

RESULTS

An analysis of pooled effect sizes from at least four individual study populations showed significant associations between coffee consumption and CVD (OR/HR, 0.71; 95% CI, 0.52-0.97) and elevated/high triglycerides (TG) (OR, 0.84; 95% CI, 0.78-0.90), sugar-sweetened beverage intake and elevated BP (OR/HR, 1.20; 95% CI, 1.09-1.33), and milk and dairy intake and elevated/high TG and low high-density lipoprotein cholesterol (HDL-C) (OR/HR, 0.82; 95% CI, 0.76-0.89 for both). Carbohydrate consumption and the low-carbohydrate-diet score were consistently related to an approximately 25% risk reduction for elevated TG and low HDL-C. A lower risk of elevated total cholesterol, but not low-density lipoprotein, was additionally observed for those with a higher low-carbohydrate-diet score. A healthy dietary pattern was only associated with a reduced risk of elevated TG in the Korea National Cancer Screenee Cohort (OR, 0.81; 95% CI, 0.67-0.98).

CONCLUSION

This study showed that milk and dairy and coffee had protective effects for CVD and its risk factors, such as BP and lipid profile, while sugar-sweetened beverages exerted harmful effects.

Dairy Product Consumption in the Prevention of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Previous meta-analyses have associated dairy products with a lower risk of metabolic syndrome (MetS). Since then, new studies evaluating not only total dairy but also different subtypes have been published in this field. The objective of the present work was to systematically review and meta-analyze the epidemiologic studies regarding the associations between the consumption of total dairy products and subtypes (milk, yogurt, and cheese) and the incidence of MetS. Relevant studies were identified through Medline and Cochrane databases. Eligible studies were prospective cohort studies that examined the association between dairy product consumption and/or different subtypes of dairy and the risk of MetS. Random-effects or fixed-effects models were assigned to calculate the pooled RR estimates with 95% CIs. From the 2994 identified articles, 12 and 11 studies were included for the qualitative and quantitative synthesis, respectively. After comparing the highest with the lowest categories, total dairy product consumption was inversely associated with the risk of MetS (9 study comparisons; RR: 0.73; 95% CI: 0.64, 0.83). Low-fat dairy and total yogurt consumption were inversely associated with the risk of MetS (low-fat dairy: 2 study comparisons; RR: 0.77; 95% CI: 0.65, 0.91; total yogurt consumption: 4 study comparisons; RR: 0.74; 95% CI: 0.66, 0.82). The linear RR per 1 serving of yogurt/d was 0.77 (95% CI: 0.60, 1.00). Low-fat yogurt and whole-fat yogurt were inversely associated with the risk of MetS (low-fat yogurt: 2 study comparisons; RR: 0.72; 95% CI: 0.62, 0.84; whole-fat yogurt: 2 study comparisons; RR: 0.81; 95% CI: 0.70, 0.94). Total milk consumption was inversely associated with the risk of MetS (6 study comparisons; RR: 0.79; 95% CI: 0.64, 0.97). Whole-fat dairy consumption was not associated with MetS risk. Our findings suggest that the consumption of total and low-fat dairy products, milk, and yogurt is inversely associated with the risk of MetS. The study protocol is available at https://www.crd.york.ac.uk/PROSPERO/ as CRD42018082480.

Dairy product consumption and its association with metabolic disturbance in a prospective study of urban adults

The role of dairy foods and related nutrients in cardiometabolic health aetiology is poorly understood. We investigated longitudinal associations between the metabolic syndrome (MetS) and its components with key dairy product exposures. We used prospective data from a bi-racial cohort of urban adults (30-64 years at baseline (n 1371)), the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS), in Baltimore City, MD (2004-2013). The average of two 24-h dietary recalls measured 4-10 d apart was computed at baseline (V1) and follow-up (V2) waves. Annual rates of change (Δ) in dairy foods and key nutrients were estimated. Incident obesity, central obesity and the MetS were determined. Among key findings, in the overall urban adult population, both cheese and yogurt (V1 and Δ) were associated with an increased risk of central obesity (hazard ratio (HR) 1·13; 95 % CI 1·05, 1·23 per oz equivalent of cheese (V1); HR 1·21; 95 % CI 1·01, 1·44 per fl oz equivalent of yogurt (V1)]. Baseline fluid milk intake (V1 in cup equivalents) was inversely related to the MetS (HR 0·86; 95 % CI 0·78, 0·94), specifically to dyslipidaemia-TAG (HR 0·89; 95 % CI 0·81, 0·99), although it was directly associated with dyslipidaemia-HDL-cholesterol (HR 1·10; 95 % CI 1·01, 1·21). Furthermore, ΔCa and ΔP were inversely related to dyslipidaemia-HDL and MetS incidence, respectively, whereas Δdairy product fat was positively associated with incident TAG-dyslipidaemia and HDL-cholesterol-dyslipidaemia and the MetS. A few of those associations were sex and race specific. In sum, various dairy product exposures had differential associations with metabolic disturbances. Future intervention studies should uncover how changes in dairy product components over time may affect metabolic disorders.

Dairy food consumption is associated with a lower risk of the metabolic syndrome and its components: a systematic review and meta-analysis

A systematic review and a meta-analysis of observational studies were performed to assess the dose–response relationship between specific types of dairy foods and the risk of the metabolic syndrome (MetS) and its components. Studies of dairy foods and the risk of the MetS and its components published up to June 2016 were searched using PubMed, EMBASE and a reference search. Random-effects models were used to estimate the pooled relative risks (RR) with 95 % CI. Finally, ten cross-sectional studies, two nested case–control studies and twenty-nine cohort studies were included for the analysis. In a dose–response analysis of cohort studies and cross-sectional studies, the pooled RR of the MetS for a one-serving/d increment of total dairy food (nine studies) and milk (six studies) consumption (200 g/d) were 0·91 (95 % CI 0·85, 0·96) and 0·87 (95 % CI 0·79, 0·95), respectively. The pooled RR of the MetS for yogurt (three studies) consumption (100 g/d) was 0·82 (95 % CI 0·73, 0·91). Total dairy food consumption was associated with lower risk of MetS components, such as hyperglycaemia, elevated blood pressure, hypertriacylglycerolaemia and low HDL- cholesterol. A one-serving/d increment of milk was related to a 12 % lower risk of abdominal obesity, and a one-serving/d increment of yogurt was associated with a 16 % lower risk of hyperglycaemia. These associations were not significantly different by study design, study location or adjustment factors. This meta-analysis showed that specific types of dairy food consumption such as milk and yogurt as well as total dairy food consumption were inversely related to risk of the MetS and its components.

