Seong-Ah Kim; Shinyoung Jun; Hyojee Joung

doi:10.4163/jnh.2015.48.6.496

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Kim, Jun, and Joung: Estimated dietary flavonoids intake of Korean adolescent: Based on the Korea National Health and Nutrition Examination Survey 2007~2012∗

Research Article

J Nutr Health 2015;48(6):496-506.

Published online: 19 January 2015

DOI: https://doi.org/10.4163/jnh.2015.48.6.496

Estimated dietary flavonoids intake of Korean adolescent: Based on the Korea National Health and Nutrition Examination Survey 2007~2012^∗

Seong-Ah Kim¹, Shinyoung Jun¹, Hyojee Joung^1,^2,

¹Division of Public Health Nutrition, Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea

²Institute of Health and Environment, Seoul National University, Seoul 08826, Korea

^†To whom correspondence should be addressed. tel: +82-2-880-2781, e-mail: hjjoung@snu.ac.kr

^∗ This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (NRF-2014R1A2A2A01003138).

Received 7 May 2015 Revised 31 May 2015 Accepted 3 November 2015

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 purpose of this study was to estimate dietary flavonoids intake of Korean adolescents.

Methods:

Using data from the 2007-2012 Korean National Health and Nutrition Examination Survey, a total of 3,957 subjects aged 12-18 were included in this study. We estimated individual daily intake of total flavonoid and six flavonoid classes including flavonols, flavones, flavanones, flavan-3-ols, anthocyanidins, and isoflavones by linking food consumption data with the flavonoids in the commonly consumed food database. The distribution of sociodemographic, health-related, and dietary factors according to flavonoids intake was examined.

Results:

Average dietary flavonoids intake of the study subjects was 195.6 mg/d in girls, and 189.4 mg/d in boys. The highest flavonoids intake group consumed significantly more fiber, vitamin C, legumes, fruits, and vegetables (p ＜ 0.01) and less fat, grains, meats and dairy foods than other lower consumption groups (p ＜ 0.001). Dietary flavonoid intake showed negative correlation with waist circumference and systolic blood pressure (p ＜ 0.05).

Conclusion:

This study provided basic data for estimation of flavonoids intake of Korean adolescents. Further research will be required for analysis of the association of flavonoids intake and health-related factors such as cardiovascular risk factors.

Keywords: flavonoid, fruit, vegetable, adolescent, KNHANES

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Table 1.

General characteristics and total flavonoid intakes by sociodemographic and dietary lifestyle factors of the study population

Variables¹⁾	Male					Female
Variables¹⁾	n	%	Mean	SE	p value	n	%	Mean	SE	p value
All	2,097	-	195.64	9.10		1,860	-	189.43	9.37
Age
12 ~ 14 y	1,106	52.74	176.11	11.23	NS²⁾	952	51.18	206.34	11.85	NS
15 ~ 18 y	991	47.26	197.27	11.17		908	48.82	180.00	14.62
Household Income
Low	249	12.11	190.16	32.36	NS	245	13.37	155.26	14.86	NS
Middle-Low	461	22.42	178.23	14.09		461	25.16	188.78	18.41
Middle-High	629	30.59	201.37	15.45		567	30.95	194.92	17.74
High	717	34.87	207.57	14.35		559	30.51	198.87	18.06
Breakfast consumption³⁾
2/2 days	1,431	68.34	200.96	9.88	NS	1,178	63.33	193.56	11.09	NS
1/2 days	305	14.57	189.99	30.53		326	17.53	183.94	24.60
0/2 days	358	17.10	184.29	17.41		356	19.14	181.55	17.72
Eating out
^<= 3 times a month	12	0.57	101.06	27.99	< 0.05	6	0.32	226.68	.	NS
1 ~ 6 times a week	1,331	63.59	193.16	11.76		1,227	65.97	187.74	10.95
>= 1 time a day	750	35.83	202.55	14.07		627	33.71	191.98	17.34
Food security⁴⁾
Food secure	1,983	94.79	197.55	9.38	NS	1,760	94.83	192.66	9.67	NS
Food insecure	109	5.21	173.39	21.50		96	5.17	134.38	27.69

¹⁾ Number of missing values was 69, 3, 4, and 9 for household income, breakfast consumption, eating out, and food security respectively.

