Association of Whole Grain Consumption with Nutrient Intakes and Metabolic Risk Factors in Generally Healthy Korean Middle-Aged Women

Ye Jin Kim; Jin Hee Yum; Seungmin Lee

doi:10.5720/kjcn.2014.19.2.176

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Kim, Yum, and Lee: Association of Whole Grain Consumption with Nutrient Intakes and Metabolic Risk Factors in Generally Healthy Korean Middle-Aged Women

Research Article

Korean J Community Nutr 2014;19(2):176-186.

Published online: 20 January 2014

DOI: https://doi.org/10.5720/kjcn.2014.19.2.176

Association of Whole Grain Consumption with Nutrient Intakes and Metabolic Risk Factors in Generally Healthy Korean Middle-Aged Women

Ye Jin Kim, Jin Hee Yum, Seungmin Lee^†

Department of Food and Nutrition, Sungshin Women's University, Seoul, Korea

^†Corresponding author Seungmin Lee Department of Food and Nutrition, Sungshin Women's University, Dobongro76ga-gil, Kangbuk-gu, Seoul 142-732, Korea Tel: (02) 920-7671 Fax: (02) 920-2076 E-mail: smlee@sungshin.ac.kr

Received 5 February 2014 Revised 18 March 2014 Accepted 18 March 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

Epidemiological studies have suggested that a higher consumption of whole grain foods can significantly reduce the risk of chronic diseases including cardiovascular diseases, type 2 diabetes and obesity. The objective of the current study was to examine associations among the consumption of whole grains and nutrient intakes and biochemical indicators associated with chronic diseases among generally healthy middle-aged Korean women.

Methods

Using 24-hour recall data from the 2008–2009 National Health and Nutrition Examination Surveys, whole grain intake (g/day) was calculated for a total of generally healthy 1,953 subjects. The subjects were divided into three groups by the level of whole grain consumption (0 g/day, > 0 and < 20 g/day or ≥ 20 g/day). Mean values or proportions of various nutrient intakes and metabolic risk factors were compared according to the level of whole grain consumption. All statistical analysis was conducted using SAS software version 9.2.

Results

We observed that the overall consumption of whole grains was quite low. Specifically, 58.2% of subjects reported no whole grain consumption on the day of the survey, and the mean whole grain intake was only 15.3 g/day. The whole grain consumption was positively associated with intakes of various macro and micronutrients, namely, plant proteins and fats, dietary fiber, calcium, plant iron, potassium, zinc, vitamin A, β-carotene, thiamin, riboflavin, niacin, vitamin B₆ and folic acid. In addition, we found significantly decreasing trends in abdominal obesity and hypertriglyceridemia as whole grain intake levels increase.

Conclusions

The study findings suggested the importance of promoting whole grain consumption as an efficient tool for improving various dietary aspects and preventing chronic diseases.

Keywords: Whole grain, Nutrient intake, Metabolic risk factor

References

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Table 1.

General characteristics of the study subjects

Variables		N (%)
Age(years)	40 − 49	1,026 (52.5)
	50 − 59	674 (34.5)
	60 − 65	253 (13.0)
Education	Primary school graduate	496 (25.9)
	Middle school graduate	367 (19.2)
	High school graduate	714 (37.3)
	College graduate	336 (17.6)
Household income	Bottom	255 (13.3)
	Bottom middle	467 (24.3)
	Middle top	563 (29.3)
	Top	365 (19.0)
Marriage status	Living with a partner	1,645 (84.2)
Marriage status	Not living with a partner	308 (15.8)
Smoking	None	1,787 (93.3)
	Past	51 (92.7)
	Current	78 (94.1)
Drinking	None	662 (34.6)
	1 − 4 time/month	1,079 (56.3)
	2 − 4 time/week	174 (99.1)
Moderate physical activity	0 − 1 times/week	1,162 (60.7)
	2 − 4 times/week	377 (19.7)
	5 − 7 times/week	376 (19.6)

Table 2.

