Journal List > Korean J Community Nutr > v.21(4) > 1038551

Kim: Quality of Diet and Nutritional Intake and Mortality Risk among South Korean Adults Based on 12-year Follow-up Data

Abstract

Objectives

Studies that reported the association between diet quality/nutritional intake status and mortality have rarely used long-term follow-up data in Asian countries, including Korea. This study investigated the association between the risk of mortality (all-cause and cause-specific) and the diet quality/nutritional intake status using follow-up 12-year mortality data from a nationally representative sample of South Koreans.

Methods

8,941 individuals who participated in 1998 and 2001 Korea Health and Nutrition Examination Surveys were linked to mortality data from death certificates. Of those individuals, 1,083 (12.1%) had died as of December, 2012. Cox proportional hazard models were used to estimate the relative risks of mortality according to the level of diet quality and intakes of major nutrients. Indicators for diet quality index and nutritional intake status were assessed using MAR (mean adequacy ratio) and energy and protein intake level compared with the 2010 Korean DRI.

Results

Higher diet quality/nutritional intake status were associated with lower mortality; the mortality risk (95% confidence interval) from all-cause of lowest MAR group vs highest was 1.66 (1.27 to 2.18) among ≥ 30 year old, and 1.98 (1.36 to 2.86) among 30~64 year old individuals. Those with below 75% of energy and protein intake of Korean DRI had higher mortality risks of all-cause mortality compared to the reference group. Diet quality/nutritional intake status was inversely associated with mortality from cardiovascular diseases and cancer.

Conclusions

Poor Diet quality/nutritional intake status were associated with a higher risk of mortality from all-cause and mortality from cardiovascular diseases and cancer among South Korean adults.

Figures and Tables

Table 1

Baseline characteristics of study subjects at the time of 1998 and 2001 KNHANS

kjcn-21-354-i001

1) Excluding missing values

Table 2

Relative risks of mortality from all cause according to diet quality and major nutrients intake level, among ≥ 30 year old individuals

kjcn-21-354-i002

1) Model 1 : Adjusted for age, sex and year of survey

2) Model 2 : Additionally adjusted for educational attainment, income level, smoking status, alcohol consumption, physical exercise

Table 3

Relative risks of age-specific mortality from all cause according to diet quality and major nutrients intake level

kjcn-21-354-i003

1) Model 1 : Adjusted for age, sex and year of survey

2) Model 2 : Additionally adjusted for educational attainment, income level, smoking status, alcohol consumption, physical exercise

Table 4

Relative risks of mortality from cardiovascular diseases and cancer according to diet quality and major nutrients intake level among ≥ 30 year old individuals

kjcn-21-354-i004

1) Excluding subjects with cancer at survey

2) Excluding subjects with cardiovascular diseases patients at survey

3) Model 1 : Adjusted for age, sex and year of survey

4) Model 2 : Additionally adjusted for educational attainment, income level, smoking status, alcohol consumption, physical exercise

Table 5

Relative risks of age-specific mortality from cardiovascular diseases and cancer according to diet quality and major nutrients intake levels

kjcn-21-354-i005

1) Excluding subjects with cancer at survey

2) Excluding subjects with cardiovascular diseases patients at survey

3) Model 1 : Adjusted for age, sex and year of survey

4) Model 2 : Additionally adjusted for educational attainment, income level, smoking status, alcohol consumption, physical exercise