Association between Milk Consumption and Metabolic Syndrome among Korean Adults: Results from the Health Examinees Study

It has been suggested that a greater dairy consumption, particularly of milk, may have contributed in lowering the prevalence of metabolic syndrome (MetS). A cross-sectional analysis was conducted to examine the association between milk consumption and MetS, and its components among Korean adults aged 40–69. A total of 130,420 subjects (43,682 men and 86,738 women) from the Health Examinees Study were selected for the final analysis. Milk consumption was estimated using a validated 106-item food frequency questionnaire. MetS was defined using the National Cholesterol Education Program, Adult Treatment Panel III (NCEP III). Logistic regression analyses were performed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) between milk consumption and MetS after adjusting for potential confounders. In this study, the average milk consumption was 77.9 g/day, with the overall prevalence of MetS being 26.1% (29.1% in men and 24.6% in women). We found that the prevalence of the MetS was significantly lower in subjects with higher milk consumption (p < 0.0001). Adjusted OR for MetS was significantly lower in the highest milk consumption category (≥1 serving/day among men; ≥2 serving/day among women) than those in the lowest milk consumption category (OR: 0.92 95%CI: 0.86–0.99, p trend = 0.0160 in men; OR: 0.68, 95%CI: 0.60–0.76, p trend < 0.0001 in women). Overall, higher milk consumption was inversely associated with the MetS components: elevated waist circumference, elevated triglyceride, and reduced high-density lipoprotein cholesterol (HDL-C) (all p trend < 0.05). This study concludes that higher milk consumption is associated with the lower odds of MetS in Korean adults.

Biomarkers of the metabolic syndrome: Influence of minerals, oligo- and trace elements

Influences of minerals, oligo- and trace elements on the concentration of biomarkers of the metabolic syndrome (MetS) are reviewed. Since food is a complex mixture of caloric compounds and essential non-caloric food components with multiple interactions and varying bioavailability, it is hard to separate or identify the effect of one single component in a total meal or diet. Moreover the diet contains various non-nutritive biologically active components, which may add some beneficial characteristics. Therefore, conclusions on the effect of components on various biomarkers of MetS are sometimes quite contradictory. Reasons therefore are mentioned. Literature data should be studied in detail to conclude whether a component is related to a reduction of MetS-related symptoms or whether its influence is merely affecting a biomarker.

Breakfast quality and cardiometabolic risk profiles in an upper middle-aged German population

Background/Objectives:

Little is known about relation of overall breakfast quality with cardiometabolic risk factors. Therefore, this study aimed to explore sex-specific associations between breakfast quality and cardiometabolic risk profiles in a sample of an upper middle-aged German population.

Subjects/Methods:

Cardiometabolic profiles of 339 men and 329 women were cross-sectionally assessed using an overall biomarker score (BScore), glycated hemoglobin (HbA1_c), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), blood pressure, body mass index (BMI) and waist circumference (WC). Overall breakfast quality was assessed by using (i) an a-priori defined breakfast quality score (BQS) and (ii) data-driven breakfast patterns based on principal component analysis (PCA). Multiple linear regression models for association of breakfast quality with all outcomes were adjusted for all potential confounders including overall diet quality.

Results:

After adjustment for all potential confounders the BQS was inversely associated with the BScore (regression beta with 95% Confidence Interval: −0.29 (052−0.06)) and HbA1c (−0.12 (−0.21, −0.04)) in men; whereas no such associations were observed in women. Four breakfast (B) patterns were identified: B-processed-food pattern, B-cereal pattern, B-high fat pattern and B-dairy & cereal pattern. The B-processed-food pattern was positively associated with HbA1c (0.09(0.01, 0.18)), BMI (0.16 (0.06, 0.26)), and WC (0.17 (0.8, 0.26)) in men, and BMI (0.13 (0.1, 0.25)) and WC (0.11(0.01.0.22)) in women. The B-cereal pattern was inversely associated with BScore (−0.23 (−0.45, −0.01)) and BMI (-0.11 (−0.20, −0.01)) in men and WC(−0.16 (−0.27, −0.05)) in women. The B-dairy & cereal pattern was also inversely associated with BScore (−0.26 (−0.48, −0.04)) in men but not in women.

Conclusions:

The overall breakfast quality was cross-sectionally associated with a healthier cardiometabolic profile, especially in upper-middle age men, independent of overall dietary quality. Such analyses should be supplemented by studies investigating the circadian sequence of food intake and metabolic consequences including hard disease endpoints.

The effects of probiotic supplement on hemoglobin in chronic renal failure patients under hemodialysis: A randomized clinical trial

Background:

Chronic inflammation is one of the causes of anemia in chronic renal failure patients under hemodialysis. Probiotics probably establish a balance between pro- and anti-inflammatory cytokines. The study was conducted to determine the effects of probiotic supplementation on hemoglobin (Hb) in hemodialysis patients.

Materials and Methods:

A parallel clinical trial was conducted in which patients were randomly allocated into two groups. The intervention group (n = 18) was given a 500 mg probiotic supplement (a capsule) every day whereas the control group (n = 18) received placebo (a capsule), both for 3 months. Hb levels and C-reactive protein (CRP) levels were measured for three periods. The data were analyzed in SPSS-16 using statistical tests including the t-test and repeated-measures ANOVA.

Results:

In the probiotic supplementation group, the mean Hb was 9.22 ± 1.04 mg/dl before the intervention and reached 10.85 ± 1.177 mg/dl afterward, while in the placebo group, the mean Hb level was 9.38 ± 0.97 mg/dl before the intervention and reached 10.03 ± 1.97 mg/dl afterward (P > 0.05). During the study, the placebo caused to increase of Hb temporary, but in longer term, the effect of probiotic was more manifested. Hb levels increased in both groups although the change was not statistically significant (P > 0.05). The findings showed no significant differences between the two groups in either the pre- or post-intervention CRP levels (P = 0.239).

Conclusion:

Probiotic supplementation decreased Hb fluctuations in hemodialysis patients but did not result in a significant increase in Hb levels. Similar studies are therefore recommended to be conducted with a prolonged duration of the study or an increased probiotic dose with larger sample size to complete the results of the present study.

Relationship between dietary factors and the number of altered metabolic syndrome components in Chinese adults: a cross-sectional study using data from the China Health and Nutrition Survey

OBJECTIVES

To study the correlation between dietary factors and the number of altered metabolic syndrome components (MetS) in Chinese adults systematically.

SETTING

A cross-sectional study using demographic and dietary data of adults aged 18-75 years from the China Health and Nutrition Survey (2009) was conducted in nine provinces in China.

