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Jang, Her, and Lee: Metabolic Syndrome Risk by Intake Ratio and Intake Pattern of Proteins in Middle-aged Men Based on the 2012–2013 Korean National Health and Nutrition Examination Survey Data
Research Article

Korean J Community Nutr 2016;21(4):366-377.

Published online: 20 January 2016

DOI: https://doi.org/10.5720/kjcn.2016.21.4.366

Metabolic Syndrome Risk by Intake Ratio and Intake Pattern of Proteins in Middle-aged Men Based on the 2012–2013 Korean National Health and Nutrition Examination Survey Data

Minkyoung Jang1), Eunsil Her2), Kyunghea Lee1), †

1)Department of Food and Nutrition, Changwon National University, Changwon, Korea

2)Department of Food and Nutriton, Changshin University, Changwon, Korea

†Corresponding author Kyunghea Lee Department of food and nutrition, Changwon, National University, 20 Changwondaehak-ro, Uichang-gu, Changwon, Gyeongnam 51140, Korea Tel: (055) 213-3514 Fax: (055) 281-7480 E-mail: khl@changwon.ac.kr ORCID: 0000-0003-0444-4824

Received 14 July 2016       Revised 19 August 2016       Accepted 25 August 2016

Copyright © 2016 Journal of the Korean Society of Community Nutrition

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

The purpose of the study was to compare intake of energy nutrients, physical characteristics, and the prevalence of metabolic syndrome according to protein intake group. Methods: Subjects were 827 men aged 40–65 years. The results presented were based on data from the 2012–2013 National Health and Nutrition Examination Survey and analyzed using SPSS. The odds ratio (OR) of metabolic syndrome was assessed according to the protein intake group and intake pattern of protein-rich foods. Results: The mean of protein intake was 73.96 ± 0.71 g. According to level of protein intake, four groups (deficient, normal, excess 1, excess 2) were created and their percentages were 8.3%, 39.6%, 37.1%, and 15.0% respectively. The mean of daily energy intake was 2,312.33 ± 24.08 kcal. It was higher in excess group 2 than in the deficiency group (p<0.001). Moreover, the intake of all energy nutrients increased significantly with protein intake group (p < 0.001). The main contribution to daily protein included mixed grains (10.96 ± 0.32 g), milled rice (7.14 ± 0.30 g), chicken (3.50 ± 0.21 g), and grilled pork belly (3.04 ± 0.16 g). With regard to physical characteristics, and blood pressure and blood test results, only body mass index increased significantly according to protein intake groups (p<0.05). The prevalence of metabolic syndrome in subjects was 38.5%, and there was no significant correlation with protein intake group. The OR of metabolic syndrome increased with protein intake, and was higher 4.452 times in excess group 2 than in the normal group (p<0.05). Conversely, the OR of metabolic syndrome according to the frequency of protein-rich food intake did not show a significant correlation. Conclusions: The results of this study can be used as significant supporting data to establish guidelines for protein intake in middle-aged men.

Keywords: middle-aged men, protein intake, OR of metabolic syndrome

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Table 1.
Distribution of protein intake ratio among study participants
Independent variable Items N (%) Mean ± SD
Protein intake group1) Deficiency group (< RNI 75%) 72 (558.3) 562.6 ± 1.22)
Moderate group (RNI 75∼< 125%) 325 (539.6) 102.0 ± 0.9
Excessive group 1 (RNI 125∼< 200%) 316 (537.1) 154.2 ± 1.4
Excessive group 2 (≥ RNI 200%) 114 (515.0) 247.1 ± 4.2
Total 827 (100.0) 162.0 ± 2.6