²⁾ Non significant

³⁾ 2/2 days : Of 2 days before KNHANES, having breakfast for 2 days, 1/2 days : Of 2 days before KNHANES, having breakfast for 1 day, 0/2 days : Of 2 days before KNHANES, having no breakfast

⁴⁾ Food secure : ‘All family membe had enough and a variety of foods during last year’ or ‘All family member had enough food (lacked variety) during last year’, Food inse cure: ‘The family could’t afford to have enough food (often/sometimes)’

Table 2.

The distribution of flavonoids intakes of the study population by sex and age group

Age	Flavonoids intake (mg/d)
Age	Male							Female
	Mean	SE	Min	25th	50th	75th	Max	Mean	SE	Min	25th	50th	75th	Max
Flavonols
12 ~ 14¹⁾	45.95	1.61	0.00	12.47	32.92	61.29	424.09	41.15	1.48	0.00	13.22	31.15	57.44	343.94
15 ~ 18¹⁾	56.65	2.62	0.00	14.01	37.47	76.39	860.28	43.96	3.37	0.00	11.71	27.78	56.67	1,847.67
Flavones
12 ~ 14	0.58	0.05	0.00	0.00	0.10	0.44	12.12	0.53	0.05	0.00	0.00	0.10	0.45	12.34
15 ~ 18	0.79	0.08	0.00	0.00	0.11	0.72	73.13	0.99	0.29	0.00	0.00	0.11	0.64	436.73
Flavanones
12 ~ 14	38.05	8.55	0.00	0.00	0.00	0.02	2,507.13	54.47	8.00	0.00	0.00	0.00	0.02	2,720.71
15-18	33.25	5.67	0.00	0.00	0.00	0.01	2,720.70	41.66	7.40	0.00	0.00	0.00	0.02	4,700.26
Flavan-3-ols
12 ~ 14	27.10	3.34	0.00	0.00	0.23	1.77	1,765.73	38.90	4.69	0.00	0.01	0.27	5.06	1,731.08
15-18	30.30	4.01	0.00	0.00	0.26	3.53	1,238.51	36.50	8.97	0.00	0.00	0.33	5.58	5,580.55
Anthocyanidins
12 ~ 14	19.50	2.88	0.00	0.00	3.01	11.26	2,031.94	24.43	3.40	0.00	0.42	3.93	12.83	904.49
15 ~ 18	23.58	3.72	0.00	0.00	2.75	10.88	2,031.93	22.16	2.76	0.00	0.00	3.06	11.53	1,707.93
soflavones
12 ~ 14	44.92	2.67	0.00	0.43	12.32	58.76	685.04	46.87	3.78	0.00	0.40	8.95	52.05	1,043.07
15 ~ 18	52.71	4.23	0.00	0.41	8.81	64.81	1,368.09	34.74	2.17	0.00	0.24	6.50	43.21	831.93
Total Flavonoids
12 ~ 14	176.11	11.23	0.00	41.74	96.38	202.50	3,139.87	206.34	11.85	0.00	44.31	98.37	223.88	2,921.32
15 ~ 18	197.27	11.17	0.00	44.41	108.02	220.93	3,213.23	180.00	14.62	0.00	36.96	85.08	199.17	7,512.11

¹⁾ Number of subjects was 1106 for male aged 12-14, 991 for male aged 15-18, 952 for female aged 12~14, and 908 for female aged

Table 3.

Nutrients and food group intake according to the quartile of total flavonoids density