PARTICIPANTS

There were 6034 eligible subjects (2800 men and 3234 women) in this study.

OUTCOMES

The primary outcome of this study were diet assessments and the number of altered MetS components. Dietary intake was measured using a combination of a 3-day period with 24-hour and household food inventory; average daily intakes of nutrients were estimated according to the Chinese Food Composition Table. Blood samples were analysed in a national central laboratory and the number of clustering MetS components was calculated by adding the presence of each MetS component.

RESULTS

After adjusting for covariates, and taking zero MetS as comparison, the high risk factors correlating with increased numbers of altered MetS components in men were higher intake of protein (70.4-73.4 g; Ptrend=0.0004), cholesterol (238.7-266.6 mg; Ptrend=0.004), meat (90.6-105.7 g; Ptrend=0.016), fish/seafood (30.4-42.3 g; Ptrend=0.001), and lower intake of coarse cereals (16.5-12.7 g; Ptrend=0.051), tubers (37.3-32.7 g; Ptrend=0.030), and dietary fibre (11.7-11.5 g; ANCOVA p=0.058). Meanwhile, the high risk factors correlating with the increased number of altered MetS components in women were higher intake of wheat (101.9-112.6 g; Ptrend=0.066) and sodium (3862.3-4005.7 mg, Ptrend=0.032), and lower intake of β-carotene (1578.6-1382.7 µg; Ptrend=0.007), milk, and dairy products (17.8-11.5 g; Ptrend=0.002).

CONCLUSIONS

Some foods and nutritional factors correlate with an increased number of altered MetS components in Chinese adults. More prospective, multicentre and clinical research work to further examine these associations is underway.

Parathyroid hormone and vitamin D are associated with the risk of metabolic obesity in a middle-aged and older Korean population with preserved renal function: A cross-sectional study

BACKGROUND

In general, obesity is a major contributor to metabolic syndrome (MetS) and is associated with insulin resistance (IR). Metabolically obese but normal weight (MONW) individuals present metabolic abnormalities and features of MetS despite having a normal range of body mass index (BMI). In recent years, different subtypes of obesity have been introduced, including metabolically healthy obese (MHO) and metabolically obese obese (MOO). Also, it has been reported that vitamin D and parathyroid hormone (PTH) are possibly linked with MetS.

METHODS AND FINDINGS

In this study, we aimed to evaluate the association between serum 25(OH)D, serum PTH, and the risk of metabolic obesity in four subtypes using nationally representative survey data for a Korean population conducted between 2008 and 2010. Of the 29,235 Korean participants, 18,997 subjects aged under 50 years were excluded. Participants with diabetes (n = 1,520), renal insufficiency (glomerular filtration rate [GFR] < 45 ml/min/1.73 m2, chronic kidney disease [CKD] stage 3b, 4, and 5 according to KDOQI classification [1]) (n = 49), history of treatment for osteoporosis (n = 455), insufficient data (n = 1,613), and fasting time less than 8 hours prior to blood collection (n = 771) were excluded for analysis. Ultimately, 5,830 adults (2,582 men and 3,248 women) were eligible for the present study. And, subtypes of obesity were divided into four types: Metabolically healthy normal weight (MHNW), Metabolically healthy obese (MHO), Metabolically obese but normal weight (MONW), and Metabolically obese obese (MOO). Female subjects with metabolic obesity were more likely to have higher levels of PTH and Male subjects with metabolic health were more likely to have higher serum 25(OH)D levels.

CONCLUSION

We concluded that a positive association between serum PTH concentration and metabolic obesity among female subjects and an inverse relationship between serum 25(OH)D levels and the risk of metabolic obesity were found among male subjects. Further prospective studies are necessary to explore the biological mechanisms underlying these sex-specific findings.

Yogurt consumption is associated with a better lifestyle in Brazilian population

BACKGROUND

The importance of dairy products is recognized for their health benefits. However, additional investigation is required to understand the characteristics of the lifestyle of people who incorporate yogurt into their eating routine. Then, the aim of this study was to compare the lifestyle of yogurt consumers and non-consumers.

METHODS

A total of 2610 individuals between the ages of 18 and 59 years were recruited and selected for the study, having as the primary criterion the report of frequency of yogurt consumption. Two study groups were formed: consumers (frequency of yogurt consumption ≥ four times a week during the last year) and non-consumers (consumption frequency of less than once a week), paired for age, sex, and socioeconomic class. A structured questionnaire was applied to obtain the data regarding anthropometric characteristics (weight, height, and waist circumference), lifestyle (food consumption, physical activity, smoking, and alcohol consumption), socioeconomic information (relationship status, level of education, and work) and presence of morbidities. Based on the quantity of consumption in grams/day of yogurt and milk, cheeses, and fruit smoothies, four other analysis groups were formed: LOW-Y/LOW-D (low consumption of yogurt and other dairy products); LOW-Y/HIGH-D (low consumption of yogurt and high consumption of other dairy products); HIGH Y/LOW-D (high consumption of yogurt and low consumption of other dairy products); and HIGH-Y/HIGH-D (high consumption of yogurt and other dairy products). Chi-squared and Student's t tests were used to assess the relationships of these factors.

RESULTS

The yogurt consumers had a higher educational level (≥8 years: 83.8% vs. 79.9%), a higher frequency of individuals working and/or currently studying (67.7% vs. 65.5%), were more physically active at leisure time (17.2% vs. 14.3%), had reduced alcohol intake (3.6 g/day vs. 6.4 g/day) and a lower frequency of smoking (21.7% vs. 25.5%) compared to non-consumers (p < 0.05). Besides, individuals included in the Groups HIGH-Y/LOW-D and HIGH-Y/HIGH-D, when compared to those included in the Group LOW-Y/LOW-D, presented a significantly greater intake of calcium, vitamin D, phosphorus, and saturated fat.

CONCLUSIONS

This research demonstrated an association between consumption of yogurt and a better lifestyle.

Diet diversity and nutritional status among adults in southwest China

BACKGROUND

With rapid urbanization in the past decades, diet diversity continues to increase in China. The present cross-sectional study aims to explore the association between dietary diversity and nutritional status among adults in southwest China.

METHODS

This study used data from 2011-2012 National Nutritional Survey in Yunnan Province, southwest China (N = 1105).Data of three consecutive 24-hour dietary recalls were used to calculate dietary diversity scores (DDS) and nutrient adequacy ratio (NAR). Body mass index and waist circumference were used to determine nutritional status. Surveylogistic procedure of SAS 9.2 software was used to examine the association between DDS and obesity by estimating odds ratio (OR) and 95% confidence intervals (CI).