1) Protein intake ratio: (Protein intake/recommended protein intake)×100 2) %

Table 2.
General characteristics of the subjects by protein intake group
Variables Items Protein intake group χ2 or F value Total
Deficiency group Moderate group Excessive group 1 Excessive group 2
Income Low 16 (21.4)1) 87 (32.6) 70 (25.2) 24 (21.7) 16.155 197 (27.3)
Middle low 24 (35.5) 90 (27.3) 77 (26.9) 24 (22.3) 215 (27.0)
Middle high 16 (22.5) 70 (20.0) 74 (21.0) 34 (28.2) 194 (21.8)
High 16 (20.6) 78 (20.1) 95 (26.9) 32 (27.8) 221 (23.9)
Education level ≤ Primary school 10 (15.0) 46 (11.9) 34 (59.4) 7 (56.1) 14.672 97 (10.4)
Middle school 7 (57.9) 47 (15.3) 25 (58.8) 13 (59.2) 92 (11.4)
High school 30 (39.3) 115 (39.0) 123 (42.3) 46 (45.6) 314 (41.2)
≥ College 25 (37.8) 117 (33.8) 134 (39.5) 48 (39.1) 324 (37.0)
Occupation Professionals or technicians 19 (29.7) 61 (16.8) 81 (25.4) 26 (23.5) 41.635∗ 187 (22.0)
Clerical support workers 4 (55.1) 44 (12.8) 35 (10.9) 11 (59.7) 94 (11.0)
Salesperson service workers 8 (59.6) 32 (59.7) 50 (16.1) 19 (18.6) 109 (13.4)
Skilled agricultural, forestry and fishery workers 4 (53.2) 35 (58.6) 23 (57.4) 6 (53.6) 68 (57.0)
Plant and machine operators, and assemblers 20 (32.3) 84 (28.6) 65 (23.2) 37 (33.6) 206 (27.6)
Elementary occupations 7 (57.0) 28 (58.5) 30 (59.3) 7 (55.2) 72 (58.2)
Inoccupation 10 (13.1) 41 (15.0) 32 (57.7) 8 (55.8) 91 (10.8)
Marital status Married 69 (94.5) 314 (95.2) 308 (97.2) 110 (95.9) 52.077 801 (96.0)
Unmarried 3 (55.5) 11 (54.8) 8 (52.8) 4 (54.1) 26 (54.0)
Age (years) 50.48 ± 0.782) 49.58 ± 0.40 49.95 ± 0.43 49.83 ± 0.68 50.417 49.96 ± 0.33

1) N (%) 2) Mean ± SD ∗: p < 0.05

Table 3.
Energy nutrient intake by protein intake group1)
Variables   Protein intake group F-value Total (N=827)
Deficiency group (N=72) Deficiency group (N=72) Moderate group (N=325) Excessive group 1 (N=316) Excessive group 2 (N=114)
Energy (kcal) 1,158.49 ± 35.912) 1,715.60 ± 18.38 2,347.33 ± 22.62 3,313.20 ± 549.33 381.140∗∗∗ 2 2,133.66 ± 16.35
Energy nutrient intake Protein (g) 32.25 ± 50.73 53.65 ± 50.52 80.55 ± 50.78 129.38 ± 124.83 1041.739∗∗∗ 73.96 ± 50.71
Fat (g) 15.78 ± 50.94 27.38 ± 50.55 46.15 ± 50.83 82.97 ± 552.25 464.921∗∗∗ 43.07 ± 50.73
Carbohydrate (g) 219.63 ± 58.32 312.13 ± 54.06 400.28 ± 54.54 508.49 ± 558.76 249.490∗∗∗ 360.13 ± 53.46
Energy ratio Carbohydrate (%) 75.02 ± 50.84 72.41 ± 50.35 68.07 ± 50.31 61.41 ± 550.54 92.386∗∗∗ 69.23 ± 50.28
Protein (%) 11.66 ± 50.28 12.75 ± 50.10 13.93 ± 50.11 15.82 ± 550.18 68.392∗∗∗ 13.54 ± 50.91
Fat (%) 13.31 ± 50.67 14.83 ± 50.28 18.00 ± 50.24 22.77 ± 550.45 68.890∗∗∗ 17.23 ± 50.23

1) Adjusted for occupation in total subjects 2) Mean ± SD ∗∗∗: p < 0.001

Table 4.
Major sources and frequency of protein intake per week (N=827)
Rank Food Daily intake(g) Food Frequency of intake per week
1 Mixed grains 10.96 ± 0.321) Cabbage kimchi 13.20 ± 0.27
2 Milled rice 7.14 ± 0.30 Mixed grains 9.74 ± 0.28
3 Fried chicken 3.50 ± 0.21 Milled rice 8.01 ± 0.30
4 Grilled pork belly 3.04 ± 0.16 Milk 1.89 ± 0.11
5 Noodles 1.96 ± 0.10 Fried eggs 1.70 ± 0.07
6 Milk 1.81 ± 0.11 Soy bean paste stew 1.31 ± 0.06
7 Ramen 1.80 ± 0.08 Kimchi stew 1.28 ± 0.06
8 Stir-fried pork 1.77 ± 0.13 Soy bean paste soup 1.24 ± 0.06
9 Fried eggs 1.72 ± 0.07 Ramen 1.08 ± 0.04
10 Squid 1.51 ± 0.11 Grilled pork belly 0.76 ± 0.03
11 Bibimbap 1.51 ± 0.09 Noodles 0.63 ± 0.03
12 Black bean sauce noodle 1.50 ± 0.10 Bibimbap 0.61 ± 0.04
13 Beef bulgogi 1.50 ± 0.10 Stir-fried pork 0.47 ± 0.03
14 Steamed pork 1.33 ± 0.11 Squid 0.45 ± 0.03
15 Kimchi stew 1.27 ± 0.06 Black bean sauce noodle 0.40 ± 0.03
16 Soy bean paste stew 1.11 ± 0.05 Fried chicken 0.34 ± 0.02
17 Stir-fried chicken 1.04 ± 0.16 Steamed pork 0.24 ± 0.02
18 Cabbage kimchi 1.02 ± 0.03 Stir-fried chicken 0.23 ± 0.02
19 Soy bean paste soup 1.01 ± 0.05 Roast beef 0.23 ± 0.02
20 Roast beef 1.00 ± 0.08 Beef bulgogi 0.20 ± 0.02

