Jo Garam, Oh Hannah, Singh Gitanjali M, Park Dahyun, Shin Min-Jeong
Department of Public Health Science, Graduate School, Korea University, Seoul 02841, Korea.
Division of Health Policy and Management, College of Health Science, Korea University, Seoul 02841, Korea.
Nutr Res Pract. 2020 Aug;14(4):384-400. doi: 10.4162/nrp.2020.14.4.384. Epub 2020 May 6.
BACKGROUND/OBJECTIVES: Dietary factors are important contributors to cardiometabolic and cancer mortality. We examined the secular trends of nine dietary factors (fruits, vegetables, whole grains, nuts and seeds, milk, red meat, processed meat, sugar-sweetened beverages, and calcium) and the associated burdens of cardiometabolic and cancer mortality in Korea using representative cross-sectional survey data from 1998 to 2016.
SUBJECTS/METHODS: Using dietary data from Korean adults aged ≥ 25 years in the Korea National Health and Nutrition Examination Survey (KNHANES), we characterized secular trends in intake levels. We performed comparative risk assessment to estimate the population attributable fraction and the number of cardiometabolic and cancer deaths attributable to each dietary factor.
A total of 231,148 cardiometabolic and cancer deaths were attributable to nine dietary risk factors in Korea from 1998 to 2016. Suboptimal intakes of fruits and whole grains were the leading contributors. Although the intakes of fruits, vegetables, and whole grains moderately improved over time, the intake levels in 2016 (192.1 g/d, 225.6 g/d, and 10.9 g/d, respectively) remained far below the optimal levels. Deaths attributable to the low intakes of nuts and seeds (4.5 g/d), calcium (440.5 mg/d), and milk (37.1 g/d) and the high intakes of red meat (54.7 g/d), processed meat (4.7 g/d), and sugar-sweetened beverages (33.0 g/d) increased since 1998. Compared with older age groups (≥ 45 years), more unfavorable changes in dietary patterns were observed in the younger population aged 25-44 years, including more sharply increased intakes of processed meat.
We observed improvement in the intakes of fruits, vegetables, and whole grains and unfavorable changes in the intakes of processed meat and sugar-sweetened beverages over the past few decades. Our data suggest that to reduce the chronic disease burden in Korea, more effective nutritional policies and interventions are needed to target these dietary risk factors.
背景/目的：饮食因素是导致心脏代谢和癌症死亡的重要因素。我们利用1998年至2016年具有代表性的横断面调查数据，研究了韩国九种饮食因素（水果、蔬菜、全谷物、坚果和种子、牛奶、红肉、加工肉类、含糖饮料和钙）的长期趋势以及与之相关的心脏代谢和癌症死亡负担。
对象/方法：我们使用韩国国家健康与营养检查调查（KNHANES）中25岁及以上韩国成年人的饮食数据，对摄入量水平的长期趋势进行了描述。我们进行了比较风险评估，以估计人群归因分数以及每种饮食因素导致的心脏代谢和癌症死亡人数。
1998年至2016年期间，韩国共有231,148例心脏代谢和癌症死亡归因于九种饮食风险因素。水果和全谷物摄入不足是主要原因。尽管水果、蔬菜和全谷物的摄入量随时间有所适度改善，但2016年的摄入量水平（分别为192.1克/天、225.6克/天和10.9克/天）仍远低于最佳水平。自1998年以来，因坚果和种子摄入量低（4.5克/天）、钙摄入量低（440.5毫克/天）和牛奶摄入量低（37.1克/天）以及红肉摄入量高（54.7克/天）、加工肉类摄入量高（4.7克/天）和含糖饮料摄入量高（33.0克/天）导致的死亡人数有所增加。与老年人群（≥45岁）相比，25至44岁的年轻人群饮食模式的不利变化更为明显，包括加工肉类摄入量的急剧增加。
在过去几十年中，我们观察到水果、蔬菜和全谷物的摄入量有所改善，而加工肉类和含糖饮料的摄入量出现了不利变化。我们的数据表明，为了减轻韩国的慢性病负担，需要针对这些饮食风险因素制定更有效的营养政策和干预措施。