RESULTS

The mean DDS was 5.2 (SD 1.1) out of nine points. Being female, younger age, belonging to Han ethnicity, having higher educational level and household income were positively associated with DDS (all P<0.05). As DDS increased, consumption also increased in most food groups except grains and vegetables. People with medium and high DDS (DDS = 5 and DDS ≥6, respectively) ingested more energy than the recommended quantity(NAR = 1.1 and 1.2, respectively). However, the intakes of Calcium and Vitamin A were seriously inadequate even for people with high DDS (NAR≤0.5). With potential confounders adjusted, people with medium and high DDS were at higher risk of general and central obesity than people with DDS ≤4 (OR = 1.4-1.9, P<0.01).

CONCLUSIONS

Our data indicated that high DDS was associated with excessive energy intake and obesity among adults in southwest China. Although dietary diversity is widely recommended, public health messages should give less emphasis on dietary diversity.

Dairy consumption is associated with a lower incidence of the metabolic syndrome in middle-aged and older Korean adults: the Korean Genome and Epidemiology Study (KoGES)

This cohort study examined the association between total and individual dairy products and the risk of developing the metabolic syndrome (MetS) and its components in Korean adults from the Korean Genome and Epidemiology Study. We prospectively analysed 5510 participants aged 40-69 years without the MetS at baseline during a 10-year follow-up period. Dairy consumption was assessed with a semi-quantitative FFQ at baseline and after 4 years. The MetS was defined according to the criteria by the National Cholesterol Education Program Adult Treatment Panel III. The Cox's proportional hazard model was used to examine the association between consumption of total dairy products, milk and yogurt in servings per week and the risk of incident MetS or individual components. A total of 2103 subjects developed the MetS (38·2 %) during an average follow-up of 67·4 months (range 17-104 months). Frequent dairy consumption (>7 servings of total dairy and milk/week, ≥4 servings of yogurt/week) was associated with a reduced risk of incident MetS and its components. In the multivariable adjusted model, hazard ratios for the MetS were 0·51 (95 % CI 0·43, 0·61) for total dairy products, 0·50 (95 % CI 0·38, 0·66) for milk and 0·67 (95 % CI 0·57, 0·78) for yogurt in frequent consumers compared with non-consumers. An inverse association between milk/yogurt and low HDL-cholesterol was shown only in women. In conclusion, high consumption of individual dairy products including milk and yogurt as well as total dairy were associated with a reduced risk of incident MetS and individual components in Korean adults.

Dietary Patterns in Relation to General and Central Obesity among Adults in Southwest China

Dietary patterns represent a broader picture of food consumption, and are better correlated with a variety of health outcomes. However, few studies have been conducted to explore the associations between dietary patterns and obesity in Southwest China. Data from the 2010-2012 National Nutrition Survey in the province of Yunnan, Southwest China, were analyzed (n = 1604, aged 18-80 years). Dietary data were collected using the 24 h dietary recall over three consecutive days. Height, weight, and waist circumference were measured following standard methods. Exploratory factor analysis was used to identify dietary patterns. Logistic regression was used to explore the association between dietary patterns and obesity. Three distinct dietary patterns were identified, which were labeled as traditional, modern, and tuber according to their key components. With potential confounders adjusted, adults in the highest quartile of the modern pattern were at higher risk of general and central obesity (odds ratio (OR) 1.95, 95% confidence interval (CI) 1.15-3.48; OR 2.01, 95% CI 1.37-2.93). In contrast, adults in the highest quartile of the tuber pattern were at lower risk of general and central obesity (OR 0.34, 95% CI 0.15-0.61; OR 0.64, 95% CI 0.43-0.95) but at higher risk of underweight (OR 2.57, 95% CI 1.20-6.45). No significant association was found between the traditional pattern and obesity. Moreover, dietary pattern differences occurred due to the differences in socio-demographic characteristics. In conclusion, the modern dietary pattern was positively, and the tuber pattern negatively, associated with general and central obesity among adults in Southwest China.

Dairy food products: good or bad for cardiometabolic disease?

Prevalence of type 2 diabetes mellitus (T2DM) is rapidly increasingly and is a key risk for CVD development, now recognised as the leading cause of death globally. Dietary strategies to reduce CVD development include reduction of saturated fat intake. Milk and dairy products are the largest contributors to dietary saturated fats in the UK and reduced consumption is often recommended as a strategy for risk reduction. However, overall evidence from prospective cohort studies does not confirm a detrimental association between dairy product consumption and CVD risk. The present review critically evaluates the current evidence on the association between milk and dairy products and risk of CVD, T2DM and the metabolic syndrome (collectively, cardiometabolic disease). The effects of total and individual dairy foods on cardiometabolic risk factors and new information on the effects of the food matrix on reducing fat digestion are also reviewed. It is concluded that a policy to lower SFA intake by reducing dairy food consumption to reduce cardiometabolic disease risk is likely to have limited or possibly negative effects. There remain many uncertainties, including differential effects of different dairy products and those of differing fat content. Focused and suitably designed and powered studies are needed to provide clearer evidence not only of the mechanisms involved, but how they may be beneficially influenced during milk production and processing.

Association of dairy products consumption with risk of obesity in children and adults: a meta-analysis of mainly cross-sectional studies

PURPOSE

The association of dairy products consumption with risk of obesity remains controversial. Therefore, we reviewed and quantitatively synthesized the evidence from observational studies with a meta-analysis.

METHODS

A literature search was performed in relevant databases. Random-effects model was used to pool odds ratios with 95% confidence intervals. Dose-response relationship was assessed by restricted cubic spline model.

RESULTS

Seventeen studies for total dairy products and 16 studies for milk with risk of obesity were eligible. The pooled odds ratios (95% confidence intervals) of obesity for the highest versus lowest category of total dairy products consumption were 0.54 (0.38-0.77) in children, 0.75 (0.69-0.81) in adults, and 0.74 (0.68-0.80) for both. Evidence of a nonlinear relationship was found (P_{for nonlinearity} = .009). Milk consumption was also associated with risk of obesity [0.81 (0.75-0.88)] both in children [0.87 (0.80-0.95)] and in adults [0.77 (0.68-0.87)], and a linear relationship (P_{for nonlinearity} = .598) suggested that risk of obesity decreased by 16% [0.84 (0.77-0.92)] for every 200 g/d increment of milk consumption.

CONCLUSIONS

This meta-analysis indicates that dairy products consumption may be associated with a decreased risk of obesity. This association may be of public health significance.