1) Mean ± SD

Table 5.
Exploratory factor analysis for food sources1)
Factors Items Factor loading Communalities Eigen values (% of variance)
Grain White rice 0.893 0.824 2.872 (9.894)2)
Multi grain rice 0.876 0.787
Meat1 Grilled pork 0.544 0.484 1.666 (9.846)
Chicken 0.661 0.533
Meat2 Roast beef 0.895 0.756 1.421 (9.098)
Beef bulgogi 0.708 0.615
Stew Soy bean paste soup 0.613 0.420 1.212 (8.669)
Soy bean paste stew 0.742 0.672
Kimchi stew 0.650 0.578
Meat3 Stir-fried pork 0.511 0.488 1.058 (8.507)
Stir-fried chicken 0.665 0.515
Squid 0.626 0.442
Noodle Ramen 0.443 0.573 1.032 (7.957)
Noodles 0.812 0.690
Black bean sauce noodle 0.615 0.506
Egg & Milk Fried eggs 0.574 0.676 1.014 (6.468)
Milk 0.810 0.717
  Total score     (60.440)

1) Adjusted for occupation in total subjects 2) KMO and Bartlett's test 0.681 (p < 0.001)

Table 6.
Anthropometric measurement and blood pressure by protein intake group1)
Variables Protein intake group F-value Total (N=827)
Deficiency group Moderate group Excessive group 1 1 Excessive group 2
(N=72) (N=325) (N=316) (N=114)
Height(cm) 168.99 ± 1.062) 169.69 ± 0.52 170.53 ± 0.35 169.91 ± 0.50 3.359∗∗∗ 169.78 ± 0.34
Weight (kg) 67.95 ± 1.86 69.37 ± 0.89 69.51 ± 0.67 70.31 ± 0.92 3.797∗∗∗ 69.28 ± 0.56
Body mass index (kg/m2)3) 23.78 ± 0.58 24.09 ± 0.30 23.85 ± 0.18 24.29 ± 0.26 2.750∗∗ 24.00 ± 0.17
Waist circumference (cm) 81.49 ± 1.52 83.16 ± 0.75 83.49 ± 0.59 85.47 ± 0.75 2.466∗∗ 83.40 ± 0.49
Systolic blood pressure (mmHg) 119.27 ± 2.86 118.45 ± 1.45 121.96 ± 0.99 121.54 ± 1.32 1.995∗ 120.30 ± 0.92
Diastolic blood pressure (mmHg) 80.84 ± 1.58 79.36 ± 1.13 82.11 ± 0.66 81.31 ± 0.97 1.206 80.90 ± 0.54

1) Adjusted for occupation, energy intake, carbohydrate intake and fat intake in total subjects 2) Mean ± SD 3) BMI (Body mass index)=Weight(kg)÷{Height (m)×{Height(m)} ∗: p < 0.05

Table 7.
Biochemical factors related to metabolic syndrome by protein intake group1)
Variables Protein intake group F-value Total (N=827)
Deficiency group (N=72) Moderate group (N=325) Excessive group 1 (N=316) Excessive group 2 (N=114)
Fasting blood sugar (mg/dL) 593.74 ± 2.442) 96.29 ± 1.23 100.63 ± 1.20 102.14 ± 51.45 1.506 98.20 ± 0.82
HDL-cholesterol (mg/dL) 5 44.88 ± 1.76 47.15 ± 0.87 48.60 ± 0.77 50.15 ± 51.14 1.638 47.70 ± 0.53
Triglyceride (mg/dL) 153.29 ± 20.42 143.82 ± 9.74 166.43 ± 8.11 177.50 ± 10.22 2.543∗∗ 160.26 ± 5.72

1) Adjusted for occupation, energy intake, carbohydrate intake and fat intake in total subjects 2) Mean ± SD

