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Chung: The relationship of ready-to-eat cereal consumption with nutrition and health status in the Korean population based on the Korea National Health and Nutrition Examination Survey 2012
Research Article

J Nutr Health 2015;48(3):258-268.

Published online: 19 January 2015

DOI: https://doi.org/10.4163/jnh.2015.48.3.258

The relationship of ready-to-eat cereal consumption with nutrition and health status in the Korean population based on the Korea National Health and Nutrition Examination Survey 2012

Chin-Eun Chung†

Department of Food and Nutrition, Ansan University, Gyeonggi 426-701, Korea

†To whom correspondence should be addressed. tel: +82-10-4224-7599, e-mail: cechung@ansan.ac.kr

Received 7 May 2015       Revised 1 June 2015       Accepted 8 June 2015

Copyright © 2015 The Korean Nutrition Society

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

Purpose:

The aim of this study was to explore the relationship of ready-to-eat cereal (RTEC) consumption with nutrition and health status. Examination of health status for this project included obesity, abdominal obesity, hypertension, hypertriglyceridemia, hypercholesterolemia, low-HDL-cholesterolemia, diabetes, anemia, and metabolic syndrome.

Methods:

Two groups, RTEC consumers and those who did not consume RTEC, were identified using 24-hour dietary recall data from the 2012 Korea National Health and Nutrition Examination Survey (KNHANES). Nutritional intakes and risk factors of the two groups were compared using covariates-adjusted statistical procedures. Statistical analyses were performed using SAS survey procedures, and strata, cluster, and weight were considered. Subjects of analysis of nutritional intake were between the ages of 1 and 75, and those considered in the risk factor analysis were between the ages of 19 and 75.

Results:

Results showed that 3.8% of the Korean population was RTEC consumers. Compared to the subjects who did not intake RTEC, RTEC consumers exhibited significantly higher intakes of calcium, thiamin, riboflavin, and vitamin C. It was also discovered that the percentage of people whose intakes were less than EAR decreased with RTEC consumption. RTEC consumption showed significant association with decreased systolic blood pressure, diastolic blood pressure, serum triglyceride, and serum total cholesterol. Consequently, prevalence of hypertension among RTEC consumers was significantly lower than that among non-consumers, and the odds ratio for hypertension was 0.19 after adjusting the models for covariates.

Conclusion:

Results of this study clearly suggest an association of RTEC consumption with improved nutritional status and cardiometabolic risk profile in Korean adults. Conduct of additional studies will be necessary in order to determine the nature of these relationships.

Keywords: Ready-to-eat cereal (RTEC), Korea National Health and Nutrition Examination Survey (KNHANES), disease prevalence, cardiometabolic risk factors

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Table 1.
Daily ready-to-eat cereal (RTEC) consumption by gender and age group, KNHANES 2012
Gender Total Men Women
Age group N1) (%2)) Mean ± SE (g/day) N (%) Mean ± SE (g/day) N (%) Mean ± SE (g/day)
1~5 60 (9.8) 19.0 ± 2.0 36 (10.0) 20.3 ± 2.2 24 (9.6) 17.5 ± 1.9
6~11 46 (6.9) 31.5 ± 2.9 23 (7.3) 33.0 ± 2.4 23 (6.5) 29.7 ± 3.4
12~18 54 (9.6) 35.6 ± 2.0 22 (6.2) 48.3 ± 1.6 32 (13.7) 28.8 ± 2.8
19~29 35 (5.7) 27.4 ± 4.1 11 (4.9) 31.5 ± 8.5 24 (6.5) 23.9 ± 3.6
30~49 53 (2.7) 27.2 ± 4.4 19 (2.8) 34.5 ± 7.5 34 (2.6) 18.6 ± 2.4
50~64 17 (1.0) 22.4 ± 2.3 5 (0.7) 26.7 ± 2.1 12 (1.2) 19.9 ± 3.0
65~75 8 (0.8) 25.4 ± 4.1 3 (0.3) 22.5 ± 4.5 5 (1.1) 26.0 ± 4.8
Total 273 (3.8) 28.5 ± 1.9 119 (3.4) 33.9± 3.1 154 (4.2) 23.9 ± 1.8

All values are sample weighted.