Dairy consumption and risk of metabolic syndrome: a meta-analysis

AIMS

To conduct a systematic review and meta-analysis of epidemiological studies in order to assess quantitatively the effect of dairy consumption on risk of metabolic syndrome.

METHODS

We searched for eligible studies published up to March 2015 through the PubMed and Embase databases and reviewed the references of relevant articles. Random-effects models were used to calculate the pooled relative risks with 95% CIs after adjusting for several confounders.

RESULTS

We identified nine prospective cohort studies including a total of 35 379 subjects and 7322 incident cases of metabolic syndrome, and 12 cross-sectional studies including 37 706 subjects. In the meta-analysis of prospective cohort studies, the pooled relative risk of incidence of metabolic syndrome for the highest vs. the lowest category of dairy consumption was 0.85 (95% CI 0.73-0.98), and for a 1-serving/day increment of dairy consumption, the pooled relative risk was 0.88 (95% CI 0.82-0.95). In the meta-analysis of cross-sectional studies, the pooled relative risk of prevalence of metabolic syndrome for the highest vs. the lowest category of dairy consumption was 0.73 (95% CI 0.63-0.86). The association was not significantly different by geographical region, follow-up time and adjustment factors.

CONCLUSION

Our findings indicate that dairy consumption is inversely associated with the incidence and prevalence of metabolic syndrome. Further well-designed cohort studies and randomized controlled trials are warranted to provide definitive evidence.

Meat and milk intake in the rice-based Korean diet: impact on cancer and metabolic syndrome

Over a few decades, Korean diet has changed from traditional diet, mainly composed of rice and vegetables, to Westernised diet rich, in meat and milk, along with the economic development and globalisation. Increasing prevalence of diet-related chronic diseases such as cancer and metabolic syndrome (MetS) is becoming a heavy burden to society and requires further attention. In this review, the association of meat and milk consumption with cancer and MetS among Koreans was discussed. Previous meta-analyses showed that meat intake was positively associated with increased risk of cancers, especially colon, as well as obesity and type 2 diabetes mellitus, and that the intake of milk and dairy products was negatively associated with colorectal cancer, obesity, and type 2 diabetes mellitus, based on studies conducted mostly in Western countries. In Korea and other Asian countries, the association of meat and milk intake with cancers were inconclusive and varied by types of cancers. Conversely, milk intake was negatively associated with MetS risk as reported in Western countries. The difference in results between Korea and Western countries might come from the differences in dietary patterns and study designs. Most Koreans still maintain traditional dietary pattern, although rapid change towards Westernised diet is underway among the younger age group. Randomised clinical trials or prospective cohort studies with consideration of combined effects of various dietary factors in Korea and other Asian countries are needed to elucidate the impact of meat and milk or related dietary patterns in their diet.

Total and Full-Fat, but Not Low-Fat, Dairy Product Intakes are Inversely Associated with Metabolic Syndrome in Adults

BACKGROUND

Growing evidence suggests that dairy products may have beneficial cardiometabolic effects. The current guidelines, however, limit the intake of full-fat dairy products.

OBJECTIVE

We investigated the association of dairy consumption, types of dairy products, and dairy fat content with metabolic syndrome (MetSyn).

METHODS

We analyzed baseline data of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort study of 15,105 adults aged 35-74 y. We excluded participants with known diabetes, cardiovascular diseases, or other chronic diseases, and those who had extreme values of energy intake, leaving 9835 for analysis. Dairy consumption was assessed by a food-frequency questionnaire. We computed servings per day for total and subgroups of dairy intake. We computed a metabolic risk score (MetScore) as the mean z score of waist circumference, systolic blood pressure, HDL cholesterol (negative z score), fasting triglycerides, and fasting glucose. We performed multivariable linear regression to test the association of servings per day of dairy products with MetScore.

RESULTS

In analyses that adjusted for demographics, menopausal status, family history of diabetes, dietary intake, nondietary lifestyle factors, and body mass index, we observed a graded inverse association for MetScore with total dairy (-0.044 ± 0.01, P = 0.009 for each additional dairy servings per day) and full-fat dairy (-0.126 ± 0.03, P < 0.001) but not with low-fat dairy intake. Associations were no longer present after additional adjustments for dairy-derived saturated fatty acids.

CONCLUSIONS

Total and especially full-fat dairy food intakes are inversely and independently associated with metabolic syndrome in middle-aged and older adults, associations that seem to be mediated by dairy saturated fatty acids. Dietary recommendations to avoid full-fat dairy intake are not supported by our findings.

Association of Serum 25-Hydroxyvitamin D and Parathyroid Hormone With Hypertension in Middle-Aged and Older Korean Adults

BACKGROUND

Previous studies have suggested that serum 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) levels are associated with hypertension. However, the associations have yet to be studied in Koreans. This study explored the relationship among serum 25(OH)D, PTH concentrations, and the presence of hypertension in middle-aged and older Korean adults using the most recent nationally representative survey data.

METHODS

A population-based, cross-sectional study was conducted with data collected from 5,260 Korean adults (aged ≥50 years) who participated in the 2010 and 2011 Korean National Health and Nutrition Examination Surveys. Hypertension was defined as a systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or current use of antihypertensive medication.

RESULTS

The prevalence of hypertension significantly increased according to the quartiles of serum PTH levels (P < 0.0001), but not of serum 25(OH)D levels. In multivariable logistic analysis, the adjusted odds ratios (ORs) for hypertension were significantly higher among participants in the highest quartile than among those in the lowest quartile of serum PTH level, after adjusting for potential confounders (OR = 1.26, 95% confidence interval: 1.02-1.56, P = 0.03). The adjusted ORs for hypertension tended to decrease across the quartiles of serum 25(OH)D level, but the associations were not significant.

CONCLUSION

Serum 25(OH)D was not associated with the presence of hypertension, whereas serum PTH was positively associated, suggesting that serum PTH may be an independent risk factor for hypertension in middle-aged and older Korean adults.

Association between serum 25-hydroxyvitamin D levels and adiposity measurements in the general Korean population

BACKGROUND/OBJECTIVES

Obesity, which is a known risk factor for many chronic diseases, has also been associated with vitamin D deficiency. This study explored the relationship between serum 25-hydroxy-vitamin D [25(OH)D] concentrations and adiposity measures in a general Korean population using the most recent, nationally representative survey data.

SUBJECTS/METHODS

The study sample consisted of 4,771 Korean adults (≥ 19 years) who participated in the fifth Korean National Health and Nutrition Examination Surveys. Serum 25(OH)D was determined by radioimmunoassay. Body mass index (BMI), waist circumference (WC) and total body fat content were measured as adiposity measurements. Total body fat content was measured by dual-energy X-ray absorptiometry.