Age-adjusted mean daily nutrient intakes according to the level of whole grain consumption

Variables	Whole grain intake level (g/day)			F	p
Variables	0 (n = 1,137)	> 0 & < 20 (n = 531)	≥ 20 (n = 285)	F	p
Energy (Kcal/day)	1,618.95 ± 922.42¹⁾	1,586.13 ± 930.21	1,709.34 ± 943.68	2.58	< 0.077
Protein (g/day)	1, 59.37 ± 991.19^a	1, 60.38 ± 991.59^ab	1, 66.09 ± 992.22^b	3.71	< 0.025∗
Plant protein (g/day)	1, 36.57 ± 990.74^a	1, 37.36 ± 991.10^a	1, 44.61 ± 991.78^b	8.85	< 0.001∗∗∗
Animal protein (g/day)	1, 22.79 ± 990.91	1, 23.02 ± 990.98	1, 21.48 ± 991.26	0.48	< 0.620
Carbohydrate (g/day)	1,273.96 ± 993.82^a	1,264.14 ± 995.21^a	1,293.08 ± 997.54^b	4.91	< 0.008∗∗
Lipid (g/day)	1, 30.36 ± 990.91	1, 31.48 ± 991.06	1, 32.15 ± 991.68	0.56	< 0.571
Plant lipid (g/day)	1, 15.81 ± 990.42^a	1, 17.65 ± 990.61^b	1, 17.96 ± 990.78^b	4.68	< 0.010∗
Animal lipid (g/day)	1, 14.55 ± 990.75	1, 13.83 ± 990.70	1, 14.19 ± 991.31	0.23	< 0.794
SFA (g/day)	1, 8 4.99 ± 990.32	1, 8 5.04 ± 990.28	1, 8 5.11 ± 990.54	0.02	< 0.982
PUFA (g/day)	1, 8 4.32 ± 990.16	1, 8 4.76 ± 990.24	1, 8 4.18 ± 990.29	1.45	< 0.237
MUFA (g/day)	1, 8 5.57 ± 990.33	1, 8 5.71 ± 990.29	1, 8 5.76 ±99 0.61	0.06	< 0.940
Fiber (g/day)	1, 21.89 ± 990.70^a	1, 22.11 ± 990.68^a	1, 27.60 ± 991.05^b	13.48	< 0.001∗∗∗
Calcium (mg/day)	1,490.07 ± 912.79^a	1,496.86 ± 914.67^a	1,560.37 ± 923.84^b	3.47	< 0.032∗
Plant Calcium (mg/day)	1,322.45 ± 998.57^a	1,329.55 ± 910.23^a	1,382.15 ± 919.48^b	3.96	< 0.020∗
Animal Calcium (mg/day)	1,167.62 ± 998.54	1,167.32 ± 999.35	1,178.22 ± 915.12	0.20	< 0.818
Iron (mg/day)	1, 13.87 ± 990.41^a	1, 13.55 ± 990.35^a	1, 17.01 ± 990.68^b	12.20	< 0.001∗∗∗
Plant Iron (mg/day)	1, 11.53 ± 990.38^a	1, 11.23 ± 990.32^a	1, 14.82 ± 990.64^b	15.32	< 0.001∗∗∗
Animal Iron (mg/day)	1, 8 2.35 ± 990.11	1, 8 2.32 ± 990.11	1, 8 2.19 ± 990.15	0.34	< 0.710
Phosphorus (mg/day)	1,861.02 ± 916.11^a	1,892.90 ± 919.41^a	1,043.14 ± 927.23^b	16.56	< 0.001∗∗∗
Sodium (mg/day)	4,034.96 ± 146.17	3,902.68 ± 104.86	3,856.83 ± 171.93	0.44	< 0.647
Potassium (mg/day)	2,712.24 ± 963.57^a	2,854.07 ± 985.21^a	3,327.88 ± 136.06^b	8.86	< 0.001∗∗∗
Zinc (mg/day)	1, 8 8.04 ± 990.19^a	1, 8 7.95 ± 990.23^a	1, 8 8.98 ± 990.33^b	4.54	< 0.011∗
Vitamin A (µgRE/day)	1,673.89 ± 921.20^a	1,677.60 ± 928.18^a	1,830.68 ± 952.18^b	4.24	< 0.015∗
Retinol (µg/day)	1, 72.11 ± 995.34	18,60.88 ± 994.04	1, 70.08 ± 996.76	1.85	< 0.160
β-carotene (µg/day)	3,529.53 ± 173.29^a	4,119.63 ± 552.76^ab	4,563.64 ± 398.14^b	3.21	< 0.042∗
Thiamine (mg/day)	1, 8 1.03 ± 990.03^a	1, 8 1.01 ± 990.02^a	1, 8 1.18 ± 990.04^b	6.28	< 0.002∗∗
Riboflavin (mg/day)	1, 8 0.97 ± 990.03^a	1, 8 0.95 ± 990.03^a	1, 8 1.10 ± 990.06^ab	3.10	< 0.046∗
Vitamin B₆ (mg/day)	1, 8 1.85 ± 990.05^a	1, 8 1.88 ± 990.05^a	1, 8 2.06 ± 990.06^b	3.83	< 0.023∗
Niacin (mg/day)	1, 14.75 ± 990.32^a	1, 15.26 ± 990.46^a	1, 17.47 ± 990.69^b	7.07	< 0.001∗∗∗
Vitamin C (mg/day)	1,112.37 ± 994.35	1,118.88 ± 995.47	1,130.21 ± 997.03	2.39	< 0.093
Folic acid (µg/day)	1,235.94 ± 995.91^a	1,258.53 ± 999.14^ab	1,285.22 ± 911.20^b	7.88	< 0.001∗∗∗
Vitamin E (mg/dayay)	1, 12.10 ± 990.99	1, 11.59 ± 990.54	1, 16.15 ± 992.26	1.93	< 0.147