Table 8.
Metabolic syndrome index and the prevalence by protein intake group1)
Variables Items Protein intake group χ2 value Total
Deficiency group Moderate group Excessive group 1 Excessive group 2
Waist circumference (cm) < 90 61 (982.4)1) 254 (979.3) 250 (979.8) 80 (969.9) 6.377 645 (978.3)
≥ 90 11 (917.6) 71 (920.7) 66 (920.2) 34 (930.1) 182 (921.7)
Total 72 (100.0) 325 (100.0) 316 (100.0) 114 (100.0) 827 (100.0)
Systolic blood pressure (mmHg) < 130 52 (970.8) 263 (980.1) 241 (978.3) 78 (968.6) 8.399 634 (976.9)
≥ 130 19 (929.2) 61 (919.9) 75 (921.7) 36 (931.4) 191 (923.1)
Total 71 (100.0) 324 (100.0) 316 (100.0) 114 (100.0) 825 (100.0)
Diastolic blood pressure (mmHg) < 85 46 (963.3) 219 (966.6) 206 (965.6) 72 (958.9) 2.551 543 (964.8)
≥ 85 25 (936.7) 105 (933.4) 110 (934.4) 42 (941.1) 282 (935.2)
Total 71 (100.0) 324 (100.0) 316 (100.0) 114 (100.0) 825 (100.0)
Fasting blood glucose (mg/dL) < 100 48 (968.8) 218 (967.1) 185 (963.1) 64 (960.4) 2.655 515 (964.7)
≥ 100 23 (931.2) 105 (932.9) 124 (936.9) 50 (939.6) 302 (935.3)
Total 71 (100.0) 323 (100.0) 309 (100.0) 114 (100.0) 817 (100.0)
Triglyceride (mg/dL) < 150 46 (963.4) 185 (954.7) 182 (955.8) 67 (958.6) 1.990 480 (956.4)
≥ 150 25 (936.6) 138 (945.3) 127 (944.2) 47 (941.4) 337 (943.6)
Total 71 (100.0) 323 (100.0) 309 (100.0) 114 (100.0) 817 (100.0)
HDL-cholesterol (mg/dL) < 40 24 (932.4) 102 (930.6) 99 (934.2) 27 (922.9) 5.399 252 (930.9)
≥ 40 47 (967.6) 221 (969.4) 210 (965.8) 87 (977.1) 565 (969.1)
Total 71 (100.0) 323 (100.0) 309 (100.0) 114 (100.0) 817 (100.0)
Retention numbers of metabolic syndrome components < 3 47 (965.7) 208 (962.6) 190 (962.7) 59 (953.7) 4.014 504 (961.5)
≥ 3 23 (934.3) 115 (937.4) 119 (937.3) 55 (946.3) 312 (938.5)
Total 70 (100.0) 323 (100.0) 309 (100.0) 114 (100.0) 816 (100.0)

1) N (%)

Table 9.
Odds ratio for metabolic syndrome by protein intake group1)3)
Variables Unadjusted Adjusted
OR (95% CI) OR (95%CI)
Protein intake group
Deficiency group 0.874 (0.445 − 1.717) 0.768 (0.345 − 1.712)
Moderate group 1.000 (reference)3) 1.000 (reference)2)
Excessive group 1 0.993 (0.688 − 1.435) 1.315 (0.761 − 2.272)
Excessive group 2 1.442 (0.874 − 2.377) 4.452 (1.544 − 12.835)

1) Adjusted for energy intake (continuous variable), carbohydrate intake (continuous variable), fat intake (continuous variable) and BMI (continuous variable) in total subjects 2) Odds ratio of deficiency, excessive 1, excessive 2 group based on the risk of moderate group 3) Calculated by Complex Samples Logistic Regression

Table 10.
Odds ratio for metabolic syndrome by the frequency of intake of proteins per week1)2)
Variables Unadjusted Adjusted
OR (95% CI) OR (95% CI)
Major sources of protein intake patterns Grain 1.028 (0.990 − 1.068) 1.050 (1.000 − 1.102)
Meat1 1.036 (0.931 − 1.154) 1.086 (0.935 − 1.262)
Meat2 1.063 (0.925 − 1.221) 1.073 (0.870 − 1.322)
Stew 1.017 (0.965 − 1.073) 1.026 (0.967 − 1.089)
Meat3 1.052 (0.791 − 1.678) 1.029 (0.774 − 2.158)
Noodle 1.022 (0.939 − 1.111) 1.032 (0.927 − 1.148)
Egg & Milk 1.000 (0.930 − 1.075) 1.025 (0.927 − 1.134)

1) Adjusted for energy intake, carbohydrate intake, fat intake and BMI in total subjects 2) Calculated by Complex Samples Logistic Regression

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