RESULTS

The serum 25(OH)D level was significantly higher in men than in women. Serum 25(OH)D concentration was positively correlated with energy intake, and it was negatively correlated with total body fat content (P < 0.0001) and percentage body fat (P < 0.0001) after adjustment for age in both sexes, while was inversely correlated with BMI only in women. In multivariable regression analysis, serum 25(OH)D was inversely associated with the total body fat content after adjustment for age, BMI, education, region, smoking, alcohol consumption, physical activity, and energy intake only in men (P = 0.0047). However, the serum 25(OH)D concentration was not associated with WC or BMI, indicators of adiposity after adjustment for potential risk factors.

CONCLUSIONS

Serum 25(OH)D concentration was independently associated with the total body fat content in a general Korean population, but it may be not associated with the indicators for estimating adiposity, such as WC or BMI.

Gender difference on the association between dietary patterns and metabolic syndrome in Korean population

PURPOSE

Dietary patterns are found to be associated with metabolic risk factors. We explored gender difference on the association between dietary patterns and the risk of metabolic syndrome (MetS) in the general Korean population.

METHOD

A total of 13,410 Korean adults (aged ≥19 years, 5384 men and 8026 women) who participated in the fifth KNHANES were studied. Dietary intake was assessed by the 24-h recall method. MetS was defined by the joint interim statement of the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute. Multivariable-adjusted logistic regression analysis was performed to identify the relationship between dietary pattern and MetS and its components by gender.

RESULTS

Three dietary patterns were derived using factor analysis by sex: traditional, Westernized, and healthy. The traditional pattern was positively associated with hypertriglyceridemia (P for trend = 0.0098), low high-density lipoprotein cholesterol (P for trend = 0.0007), elevated blood pressure (P for trend = 0.0328), and MetS (P for trend = 0.0003) in women only after adjusting for age, body mass index, socioeconomic status, and lifestyle factors. In contrast, the healthy pattern (HP) was negatively associated with abdominal obesity (P for trend = 0.0051) in women. For men, the HP was negatively associated with hypertriglyceridemia (P for trend = 0.0025) after adjustment for potential confounders. The Westernized pattern was not associated with MetS or its components in either men or women.

CONCLUSION

There may be gender differences on the relationship between dietary patterns and metabolic risk factors in Korean population.

Protective role of dairy and its constituents on vascular function independent of blood pressure-lowering activities

Greater intakes of dairy are frequently associated with reduced risk of cardiovascular disease. These observational studies have served as the basis for controlled interventions aimed at defining the cardioprotective mechanisms of dairy. Understanding these relationships is of public health importance because most of the US population fails to meet dietary recommendations for dairy, suggesting that many individuals could lower their cardiovascular disease risk by relatively simple dietary modification. Clinical studies investigating the acute ingestion of dairy or its constituents, including short-term (≤2 week) supplementation studies or those assessing postprandial responses, have largely shown benefits on vascular function without concomitant improvements in blood pressure. Chronic interventions have been less conclusive, with some showing benefits and others indicating a lack of improvement in vascular function regardless of blood pressure changes. Vasoprotective activities of dairy are likely mediated through improvements in nitric oxide bioavailability, oxidative stress, inflammation, and insulin resistance. Future controlled studies are needed to determine if these health benefits are mediated directly by dairy or indirectly by displacing other dietary components that otherwise impair vascular health.

The scale of the evidence base on the health effects of conventional yogurt consumption: findings of a scoping review

BACKGROUND

The health effects of conventional yogurt have been investigated for over a century; however, few systematic reviews have been conducted to assess the extent of the health benefits of yogurt.

OBJECTIVE

The aim of this scoping review was to assess the volume of available evidence on the health effects of conventional yogurt.

METHODS

The review was guided by a protocol agreed a priori and informed by an extensive literature search conducted in November 2013. Randomized controlled trials were selected and categorized according to the eligibility criteria established in the protocol.

RESULTS

213 studies were identified as relevant to the scoping question. The number of eligible studies identified for each outcome were: bone health (14 studies), weight management and nutrition related health outcomes (81 studies), metabolic health (6 studies); cardiovascular health (57 studies); gastrointestinal health (24 studies); cancer (39 studies); diabetes (13 studies), Parkinson's disease risk (3 studies), all-cause mortality (3 studies), skin complaints (3 studies), respiratory complaints (3 studies), joint pain/function (2 studies); the remaining 8 studies reported a variety of other outcomes. For studies of a similar design and which assessed the same outcomes in similar population groups, we report the potential for the combining of data across studies in systematic reviews.

CONCLUSIONS

This scoping review has revealed the extensive evidence base for many outcomes which could be the focus of systematic reviews exploring the health effects of conventional yogurt consumption.

Association between fried food consumption and hypertension in Korean adults

The present study explored the relationships between fried food consumption and metabolic risk factors and hypertension in Korean adults. The study was based on the fifth Korean National Health and Nutrition Examination Survey between 2010 and 2011. A total of 9221 Korean adults aged ≥19 years were studied. Fried food consumption was assessed using a validated FFQ. Metabolic risk factors such as waist circumference, fasting plasma glucose (FPG), TAG, HDL-cholesterol and systolic and diastolic blood pressure (SBP and DBP) were measured. Hypertension was defined as SBP≥140 mmHg, DBP≥90 mmHg or current use of antihypertensive medication. Adjusted OR for elevated blood pressure significantly increased in men (OR 1·62; 95 % CI 1·11, 2·37;Ptrend=0·0447) and women (OR 2·20; 95 % CI 1·21, 4·00;Ptrend=0·0403) with a greater than twice a week consumption of fried food compared with those who rarely consumed fried food. However, fried food consumption was not associated with other metabolic risk factors (abdominal obesity, high FPG, hypertriacylglycerolaemia, low HDL-cholesterol and the metabolic syndrome). The adjusted OR for hypertension increased by 2·4-fold in women (OR 2·37; 95 % CI 1·19, 4·72;Ptrend=0·0272) with a greater than twice a week fried food consumption compared with those who rarely consumed it. No significant association was found between fried food consumption and hypertension in men. This study suggests that frequent fried food consumption is associated with hypertension in Korean women. Further studies are needed to investigate the effect of different types of fried foods on hypertension.

Consumption of Yogurt, Low-Fat Milk, and Other Low-Fat Dairy Products Is Associated with Lower Risk of Metabolic Syndrome Incidence in an Elderly Mediterranean Population

BACKGROUND

The association between consumption of dairy products and the risk of developing metabolic syndrome (MetS) is unclear.