¹⁾ Mean ± SE

ab: Different letters within a category represent statistical differences by whole grain intakes from Tukey-Kramer's multiple comparison test

^∗ : p < 0.05, ∗∗: p < 0.01, ∗∗∗: p < 0.001

Table 3.

Mean daily nutrient density according to the level of whole grain consumption

Variables	Whole grain intake level (g/day)			F	p
Variables	0	> 0 & < 20	≥ 20	F	p
Protein (g/1000 kcal)	16,36.38 ± 90.40¹⁾	16,38.61 ± 990.81	16,38.53 ± 990.80	5.35	< 0.052
Plant protein (g/1000 kcal)	16,22.59 ± 90.30^a	16,24.01 ± 990.68^ab	16,25.69 ± 990.71^b	9.24	< 0.001∗∗∗
Animal protein (g/1000 kcal)	16,13.79 ± 90.46	16,14.60 ± 990.53	16,12.84 ± 990.66	2.08	< 0.127
Carbohydrate (g/1000 kcal)	1,170.90 ± 91.23^a	1,167.47 ± 991.32^a	1,172.36 ± 991.83^ab	3.11	< 0.046∗
Lipid (g/1000 kcal)	16,18.27 ± 90.38	16,19.42 ± 990.41	16,18.43 ± 990.61	2.32	< 0.099
Plant lipid (g/1000 kcal)	168,9.71 ± 90.21^a	16,10.96 ± 990.28^b	16,10.39 ± 990.31^b	7.06	< 0.001∗∗∗
Animal lipid (g/1000 kcal)	168,8.55 ± 90.35	168,8.45 ± 990.31	168,8.04 ± 990.54	0.30	< 0.739
SFA (g/1000 kcal)	168,2.87 ± 90.14	168,3.01 ± 990.13	168,2.85 ± 990.21	0.36	< 0.695
PUFA (g/1000 kcal)	168,2.55 ± 90.07^a	168,2.87 ± 990.11^b	168,2.38 ± 990.13^a	4.13	< 0.017∗
MUFA (g/1000 kcal)	168,3.21 ± 90.14	168,3.43 ± 990.14	168,3.17 ± 990.24	0.79	< 0.453
Fiber (g/1000 kcal)	16,13.50 ± 90.25^a	16,14.25 ± 990.29^a	16,16.17 ± 990.44^b	14.51	< 0.001∗∗∗
Calcium (mg/1000 kcal)	1,303.21 ± 96.10	1,319.23 ± 998.05	1,329.22 ± 910.63	2.71	< 0.068
Plant Calcium (mg/1000 kcal)	1,200.58 ± 93.99^a	1,213.33 ± 995.79^ab	1,221.25 ± 997.49^b	3.96	< 0.020∗
Animal Calcium (mg/1000 kcal)	1,102.62 ± 94.78	1,105.89 ± 995.38	1,107.97 ± 998.87	0.19	< 0.827
Iron (mg/1000 kcal)	168,8.47 ± 90.17^a	168,8.75 ± 990.22^a	168,9.79 ± 990.28^b	7.81	< 0.001∗