1) Number of people who consumed RTEC in each age group

2) Percent of people who consumed RTEC in each age group

Table 2.
Daily nutrient intakes by Ready-to-eat cereal (RTEC) consumption for 1~18 and 19~75 years of age, KNHANES 2012
RTEC consumption 1~18 year 19~75 year
Nutrient RTEC consumer (n = 160) Mean ± SE RTEC non-consumer (n = 1,482) Mean ± SE P value RTEC consumer (n = 113) Mean ± SE RTEC non-consumer (n = 4,846) Mean ± SE P value
Energy (kcal) 1,827.5 ± 83.3 1,863.3 ± 33.1 0.6778 2,318.4 ± 110.4 2,052.9 ± 22.3 0.0183∗
Protein (g) 65.2 ± 4.2 67.1 ± 1.7 0.6492 86.4 ± 7.9 74.8 ± 1.0 0.1451
Lipid (g) 46.7 ± 4.0 48.5 ± 1.3 0.6594 62.2 ± 4.8 45.2 ± 0.9 0.0008∗
Carbohydrate (g) 290.7 ± 16.1 290.7 ± 4.8 0.9963 341.1 ± 14.8 319.0 ± 3.1 0.1583
%energy from protein 14.0± 0.4 14.2 ± 0.2 0.7077 14.7 ± 0.8 14.5 ± 0.1 0.8282
%energy from lipid 22.3 ± 1.3 22.5 ± 0.3 0.9268 22.9 ± 0.9 18.8 ± 0.2 < .0001
%energy from carbohydrate 64.4 ± 1.4 63.5 ± 0.4 0.5101 61.1 ± 1.8 64.6 ± 0.3 0.0765
Calcium (mg) 558.9 ± 21.7 481.8 ± 12.3 0.0011∗ 663.6 ± 35.6 504.9 ± 8.0 < .0001
Phosphorus (mg) 1,068.6 ± 52.2 1,058.6 ± 17.7 0.8547 1,335.7 ± 81.3 1,197.4 ± 13.1 0.0924
Iron (mg) 11.8 ± 1.2 11.3 ± 0.3 0.6586 14.3 ± 0.8 15.5 ± 0.3 0.1915
Natrium (g) 3,296.8 ± 324.0 3,395.7 ± 81.7 0.7619 5,075.4 ± 459.6 4,965.9 ± 74.7 0.8112
Potassium (g) 2,411.7 ± 169.7 2,343.8 ± 52.8 0.6675 3,255.0 ± 172.9 3,100.0 ± 41.9 0.3774
Vitamin A (µgRE) 749.5 ± 68.4 693.3 ± 52.5 0.5238 935.5 ± 69.7 924.5 ± 36.7 0.8879
Thiamin (mg) 1.4 ± 0.1 1.2 ± 0.0 0.0129∗ 1.8 ± 0.2 1.4 ± 0.0 0.0199∗
Riboflavin (mg) 1.6 ± 0.1 1.2 ± 0.0 < .0001∗ 1.9 ± 0.2 1.3 ± 0.0 0.0004∗
Niacin (mg) 16.5 ± 1.2 13.6 ± 0.3 0.0106∗ 22.3 ± 1.6 17.9 ± 0.2 0.0067∗
Vitamin C (mg) 132.6 ± 11.8 81.8 ± 3.3 0.0005∗ 131.4 ± 9.6 110.8 ± 2.7 0.0454∗

All values are sample weighted.

p values from t test by proc surveyreg procedure adjusted for covariates (age group, education, residential area, and occupation).

∗ Means are significantly different between RTEC consumer and non-consumer by t test at α = 0.05.

Table 3.
Percentage of people whose intakes are less than EAR by Ready-to-eat cereal (RTEC) consumption, for 1~18 and 19~75 year of age, KNHANES 2012 (%)
RTEC consumption 1~18 year 19~75 year
Nutrient RTEC consumer (n = 160) Mean ± SE RTEC non-consumer (n = 1,482) Mean ± SE P value RTEC consumer (n = 113) Mean ± SE RTEC non-consumer (n = 4,846) Mean ± SE P value
Protein 5.6 ± 3.6 9.0 ± 1.1 0.3504 9.5 ± 3.1 14.6 ± 0.8 0.1594
Calcium 69.3 ± 4.8 75.9 ± 1.6 0.1917 36.1 ± 5.4 68.9 ± 1.0 < .0001∗
Phosphorus 11.8 ± 3.7 14.3 ± 1.4 0.5616 4.6 ± 2.4 8.7 ± 0.6 0.0958
Iron 31.3 ± 5.5 43.9 ± 1.9 0.0404∗ 22.3 ± 4.0 22.8 ± 1.1 0.9120
Vitamin A 19.5 ± 4.6 38.6 ± 1.9 < .0001∗ 18.2 ± 4.5 37.8 ± 1.3 < .0001∗
Thiamin 8.7 ± 3.6 23.2 ± 1.5 0.0001∗ 15.4 ± 4.1 32.0 ± 1.0 0.0002∗
Riboflavin 8.4 ± 3.4 34.9 ± 1.8 < .0001∗ 20.3 ± 3.9 51.1 ± 1.0 < .0001∗
Niacin 14.3 ± 4.7 26.5 ± 1.7 0.0125∗ 11.5 ± 3.4 27.2 ± 1.0 0.0125∗
Vitamin C 34.1 ± 4.3 52.4 ± 1.9 0.0013∗ 32.2 ± 5.4 44.9 ± 1.2 0.0298∗