OBJECTIVE

The purpose of this study was to evaluate the associations between consumption of dairy products (total and different subtypes) and incident MetS in a Mediterranean population at high cardiovascular disease risk.

METHODS

We prospectively analyzed 1868 men and women (55-80 y old) without MetS at baseline, recruited from different PREDIMED (Prevención con Dieta Mediterránea) centers between October 2003 and June 2009 and followed up until December 2010. MetS was defined according to updated, harmonized criteria. At baseline and yearly thereafter, we determined anthropometric variables, dietary habits by a 137-item validated food-frequency questionnaire, and blood biochemistry. Multivariable-adjusted HRs of MetS or its components were estimated for each of the 2 upper tertiles (vs. the lowest one) of mean consumption of dairy products during the follow-up.

RESULTS

During a median follow-up of 3.2 y, we documented 930 incident MetS cases. In the multivariable-adjusted model, HRs (95% CIs) of MetS for the comparison of extreme tertiles of dairy product consumption were 0.72 (0.61, 0.86) for low-fat dairy, 0.73 (0.62, 0.86) for low-fat yogurt, 0.78 (0.66, 0.92) for whole-fat yogurt, and 0.80 (0.67, 0.95) for low-fat milk. The respective HR for cheese was 1.31 (1.10, 1.56).

CONCLUSIONS

Higher consumption of low-fat dairy products, yogurt (total, low-fat, and whole-fat yogurt) and low-fat milk was associated with a reduced risk of MetS in individuals at high cardiovascular disease risk from a Mediterranean population. Conversely, higher consumption of cheese was related to a higher risk of MetS. This trial was registered at controlled-trials.com as ISRCTN35739639.

Postprandial Plasma Phospholipids in Men Are Influenced by the Source of Dietary Fat

BACKGROUND

Postprandial lipemia represents a risk factor for chronic diseases, including type 2 diabetes. Little is known about the effect of dietary fat on the plasma lipidome in the postprandial period.

OBJECTIVE

The objective of this study was to assess the effect of dairy fat and soy oil on circulating postprandial lipids in men.

METHODS

Men (40-60 y old, nonsmokers; n = 16) were randomly assigned in a crossover design to consume 2 breakfast meals of dairy-based or soy oil-based foods. The changes in the plasma lipidome during the 4-h postprandial period were analyzed with electrospray ionization tandem mass spectrometry and included 316 lipid species in 23 classes and subclasses, representing sphingolipids, phospholipids, glycerolipids, and sterols.

RESULTS

Nonparametric Friedman tests showed significant changes in multiple plasma lipid classes, subclasses, and species in the postprandial period after both dairy and soy meals. No difference was found in triglyceridemia after each meal. However, 6 endogenous lipid classes increased after dairy but decreased after soy (P < 0.05), including ether-linked phospholipids and plasmalogens and sphingomyelin (not present in soy), dihexosylceramide, and GM3 ganglioside. Phosphatidylcholine and phosphatidylinositol were not affected by the soy meal but were significantly elevated after the dairy meal (8.3% and 16%, respectively; P < 0.05).

CONCLUSIONS

The changes in postprandial plasma phospholipids in men relate to the diet composition and the relative size of the endogenous phospholipid pools. Despite similar lipemic responses as measured by changes in triglyceride concentrations, the differential responses to dairy and soy meals derived through lipidomic analysis of phospholipids suggest differences in the metabolism of soybean oil and dairy fat. The increased concentrations of plasmalogens, with potential antioxidant capacity, in the postprandial period after dairy but not soy meals may represent a further important difference in the response to these sources of fat. The trial was registered at www.anzctr.org.au as ACTRN12610000562077.

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.

Dyslipidemia patterns are differentially associated with dietary factors

BACKGROUND AND AIMS

Dyslipidemia, a strong predictor of cardiovascular diseases, is prevalent among Korean adults, but little is known about the associations between overall lipid profiles and dietary factors. We identified dyslipidemia patterns among lipid indicators and examined dietary factors associated with dyslipidemia patterns in Korean adults.

METHODS

Subjects in this cross-sectional study were recruited from the Family Medicine Division or the Health Examination Center of the general hospital in Seoul between 2010 and 2012. Measurements of biochemical and dietary variables repeated three times were collected from a total of 138 subjects at 3- to 4-month intervals when the subjects visited the hospital. Dietary intake data were obtained using 24-h recalls. In order to estimate typical values for biochemical and dietary variables, the averages of repeated measures for each subject were calculated. To identify dyslipidemia patterns, factor analysis was used based on total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), triglycerides (TG), and high-density lipoprotein cholesterol (HDLC).

RESULTS

Two dyslipidemia patterns, (1) TC & LDLC and (2) TG & HDLC, were identified. Dietary fat and cholesterol intakes were positively associated with the TC & LDLC pattern score, but not associated with the TG & HDLC pattern score. The TG & HDLC pattern was significantly associated with low intakes of calcium, potassium, milk and dairy products.

CONCLUSIONS

Two dyslipidemia patterns were associated with dietary factors in Korean adults. Further studies should investigate specific dietary recommendations according to lipid profiles in the prevention and management of dyslipidemia in Korea.

Association between yogurt consumption and the risk of metabolic syndrome over 6 years in the SUN study

BACKGROUND

The role of yogurt consumption in the development of metabolic syndrome (MetS) is not fully understood and the available epidemiologic evidence is scarce. The aim of our study was to assess the association between total, whole-fat, or low-fat yogurt consumption and the risk of developing MetS.

METHODS

Yogurt consumption was assessed at baseline through a 136-item validated FFQ. MetS was defined following the harmonized definition for MetS according to the AHA and the IDF criteria. Logistic regression models were used.

RESULTS

During the first 6-y of follow-up of the SUN cohort, 306 incident cases of MetS were identified. Frequent consumption [≥875 g/week (≥7 servings/week) versus ≤ 250 g/week (2 servings/week)] of total, whole-fat and low-fat yogurt consumption showed non-significant inverse associations with MetS [OR = 0.84 (95% CI: 0.60-1.18); 0.98 (95% CI: 0.68-1.41); and 0.63 (95% CI: 0.39-1.02) respectively]. Only one component of the MetS, central adiposity, was inversely associated with total and whole-fat yogurt consumption [OR = 0.85 (95% CI: 0.74-0.98) and 0.85 (95% CI: 0.73-0.99) respectively]. In the joint assessment of exposure to total yogurt consumption and fruit consumption, those in the highest category of total yogurt consumption, and having a high fruit consumption (above the median ≥264.5 g/day) exhibited a significantly lower risk of developing MetS [OR = 0.61 (95% CI: 0.38-0.99)] compared with those in the lowest category of total yogurt consumption and had fruit consumption below the study median.