Plant Iron (mg/1000 kcal)	168,7.01 ± 90.16^a	168,7.25 ± 990.20^a	168,8.48 ± 990.27^b	10.97	< 0.001∗∗∗
Animal Iron (mg/1000 kcal)	168,1.46 ± 90.07	168,1.50 ± 990.06	168,1.31 ± 990.09	1.41	< 0.245
Phosphorus (mg/1000 kcal)	1,531.26 ± 95.47^a	1,571.17 ± 997.31^b	1,621.00 ± 910.30^c	34.85	< 0.001∗∗∗
Sodium (mg/1000 kcal)	2,581.69 ± 92.34	2,596.89 ± 966.29	2,354.54 ± 996.83	2.20	< 0.113
Potassium (mg/1000 kcal)	1,672.64 ± 24.99^a	1,827.65 ± 936.60^b	1,922.74 ± 949.95^b	14.21	< 0.001∗∗∗
Zinc (mg/1000 kcal)	168,4.94 ± 90.08	168,5.09 ± 990.15	168,5.28 ± 990.13	2.33	< 0.099
Vitamin A (µgRE/1000 kcal)	1,421.79 ± 12.10^a	1,440.80 ± 917.21^a	1,505.43 ± 931.86^ab	3.06	< 0.048∗
Retinol (µg/1000kcal)	16,42.61 ± 93.01	16,36.80 ± 991.87	16,42.50 ± 994.57	2.05	< 0.130
β-carotene (µg/1000 kcal)	2,161.93 ± 78.60^a	2,596.44 ± 248.90^a	2,684.50 ± 195.91^ab	3.98	< 0.020∗
Thiamine (mg/1000 kcal)	168,0.63 ± 90.01^a	168,0.65 ± 990.01^a	168,0.69 ± 990.01^b	6.14	< 0.002∗∗
Riboflavin (mg/1000 kcal)	168,0.59 ± 90.01	168,0.61 ± 990.02	168,0.63 ± 990.02	1.69	< 0.186
Vitamin B₆ (mg/1000 kcal)	168,1.13 ± 90.02^a	168,1.19 ± 990.02^a	168,1.23 ± 990.03^ab	5.08	< 0.007∗∗
Niacin (mg/1000 kcal)	168,9.07 ± 90.13^a	168,9.74 ± 990.20^b	16,10.23 ± 990.27^b	10.82	< 0.001∗∗∗
Vitamin C (mg/1000 kcal)	16,70.34 ± 92.49	16,77.37 ± 993.49	16,78.98 ± 994.36	2.35	< 0.097
Folic acid (µg/1000 kcal)	1,147.20 ± 93.06^a	1,167.79 ± 996.12^b	1,169.83 ± 995.56^b	8.17	< 0.001∗∗∗
Vitamin E (mg/1000 kcal)	168,6.81 ± 90.29	168,7.21 ± 990.27	168,8.34 ± 990.69	2.38	< 0.094

1) Mean ± SE

ab: Different letters within a category represent statistical differences by whole grain intakes from Tukey-Kramer's multiple comparison test

^∗ : p < 0.05, ∗∗: p < 0.01, ∗∗∗: p < 0.001

Table 4.