All values are sample weighted.

p values from t test by proc surveyreg procedure adjusted for covariates (age group, education, residential area, and occupation).

∗ Means are significantly different between RTEC consumer and non-consumer by t test at α = 0.05.

Table 4.
Percentage of people whose intakes are over UL by Ready-to-eat cereal (RTEC) consumption, for 1~18 and 19~75 years of age, KNHANES 2012 (%)
RTEC consumption 1~18 year 19~75 year
Nutrient RTEC consumer (n = 160) Mean ± SE RTEC non-consumer (n = 1,482) Mean ± SE P value RTEC consumer (n = 113) Mean ± SE RTEC non-consumer (n = 4,846) Mean ± SE P value
Calcium 0.0 ± 0.0 0.2 ± 0.1 0.0956 0.0 ± 0.0 0.2 ± 0.1 0.0225∗
Phosphorus 0.0 ± 0.0 0.1 ± 0.1 0.3187 0.0± 0.0 0.4 ± 0.2 0.0052∗
Iron 3.3 ± 1.8 1.5 ± 0.4 0.3207 0.0 ± 0.0 2.4 ± 0.3 < .000∗
Vitamin A 7.0 ± 1.9 7.7 ± 1.0 0.7912 0.8 ± 0.6 3.0 ± 0.4 0.0011∗
Niacin 25.7 ± 4.7 17.4 ± 1.3 0.0901 12.2 ± 4.1 5.7 ± 0.5 0.1290
Vitamin C 1.3 ± 0.9 0.2 ± 0.1 0.2435 0.0 ± 0.0 0.0 ± 0.0 0.3195

All values are sample weighted.

p values from t test by proc surveyreg procedure adjusted for covariates (age group, education, residential area, and occupation).

∗ Means are significantly different between RTEC consumer and non-consumer by t test at α = 0.05.

Table 5.
Demographic characteristics by ready-to-eat cereal (RTEC) consumption: for 19~75 years of age, KNHANES 2012
Demographic characteristics Stratified sample n RTEC consumer n (%) RTEC non-consumer n (%) P value
Total
  19~75 year 4,702 107 (2.7) 4,595 (97.3)  
Gender
  Men 1,890 37 (2.6) 1,853 (97.4) 0.7287
  Women 2,812 70 (2.8) 2,742 (97.2)
Age (year)
  19~29 571 30 (6.1) 487 (93.9)  
  30~49 1,652 53 (2.7) 1,599 (97.3) < 0.0001∗
  50~64 1,491 17 (1) 1,474 (99.0)
  65~75 1,042 7 (0.7) 1,035 (99.3)  
Household income
  1st quartile 757 11 (2.4) 746 (97.6)  
  2nd quartile 1,229 20 (1.8) 1,209 (98.2) 0.1977
  3rd quartile 1,254 33 (2.6) 1,221 (97.3)
  4th quartile 1,390 43 (3.7) 1,347 (96.3)  
Smoke
  Non-smoker 3,764 93 (3.0) 3,671 (97.0) 0.0562
  Smoker 786 12 (1.6) 774 (98.4)
Alcohol
  Non-drinker 1,360 29 (2.6) 1,331 (97.4) 0.8593
  Drinker 3,190 76 (2.9) 3,114 (97.3)
Exercise
  Non-exerciser 832 15 (2.3) 817 (97.7) 0.6164
  Exerciser 3,870 92 (2.7) 3,778 (97.3)
Education
  Elementary school graduates 1,562 4 (0.3) 1,558 (99.7)  
  High school graduates 1,555 35 (2.3) 1,520 (97.7) < 0.0001∗
  College graduates 1,353 63 (4.8) 1,290 (95.2)  
Residential area
  Urban 2,235 61 (3.5) 2,174 (96.5) 0.0220∗
  Other Region 2,467 46 (1.8) 2,421 (98.1)
Occupation
  Professional 589 27 (5.4) 562 (94.6)  
  Office/service worker 913 15 (1.8) 898 (98.2) 0.0023∗
  Agricultural/technical worker 1,177 15 (1.8) 1,162 (982)
  Student/housewife 1,787 45 (2.1) 1,742 (97.6)  