CONCLUSION

No significant association between yogurt consumption and MetS was apparent. Only one component out of the 5 MetS criteria, central adiposity, was inversely associated with high yogurt consumption. The combination of high consumption of both yogurt and fruit was inversely associated with the development of MetS.

Dairy consumption is associated with a lower prevalence of metabolic syndrome among young adults from Ribeirão Preto, Brazil

OBJECTIVE

It has been suggested that a greater dairy consumption is a contributing factor to a lower prevalence of metabolic syndrome (MetS) as a result of the possible actions of some milk nutrients. However, results remain controversial. The aim of this study was to examine the association between dairy consumption and MetS and its components.

METHODS

Dairy consumption and biochemical and anthropometric parameters were determined in 2031 young adults ages 23 to 25 y. Food consumption was assessed using a food frequency questionnaire. The estimated habitual portion of dairy products consumed daily was divided into quintiles. The criteria of the International Diabetes Federation (IDF) and of the Joint Interim Statement (JIS) were used for the classification of MetS. Nonadjusted and adjusted odds ratios (ORs) were estimated by logistic regression.

RESULTS

The prevalence of MetS was 11.9% by the IDF criteria and 9% by the JIS criteria. A greater dairy consumption was associated with a lower prevalence of MetS according to both IDF (OR, 0.61; 95% confidence interval [CI], 0.38-0.97) and JIS (OR, 0.62; 95% CI, 0.39-0.98) criteria when the last quintile was compared with the first. The association persisted in the model adjusted for demographic, socioeconomic, dietary, and lifestyle variables according to the IDF (OR, 0.53; 95% CI, 0.30-0.93) and was borderline according to the JIS (OR, 0.59; 95% CI, 0.34-1.00), but lost significance when data were adjusted for calcium in both models.

CONCLUSIONS

A greater dairy consumption is associated with a lower prevalence of MetS, with calcium probably being the nutrient responsible for this association.

Prevalence of and factors associated with albuminuria in the Korean adult population: the 2011 Korea National Health and Nutrition Examination Survey

BACKGROUND

Microalbuminuria is associated with increased risk of renal disease and cardiovascular diseases even in non-diabetic subjects. High incidence rates of microalbuminuria have been found in a number of population-based studies. However, the prevalence and risk factors associated with microalbuminuria in the general population in Korea are unclear.

OBJECTIVES

The present study was performed to estimate the prevalence of microalbuminuria and investigate the associated risk factors in the general adult population using the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-2) data from 2011.

METHODS

A total of 5,202 participants (mean age, 45.6 years; men, 2,337; women, 2,865) were included in the analysis. Microalbuminuria was evaluated in participants of KNHANES V-2 based on the urine albumin-creatinine ratio. Estimated glomerular filtration rate was calculated using the Modification of Diet in Renal Disease study equation.

RESULTS

The weighted prevalence of microalbuminuria was 5.2% (95% CI, 4.4-6.1) in the general population. The prevalence of albuminuria is increased with age. After adjustment for age and sex, the presence of albuminuria was associated with increased waist circumference, systolic and diastolic blood pressure, aspartate aminotransferase, triglyceride, fasting plasma glucose, and the presence of hypertension and diabetes. In logistic regression analyses, older age, female sex, diabetes, hypertension, and serum aspartate aminotransferase were independently associated with the presence of albuminuria.

CONCLUSION

The prevalence of microalbuminuria was found to be 5.2%, and conventional risk factors for cardiovascular diseases are closely related to the presence of microalbuminuria in Korea. Microalbuminuria may be a useful marker to identify individuals with increased risk of cardiovascular disease.

Dairy products and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies

BACKGROUND

The association between intake of dairy products and the risk of type 2 diabetes has been investigated in several studies, but the evidence is not conclusive.

OBJECTIVE

We conducted an updated systematic review and dose-response meta-analysis of dairy product intake and the risk of type 2 diabetes.

DESIGN

We searched the PubMed database for prospective cohort and nested case-control studies of dairy product intake and risk of type 2 diabetes up to 5 June 2013. Summary RRs were estimated by use of a random-effects model.

RESULTS

Seventeen cohort studies were included in the meta-analysis. In the dose-response analysis, the summary RRs (95% CIs) were 0.93 (0.87, 0.99; I(2) = 33%) per 400 g total dairy products/d (n = 12), 0.98 (0.94, 1.03; I(2) = 8%) per 200 g high-fat dairy products/d (n = 9), 0.91 (0.86, 0.96; I(2) = 40%) per 200 g low-fat dairy products/d (n = 9), 0.87 (0.72, 1.04; I(2) = 94%) per 200 g milk/d (n = 7), 0.92 (0.86, 0.99; I(2) = 0%) per 50 g cheese/d (n = 8), and 0.78 (0.60, 1.02; I(2) = 70%) per 200 g yogurt/d (n = 7). Nonlinear inverse associations were observed for total dairy products (P-nonlinearity < 0.0001), low-fat dairy products (P-nonlinearity = 0.06), cheese (P-nonlinearity = 0.05), and yogurt (P-nonlinearity = 0.004), and there was a flattening of the curve at higher intakes.

CONCLUSIONS

This meta-analysis suggests that there is a significant inverse association between intakes of dairy products, low-fat dairy products, and cheese and risk of type 2 diabetes. Any additional studies should assess the association between other specific types of dairy products and the risk of type 2 diabetes and adjust for more confounding factors.

Dietary strategies to reduce metabolic syndrome

Metabolic syndrome (MetS) is a cluster of metabolic abnormalities characterized by central obesity, dyslipidemias, hypertension, high fasting glucose, chronic low-grade inflammation and oxidative stress. This condition has become an increasing problem in our society where about 34 % of adults are diagnosed with MetS. In parallel with the adult situation, a significant number of children present lipid abnormalities and insulin resistance, which can be used as markers of MetS in the pediatric population. Changes in lifestyle including healthy dietary regimens and increased physical activity should be the first lines of therapy to decrease MetS. In this article, we present the most recent information on successful dietary modifications that can reduce the parameters associated with MetS. Successful dietary strategies include energy restriction and weight loss, manipulation of dietary macronutrients--either through restriction of carbohydrates, fat, or enrichment in beneficial fatty acids, incorporation of functional foods and bioactive nutrients, and adherence to dietary and lifestyle patterns such the Mediterranean diet and diet/exercise regimens. Together, the recent findings presented in this review serve as evidence to support the therapeutic treatment of MetS through diet.