Mean % Dietary Reference Intakes according to the level of whole grain consumption

Variables	Whole grain intake level(g/day)			F	p
Variables	0 (n = 1,137)	> 0 & < 20 (n = 531)	≥ 20 (n = 285)	F	p
Protein (%DRI)	132.26 ± 62.66^a1)	135.15 ± 3.50^a	147.59 ± 64.88^ab	3.92	< 0.021∗
Dietary Fiber (%DRI)	109.37 ± 63.49^a	110.35 ± 3.36^a	137.85 ± 65.19^b	13.47	< 0.001∗∗∗
Calcium (%DRI)	672.98 ± 61.89^a	674.51 ± 2.22^a	683.58 ± 63.53^b	3.45	< 0.033∗
Phosphorus (%DRI)	123.24 ± 62.31^a	128.24 ± 2.77^a	149.53 ± 63.87^b	16.87	< 0.001∗∗∗
Sodium (%DRI)	278.50 ± 10.11	268.96 ± 7.12	266.22 ± 11.81	0.42	< 0.655
Potassium (%DRI)	677.59 ± 61.81^a	681.82 ± 2.42^a	695.29 ± 63.84^b	9.09	< 0.001∗∗∗
Vitamin A (%DRI)	112.47 ± 63.54^a	113.37 ± 4.60^a	138.77 ± 68.76^b	4.24	< 0.015∗
Vitamin E (%DRI)	121.42 ± 69.99	117.09 ± 5.33	162.37 ± 22.55	1.91	< 0.150
Vitamin C (%DRI)	112.29 ± 64.30	118.66 ± 5.51	130.04 ± 67.00	2.35	< 0.097
Thiamine (%DRI)	694.28 ± 62.38^a	692.76 ± 2.29^a	107.82 ± 63.75^b	6.26	< 0.002∗∗
Riboflavin (%DRI)	681.21 ± 62.76^a	680.20 ± 2.59^a	692.65 ± 64.62^b	3.08	< 0.047∗
Niacin (%DRI)	105.83 ± 62.35^a	110.36 ± 3.36^a	125.78 ± 64.90^b	7.63	< 0.010∗∗
Vitamin B₆ (%DRI)	132.18 ± 63.68^a	134.41 ± 3.64^a	147.16 ± 64.42^b	3.83	< 0.023∗
₆ Folic acid (%DRI)	658.94 ± 61.46^a	664.50 ± 2.24^a	671.20 ± 62.79^ab	7.81	< 0.001∗∗∗

¹⁾ Mean ± SE

ab: Different letters within a category represent statistical differences by whole grain intakes from Tukey-Kramer's multiple comparison test

^∗ : p < 0.05, ∗∗: p < 0.01, ∗∗∗: p < 0.001

Table 5.

Subjects meeting Dietary Reference Intakes according to the level of whole grain consumption

Variables	Whole grain intake level (g/day)			F	p
Variables	0 (n = 1,137)	> 0 & < 20 (n = 531)	≥ 20 (n = 285)	F	p
Protein (%DRI)	715 (64.5)¹⁾	349 (68.1)	214 (72.9)	2.49	< 0.083
Dietary Fiber (%DRI)	491 (43.4)	255 (49.8)	177 (61.7)	12.46	< 0.001∗∗∗
Calcium (%DRI)	225 (20.7)	112 (21.0)	67 (24.7)	0.86	< 0.426
Phosphorus (%DRI)	645 (58.2)	344 (67.6)	228 (78.1)	15.61	< 0.001∗∗∗
Sodium (%DRI)	1,053 (93.4)	491 (92.7)	255 (88.8)	2.77	< 0.063
Potassium (%DRI)	232 (20.9)	115 (22.4)	88 (30.2)	4.41	< 0.012∗
Vitamin A (%DRI)	474 (42.1)	228 (44.6)	139 (50.7)	2.47	< 0.085
Vitamin E (%DRI)	423 (38.8)	224 (46.1)	139 (49.1)	5.60	< 0.004∗∗
Vitamin C (%DRI)	460 (40.2)	227 (44.0)	143 (49.8)	3.40	< 0.033∗
Thiamine (%DRI)	360 (32.3)	173 (34.0)	129 (42.7)	4.30	< 0.014∗
Riboflavin (%DRI)	271 (25.7)	114 (22.7)	82 (27.8)	1.20	< 0.303
Niacin (%DRI)	479 (44.9)	247 (49.3)	166 (55.2)	3.82	< 0.022∗
Vitamin B₆ (%DRI)	642 (57.6)	314 (62.0)	215 (74.0)	9.04	< 0.001∗∗∗
Folic acid (%DRI)	136 (12.7)	62 (12.6)	49 (17.6)	1.86	< 0.155

¹⁾ N (%), ∗: p < 0.05, ∗∗: p < 0.01, ∗∗∗: p < 0.001

Table 6.