References

1. Statistics Korea. 2014 Cause of death statistics [Internet]. 2015. cited 2016 Apr 28. Available from: http://www.kosis.kr.
2. Kim HR. Nutrition transition and shiting diet linked noncommunicable diseases and policy issues. Health Welf Policy Forum. 2013; 198:27–37.
3. Oh IH, Yoon SJ, Kim EJ. The burden of disease in Korea. J Korean Med Assoc. 2011; 54(6):646–652.
4. World Health Organization. Diet, nutrition and the prevention of chronic diseases. WHO;2003. Report No. 916.
5. World Health Organization. Draft action plan for the prevention and control of noncommunicable diseases 2013-2020 [Internet]. 2013. cited 2016 Apr 28. Available from: http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_9-en.pdf.
6. Tognon G, Lissner L, sæbye D, Walker KZ, Heitmann BL. The Mediterranean diet in relation to mortality and CVD: a Danish cohort study. Br J Nutr. 2014; 111(1):151–159.
7. Buckland G, Agudo A, Travier N, Huerta JM, Cirera L, Tormo MJ. Adherence to the Mediterranean diet reduces in the Spanish cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Spain). Br J Nutr. 2011; 106(10):1581–1591.
8. Huijbreght P, Feskens E, Räsäsnen L, Fidanza F, Nissinen A, Menotti A. Dietary pattern and 20 year mortality in elderly men in Finland, Italy, and the Netherlands: longitudinal cohort study. BMJ. 1997; 315(7099):13–17.
9. Kant AK, Schatzkin A, Graubard BI, Schairer C. A prospective study of diet quality and mortality in women. JAMA. 2000; 283(16):2109–2115.
10. Vasto S, Scapagnini G, Rizzo C, Monastero R, Marchese A, Caruso C. Mediterranean diet and longevity in Sicily. Rejuvenation Res. 2012; 15(2):184–188.
11. Pérez-López FR, Chedraui PC, Haya J, Cuadros JL. Effects of the Mediterranean diet on longevity and age-related morbid conditions. Maturitas. 2009; 64(2):67–79.
12. Milaneschi Y, Tanaka T, Ferrucci L. Nutritional determinants of mobility. Curr Opin Clin Nutr Metab Care. 2010; 13(6):625–629.
13. Milaneschi Y, Bandinelli S, Corsi AM, Lauretani F, Paolisso G, Dominguez LJ. Mediterranean diet and mobility decline in older persons. Exp Gerontol. 2011; 46(4):303–308.
14. Yu D, Zhang X, Xiang YB, Yang G, Li H, Gao YT. Adherence to the dietary guidelines and mortality: a report from prospective cohort studies of 134,000 Chinese adults in urban Shanghai. Am J Clin Nutr. 2014; 100(2):693–700.
15. Kurotani K, Akter S, Kashino I, Goto A, Mizoue T, Noda M. Quality of diet and mortality among Japanese men and women: Japan public health center based prospective study. BMJ. 2016; 352:i1209.
16. van Lee L, Geelen A, Kiefte-de JC, Witteman JC, Hofman A, Vonk N. Adherence to the Dutch dietary guidelines is inversely associated with 20-year mortality in a large prospective cohort study. Eur J Clin Nutr. 2016; 70(2):262–268.
17. Russell J, Flood V, Rochtchina E, Gopinath B, Allman-Farinelli M, Bauman A. Adherence to dietary guidelines and 15-year risk of all-cause mortality. Br J Nutr. 2013; 109(3):547–555.
18. Bälter K, Möller E, Fondell E. The effect of dietary guidelines on cancer risk and mortality. Curr Opin Oncol. 2012; 24(1):90–102.
19. Shimazu T, Kuriyama S, Hozawa A, Ohmori K, Sato Y, Nakaya N. Dietary patterns and cardiovascular disease mortality in Japan: a prospective cohort study. Int J Epidemiol. 2007; 36(3):600–609.
20. Drewnowski A, Henderson SA, Shore AB, Fischler C, Preziosi P, Hercberg S. Diet quality and dietary diversity in France: Implications for the French paradox. J Am Diet Assoc. 1996; 96(7):663–669.
21. Waijers PM, Ocke MC, van Rossum CT, Peeters PH, Bamia C, Chloptsios Y. Dietary patterns and survival in older Dutch women. Am J Clin Nutr. 2006; 83(5):1170–1176.
22. Mai V, Kant AK, Flood A, Lacey JV, Schairer C, Schatzkin A. Diet quality and subsequent cancer incidence and mortality in a prospective cohort of women. Int J Epidemiol. 2005; 34(1):54–60.