Dietary intakes²⁾	Quartile of total flavonoids density (mg/1,000 kcal)¹⁾
Dietary intakes²⁾	Q1 (n = 989)	Q2 (n = 989)	Q3 (n = 990)	Q4 (n = 989)
Food group (g/d)
Grains	357.22 ± 6.41	355.44 ± 6.68	345.37 ± 6.73	302.59 ± 5.44∗∗∗
Legumes	25.69 ± 4.15	35.93 ± 3.15	54.29 ± 3.77	67.25 ± 3.94∗∗∗
Vegetables	157.49 ± 5.02	218.29 ± 6.45	265.80 ± 7.07	229.90 ± 5.59∗∗∗
Fruits	135.09 ± 16.25	176.64 ± 13.02	182.95 ± 11.20	398.79 ± 14.73∗∗∗
Meats	150.41 ± 7.22	161.22 ± 7.85	163.51 ± 8.60	134.23 ± 6.39∗∗
Miik and Dairy products	308.26 ± 13.55	273.53 ± 10.41	271.47 ± 9.72	258.48 ± 9.41∗∗∗
Nutrients
Total energy (kcal/d)	2,102.05 ± 34.87	2,205.27 ± 35.22	2,168.70 ± 35.78	2,008.72 ± 29.78∗∗∗
Carbohydrate (g/d)	319.29 ± 5.02	337.48 ± 5.08	330.84 ± 4.92	326.08 ± 5.01
Carbohydrate (% of total energy)	62.60 ± 0.45	62.63 ± 0.37	62.30 ± 0.37	64.93 ± 0.35∗∗∗
Protein (g/d)	71.27 ± 1.43	79.21 ± 1.85	81.53 ± 1.71	72.09 ± 1.32
Protein (% of total energy)	13.65 ± 0.15	14.32 ± 0.16	14.94 ± 0.13	14.22 ± 0.15
Fat (g/d)	57.74 ± 1.70	57.93 ± 1.36	57.53 ± 1.57	48.31 ± 1.05∗∗∗
Fat (% of total energy)	23.75 ± 0.40	23.05 ± 0.31	22.76 ± 0.32	20.86 ± 0.28∗∗∗
Dietary fiber (g/d)	4.75 ± 0.12	5.58 ± 0.13	5.91 ± 0.14	6.23 ± 0.14∗∗∗
Calcium (mg/d)	455.40 ± 12.83	479.76 ± 12.26	530.57 ± 12.96	520.59 ± 11.82∗∗∗
Phosphorus (mg/d)	1,105.23 ± 19.18	1,195.75 ± 20.29	1,262.52 ± 22.19	1,171.99 ± 19.71
Iron (mg/d)	11.30 ± 0.41	12.66 ± 0.45	13.75 ± 0.38	13.42 ± 0.33∗∗∗
Sodium (mg/d)	4,021.73 ± 86.22	4,340.68 ± 101.43	4,681.57 ± 108.67	4,068.21 ± 81.47
Vitamin C (mg/d)	53.00 ± 2.06	72.28 ± 2.23	89.14 ± 2.54	154.11 ± 5.37∗∗∗

¹⁾ Energy adjusted flavonoid intake was obtained by dividing flavonoid intake by 1,000 kcal.

²⁾ All values are Mean ± SE. ∗p for trend < 0.05, ∗∗p for trend < 0.01, ∗∗∗p for trend < 0.001, p for trend value was from GLM analysis.

Table 4.

The regression estimates of several food group intakes on the flavonoid intakes

Variables (100 g/d)	Flavonoid intake (mg/1,000 kcal)¹⁾
Variables (100 g/d)	Slope (β coeff.)	P-value	Model R² ²⁾³⁾
Total flavonoid density
Grains	-12.815	0.0003	0.3242
Legumes	36.099	0.0001
Vegetables	3.225	0.2935
Fruits	26.830	< .0001
Meats	-7.187	0.0024
Miik and Dairy products	-6.347	0.0002
Flavonol density
Grains	-2.761	< .0001	0.1728
Legumes	5.768	0.0847
Vegetables	5.969	< .0001
Fruits	0.904	0.0684
Meats	-0.226	0.6045
Miik and Dairy products	-1.498	< .0001
Anthocyanidin density
Grains	-3.504	0.0619	0.1727
Legumes	-2.078	0.4608
Vegetables	0.613	0.6507
Fruits	7.970	0.0290
Meats	-1.766	0.1169
Miik and Dairy products	-0.499	0.4859
Isoflavone density
Grains	-3.805	0.0001	0.2409
Legumes	27.953	< .0001
Vegetables	1.141	0.2459
Fruits	2.427	0.0418
Meats	-2.416	0.0087
Miik and Dairy products	-0.502	0.4860

¹⁾ Energy adjusted flavonoid intake was obtained by dividing flavonoid intake by 1,000 kcal.

²⁾ adjusted for sex, age

³⁾ The results of flavone, flavanone, and flavan-3-ol density were not presented because R< 0.15.

Table 5.