All values are sample weighted.

p values from the chi-square test

∗ Significantly associated between RTEC consumption and demographic variable from the chi-square test at a = 0.05.

Table 6.
Anthropometric and other cardiometabolic risk factors by Ready-to-eat cereal (RTEC) consumption for 19~75 years of age KNHANES 2012
RTEC consumption RTEC consumer RTEC non-consumer P value1)
Risk factor N Mean ± SE N Mean ± SE
Body mass index (kg/m2) 107 22.9 ± 0.4 4,582 23.8 ± 0.1 0.6682
Waist circumference (cm) 106 77.3 ± 1.3 4,580 80.9 ± 0.3 0.3040
Systolic blood pressure (mmHg) 104 109.9 ± 1.2 4,574 117.6 ± 0.4 0.0064∗
Diastolic blood pressure (mmHg) 104 72.6 ± 1.0 4,574 76.4 ± 0.3 0.0327∗
Serum triglyceride (mg/dl) 102 105.3 ± 6.7 4,367 134.1 ± 2.2 0.0155∗
Serum total cholesterol (mg/dl) 102 177.6 ± 3.4 4,367 189.0 ± 0.8 0.0477∗
Serum HDL-cholesterol (mg/dl) 102 49.4 ± 1.3 4,281 50.2 ± 0.3 0.0734
Plasma glucose (mg/dl) 102 92.8 ± 2.1 4,359 97.4 ± 0.5 0.9919
Hemoglobin (g/dl) 102 14.1 ± 0.2 4,356 14.3 ± 0.0 0.0569

All values are sample weighted.

p values from t test by proc surveyreg procedure adjusted for covariates (age group, education, residential area, and occupation)

∗ Means are significantly different between RTEC consumer and non-consumer by t test at α = 0.05.

Table 7.
Prevalence of chronic diseases by Ready-to-eat cereal (RTEC) consumption and Odds Ratio (and 95% confidence interval) for 19~75 years of age, KNHANES 2012
Chronic disease RTEC consumer RTEC non-consumer P value1) Odds ratio3) 95% CI P value2)
N Mean (%) ± SE N Mean (%) ± SE
Obesity 107 24.0 ± 5.0 4,582 32.7 ± 1.0 0.5861 0.86 (0.49, 1.53) 0.6013
Abdominal obesity 106 16.6 ± 4.0 4,580 31.0 ± 1.1 0.4730 0.81 (0.45, 1.43) 0.4890
Hypertension 100 3.4 ± 1.8 4,342 25.3 ± 1.0 < 0.0001∗ 0.19 (0.06, 0.60) 0.0042∗
Dyslipidemia
Hypertriglyceridemia 86 6.1 ± 2.5 3,681 15.6 ± 0.8 0.0638 0.51 (0.21, 1.22) 0.1311
Hypercholesterolemia 97 3.5 ± 1.6 4,113 13.0 ± 0.6 0.0434∗ 0.44 (0.17, 1.10) 0.0789
Low HDL-cholesterolemia 102 12.7 ± 4.2 4,281 18.0 ± 0.8 0.5774 0.83 (0.40, 1.74) 0.6184
Diabetes 97 3.0 ± 1.7 4,122 7.9 ± 0.5 0.6799 0.76 (0.25, 2.30) 0.6277
Anemia 102 6.4 ± 2.5 4,356 6.5 ± 0.5 0.7213 0.88 (0.37, 2.01) 0.7282
Metabolic syndrome 107 10.8 ± 3.8 4,595 23.0 ± 0.9 0.3852 0.68 (0.26, 1.77) 0.4316

All values are sample weighted.

1) p values from t test by proc surveyreg procedure adjusted for covariates (age group, education, residential area, and occupation).

2) p value from the Wald's chi square test 3) Odds ratios (reference = RTEC non-consumer) were adjusted for age group, education, residential area, and occupation from logistic regression models.

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