Multivariate-adjusted¹⁾ mean biochemical & anthropometric parameters according to the level of whole grain consumption

Variables	Whole grain intake level (g/day)			F	p
Variables	0	> 0 & < 20	≥ 20	F	p
Blood glucose (mg/dL) (n = 1,831)	992.65 ± 0.79²⁾	992.20 ± 1.04	991.92 ± 0.98	0.50	< 0.610
Insulin (µIU/mL) (n = 956)	999.32 ± 0.50^a	998.38 ± 0.48^b	998.91 ± 0.52^ab	5.60	< 0.004∗∗
Total cholesterol (mg/dL) (n = 1,840)	198.65 ± 2.48	198.76 ± 2.57	195.34 ± 3.38	0.81	< 0.448
HDL-cholesterol (mg/dL) (n = 956)	956.57 ± 1.33^a	957.41 ± 1.64^a	953.10 ± 1.67^b	6.96	< 0.001∗∗∗
LDL-cholesterol (mg/dL) (n = 244)	125.44 ± 5.48	124.13 ± 6.51	126.59 ± 6.95	0.10	< 0.905
Triglyceride (mg/dL) (n = 1,840)	124.86 ± 7.35^a	117.35 ± 7.41^a	111.89 ± 7.99^b	4.76	< 0.009∗∗
Waist circumference (cm) (n = 1,881)	978.25 ± 0.55	977.54 ± 0.68	977.91 ± 0.74	1.08	< 0.341
Body mass index (kg/m²) (n = 1,883)	923.06 ± 0.17	922.92 ± 0.22	923.21 ± 0.26	0.76	< 0.470
Systolic blood pressure (mmHg) (n = 900)	109.86 ± 1.43	109.48 ± 1.94	109.55 ± 1.77	0.05	< 0.951
Diastolic blood pressure (mmHg) (n = 900)	973.09 ± 0.95	971.69 ± 1.25	972.80 ± 1.20	0.98	< 0.377

¹⁾ Adjusted for age, smoking status, educational status, income status, and marriage status

²⁾ Mean ± SE

ab: Different letters within a category represent statistical differences by whole grain intakes from Tukey-Kramer's multiple comparison test

^∗ : p < 0.05, ∗∗: p < 0.01, ∗∗∗: p < 0.001

Table 7.

Multivariate-adjusted¹⁾ proportions of metabolic risks according to the level of whole grain consumption

Variables	Whole grain intake level (g/day)			F	p
Variables	0	> 0 & < 20	≥ 20	F	p
Waist circumference (cm) ≥ 85	21.4 ± 2.6^2),a	17.0 ± 3.2^b	15.5 ± 3.5^b	3.10	0.046∗
Triglyceride (mg/dL) ≥ 150	20.4 ± 2.6^a	16.8 ± 3.1^a	12.8 ± 3.5^b	4.20	0.016∗
HDL-cholesterol (mg/dL) < 50	72.1 ± 4.2	68.8 ± 5.6	64.6 ± 6.1	1.20	0.303
Blood glucose (mg/dL) ≥ 100	20.2 ± 2.9	17.4 ± 3.3	15.6 ± 3.3	1.37	0.256
Blood pressure (mmHg) ≥ 130/85	96.7 ± 1.8	92.6 ± 2.4	94.1 ± 3.1	1.53	0.219

¹⁾ Adjusted for age, smoking status, educational status, income status, and marriage status

²⁾ Mean ± SE

ab: Different letters within a category represent statistical differences by whole grain intakes from Tukey-Kramer's multiple comparison test

^∗ : p < 0.05, ∗∗: p < 0.01, ∗∗∗: p < 0.001

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