Top five food sources for the flavonoid intake among Korean adolescent

Compound	Rank	Food item	Everage intake (mg/day/person)	Contribution rate (%)	Cumulative contribution rate (%)
Flavonols	1	Onion	32.32	68.70	68.70
	2	Radish	3.09	6.58	75.27
	3	Radish leaves	2.80	5.94	81.22
	4	Apple	2.09	4.45	85.67
	5	Tangerine	0.98	2.08	87.75
Flavones	1	Sweetpepper	0.32	41.30	41.30
	2	Parsley, dried	0.11	14.28	55.58
	3	Watermelon	0.07	8.79	64.37
	4	Green pepper	0.06	7.93	72.30
	5	Kumquat	0.05	5.90	78.20
Flavanones	1	Tangerine	34.59	77.66	77.66
	2	Tangerinejuice	5.30	11.91	89.57
	3	Orange	1.52	3.41	92.98
	4	Fruits juice	1.00	2.25	95.23
	5	Orange juice	0.99	2.22	97.45
Flavan-3-ols	1	Apple	28.86	84.08	84.08
	2	Green tea	1.65	4.80	88.88
	3	Milk	0.75	2.19	91.06
	4	Green tea, Dried powder	0.69	2.02	93.08
	5	Strawberry	0.55	1.61	94.69
Anthocyanins	1	Grape	7.25	32.47	32.47
	2	Strawberry	3.69	16.55	49.02
	3	Persimmon	3.17	14.21	63.23
	4	Radish	2.94	13.17	76.40
	5	Well polished rice	0.90	4.05	80.44
Isoflavones	1	Soybean curd	28.16	61.35	61.35
	2	Tangerine	9.55	20.80	82.15
	3	Soybean sprout	4.48	9.77	91.91
	4	Doenjang, Soybean paste	1.16	2.53	94.44
	5	Soybean curd, Unpressed	0.81	1.76	96.21
Total flavonoids	1	Tangerine	45.49	23.34	23.34
	2	Onion	32.32	16.58	39.93
	3	Apple	31.13	15.97	55.90
	4	Soybean curd	28.16	14.45	70.35
	5	Grape	7.91	4.06	74.41

Table 6.

Sociodemographic, health-related and dietary lifestyle characteristics according to the quartile of total flavonoids density

Variables²⁾	Total flavonoids density (mg/1000kcal)¹⁾
Variables²⁾	Q1 (n = 989)	Q2 (n = 989)	Q3 (n = 990)	Q4 (n = 989)
Sociodemographic factor
Age (yr)	15.08 ± 0.07	15.02 ± 0.07	14.95 ± 0.08	15.03 ± 0.08
Female, %	40.96	46.98	43.34	51.06∗
Household Income (KRW/month)	418.52 ± 21.20	454.47 ± 39.38	439.61 ± 36.59	416.94 ± 23.77
Health-realted factor
BMI (kg/m²)	21.07 ± 0.16	20.83 ± 0.15	21.09 ± 0.16	20.79 ± 0.12
Waist circumference (cm)	70.82 ± 0.42	70.45 ± 0.39	71.24 ± 0.42	69.87 ± 0.35∗
Systolic blood pressure (mmHg)	107.09 ± 0.41	108.02 ± 0.42	107.95 ± 0.46	106.59 ± 0.45∗
Diastolic blood pressure (mmHg)	67.62 ± 0.35	68.54 ± 0.33	67.42 ± 0.42	67.80 ± 0.36
Fasting blood glucose (mg/d)	88.71 ± 0.44	88.87 ± 0.33	88.60 ± 0.30	88.36 ± 0.29
Triglyceride (mg/dL)	85.50 ± 2.14	86.19 ± 2.31	88.47 ± 2.38	84.18 ± 1.86
Total cholesterol (mg/dL)	156.40 ± 1.24	154.78 ± 1.17	156.59 ± 1.22	156.11 ± 1.18
Ditary lifestyle factor
Regular breakfast eater³⁾, %	58.98	64.17	66.73	63.41
Eating out ^>₌ 1 time a day, %	40.66	37.72	34.06	38.10
Household with food secure⁴⁾, %	94.42	93.41	93.90	96.15

¹⁾ Energy adjusted flavonoid intake was obtained by dividing flavonoid intake by 1,000 kcal.

²⁾ All values are Mean ± SE unless otherwise noted.

³⁾ Regular breakfast consumption : Of 2 days before KNHANES, having breakfast for 2 days

⁴⁾ Household with food secure : ‘All family member had enough and a variety of foods during last year’ or ‘All family member had enough food (lacked variety) during last year’.

∗p value < 0.05, p value from GLM analysis for continuous values and from chi-square test for categorical values

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