23. Trichopoulou A, Kouris-Blazos A, Wahlqvist ML, Gnardellis C, Lagiou P, Polychronopoulos E. Diet and overall survival in elderly people. BMJ. 1995; 311(7018):1457–1460.
24. Osler M, Schroll M. Diet and mortality in a cohort of elderly people in a north European community. Int J Epidemiol. 1997; 26(1):155–159.
25. Kennedy ET, Ohls J, Carlson S, Fleming K. The healthy eating index: design and applications. J Am Diet Assoc. 1995; 95(10):1103–1108.
26. McCullough ML, Feskannich D, Stampfer MJ, Giovannucci EL, Rimm EB, Hu FB. Diet quality and major chronic diseases risk in men and women: Moving toward improved dietary guidance. Am J Clin Nutr. 2002; 76(6):1261–1271.
27. Esposito K, Marfella R, Ciotola M, Palo CD, Giugliano F, Giugliano G. Effect of a Mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome. JAMA. 2004; 292(12):1440–1446.
28. Seymour JD, Calle EE, Flagg EW, Coates RJ, Ford ES, Thun MJ. Diet quality index as a predictor of short-term mortality in the American Cancer Society Cancer Prevention Study II Nutrition Cohort. Am J Epidemiol. 2003; 157(11):980–988.
29. Haveman-Nies A, Burema J, Cruz JAA, Osler M, van Staveren WA. Dietary quality and lifestyle factors in relation to 10-year mortality in older Europeans: The SENECA Study. Am J Epidemiol. 2002; 156(10):962–968.
30. Knoops KT, de Groot LC, Kromhout D, Perrin AE, Moreiras-Varela O, Menotti A. Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: The HALE project. JAMA. 2004; 292(12):1433–1439.
31. de Groot LC, Verheijden MW, de Henauw S, Schroll M, van Staveren WA. Lifestyle, nutritional status, health, and mortality in elderly people across Europe: A review of the longitudinal results of the SENECA study. J Gerontol A Biol Sci Med Sci. 2004; 59(12):1277–1284.
32. Ford ES, Bergmann MM, Boeing H, Li C, Capewell S. Healthy lifestyle behaviors and all-cause mortality among adults in the United States. Prev Med. 2012; 55(1):23–27.
33. Farchi G, Fidanza F, Grossi P, Lancia A, Mariotti S, Menotti A. Relationship between eating patterns meeting recommendations and subsequent mortality in 20 years. Eur J Clin Nutr. 1995; 49(6):408–419.
34. Baker JP, Detsky AS, Wesson DE, Wolman SL, Stewart S, Whitewell J. Nutritional assessment: A comparison of clinical judgement and objective measurements. N Engl J Med. 1982; 306(16):969–972.
35. Volkert D, Kruse W, Oster P, Schlierf G. Malnutrition in geriatric patients: Diagnostic and prognostic significance of nutritional parameters. Ann Nutr Metab. 1992; 36(2):97–112.
36. Mowe M, Bøhmer T, Kindt E. Reduced nutritional status in an elderly popultion (>70 y) is probable before disease and possibly contributes to the development of disease. Am J Clin Nutr. 1994; 59(2):317–324.
37. Oh KW, Nam CM, Park JH, Yoon JY, Sim JS, Lee KH. A case-control study on dietary quality and risk for coronary heart disease in Korean men. Korean J Nutr. 2003; 36(6):613–621.
38. Woo J, Ho SC, Yu AL. Lifestyle factors and health outcomes in elderly Hong Kong Chinese aged 70 years and over. Gerontology. 2002; 48(4):234–240.
39. Kim HR. A Study on the association of diet quality and risk of mortality and major chronic diseases from nationally representative longitudinal data. Health Soc Welf Rev. 2013; 33(3):5–30.
40. Bonaccio M, Iacoviello L, de Gaetano G. The Mediterranean diet: The reasons for a success. Thromb Res. 2012; 129(3):401–404.
41. Yook SM, Park S, Moon HK, Kim K, Shim JE, Hwang JY. Development of Korean healthy eating index for adults using the Korea National Health and Nutrition Survey data. J Nutr Health. 2015; 48(5):419–428.
TOOLS
ORCID iDs

Hye-Ryun Kim
https://orcid.org/http://orcid.org/0000-0003-0922-6367

Similar articles