Association of Fatty Acid Intake and Dyslipidemia in Korean Adults: Korea National Health and Nutrition Survey, 1998-2007

한국 성인의 지방산 섭취와 이상 지혈증과의 관련성 -1998~2007 국민건강영양조사 자료에 근거하여-

  • Park, Yong-Soon (Dept. of Food & Nutrition, Hanyang University) ;
  • Park, Hyo-Jin (Dept. of Food & Nutrition, Hanyang University) ;
  • Won, Sun-Im (Dept. of Human Nutrition & Food Science, Chungwoon University)
  • 박용순 (한양대학교 식품영양학과) ;
  • 박효진 (한양대학교 식품영양학과) ;
  • 원선임 (청운대학교 식품영양학과)
  • Received : 2011.09.19
  • Accepted : 2011.11.07
  • Published : 2011.12.31

Abstract

The purpose of this study was to examine the association between fatty acid intake and dyslipidemia in Korean adults, using data from the Korean National Health and Nutrition Examination Survey (KNHANES)I, II, III, and IV. After excluding subjects who had missing data for the dietary intakes, anthropometric measurments and laboratory tests, a total of 15,804 subjects aged 20~64 y (6,838 men and 8,966 women) from KNHANES 1998~2007 were included. All data were analyzed using SPSS Statistics software (version 18.0). Associations between fatty acid intakes and dyslipidemia were analyzed by logistic regression analysis after adjusting for age, BMI, energy intake, marital status, job, education level, alcohol intake, and smoking status. Fatty acid intakes were significantly higher in men than in women. The risk of hypertriglyceridemia was significantly and negatively associated with intakes of TFA, SFA, MUFA, PUFA, EPA, DHA, n-3 PUFA, and n-6 PUFA in both men and women. The risk of hypercholesterolemia was not significantly associated with any fatty acid intakes in either sex. The risk of high LDL cholesterolaemia was significantly and positively associated with intakes of TFA, MUFA, PUFA, LNA, n-3 PUFA, and n-6 PUFA in men however, there was no significant association with any fatty acids in women. The risk of low HDL cholesterolaemia was significantly and positively associated with intakes of TFA, MUFA, PUFA, LNA, n-3 PUFA, and n-6 PUFA in men, and was significantly and negatively associated with intakes of MUFA, PUFA, LNA, and n-3 PUFA in women. These results show that dyslipidemia is significantly associated with individual intake of fatty acids, suggesting that fatty acid type may be related to the risk of dyslipidemia.

Keywords

References

  1. Atherosclerosis study group (1984) Optimal resources for primary prevention of atherosclerotic disease. Circulation 70: 155A-205A.
  2. Ballantyne CM, Olsson AG, Cook TJ, Mercuri MF, Pedersen TR, Kjekshus J (2001) Influence of low high-density lipoprotein cholesterol and elevated triglyceride on coronary heart disease events and Response to Simvastatin Therapy in 4S. Circulation 104: 3046-51. https://doi.org/10.1161/hc5001.100624
  3. Beauchesne-Rondeau E, Gascon A, Bergeron J, Jacques H (2003) Plasma lipids and lipoproteins in hypercholesterolemic men fed a lipid lowering diet containing lean beef, lean fish, or poultry. Am J Clin Nutr 77: 587-593. https://doi.org/10.1093/ajcn/77.3.587
  4. Bonanome A, Grundy SM (1988) Effect of dietary stearic acid on plasma cholesterol and lipoprotein levels. N Engl J Med 318: 1244-1248. https://doi.org/10.1056/NEJM198805123181905
  5. Bowman BA, Russell RM (2001) Present knowledge in nutrition. 8th ed. ILSI, Washington DC, USA. pp 56-58.
  6. Cohen JD, Cziraky MJ, Cai Q, Wallace A, Wasser T, Crouse JR, Jacobson TA (2010) 30-years trends in serum lipids among united states adult:results from the National Health and Nutrition Examination SurveyII,III, and 1999-2006. Am J Cardiol 106: 969-975. https://doi.org/10.1016/j.amjcard.2010.05.030
  7. Criqui MH, Wallace RB, Heiss G, Mishkel M, Schonfeld G, Jones GT (1980) Cigarette smoking and plasma high-density lipoprotein cholesterol: The lipid research clinics program prevalence study. Circulation 62: IV70-IV76.
  8. Elizabeth R De O e S, Foster D, Harper MM, Seidman CE, Smith JD, Breslow JL, Brinton EA (2000) Alcohol consumption raises HDL cholesterol levels by increasing the transport rate of apolipoproteins A-I and A-II. Circulation 102: 2347. https://doi.org/10.1161/01.CIR.102.19.2347
  9. Estruch R, Martinez-Gonzalez MA, Corella D, Basora-Gallisa J, Ruiz-Gutierrez V, Covas MI, Fiol M, Gomez-Gracia E, Lopez-Sabater MC, Escoda R, Pena MA, Diez-Espino J, Lahoz C, Lapetra J, Saez G, Ros E, PREDIMED Study Investigators (2009). Effects of dietary fibre intake on risk factors for cardiovascular disease in subjects at high risk. J Epidemiol Community Health 63 :582-588. https://doi.org/10.1136/jech.2008.082214
  10. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Execute summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults(Adult Treatment Panel III). JAMA 285: 2486-2497. https://doi.org/10.1001/jama.285.19.2486
  11. Gonzalez-Requejo A, Sanchez-mayle M, Baeza J, Arnaiz P, Vila S, Asensio J, Ruiz-Jarabo C (1995) Relations between nurtrient intake and serum lipid and apolipoprotein lebels. J Pediatr 127: 53-57. https://doi.org/10.1016/S0022-3476(95)70256-3
  12. Goulding MR, Rogers ME, Smith SM (2003) Public health and aging: Trends in aging-United States and worldwide. JAMA 289: 1371-1373. https://doi.org/10.1001/jama.289.11.1371
  13. Grundy SM (1997) What is the desirable ratio of saturated, polyunsaturated, and monounsaturated fatty acids in the diet? Am J Clin Nutr 66: 988S-990S. https://doi.org/10.1093/ajcn/66.4.988S
  14. Harris WS (1997) n-3 Fatty acids and serum lipoproteins: Human studies. Am J Clin Nutr 65: 1645S-1654S. https://doi.org/10.1093/ajcn/65.5.1645S
  15. Haskell WL (2003) Cardiovascular disease prevention and lifestyle interventions: Effectiveness and efficacy. J Cardiovasc Nurs 18: 245-255. https://doi.org/10.1097/00005082-200309000-00003
  16. Hauner H, Stangl D, Schmatz C, Burger K, Blomer H, Pfeiffer EF (1990) Body fat distribution in men with angiographically confirmed coronary artery disease. Atherosclerosis 85: 203-210. https://doi.org/10.1016/0021-9150(90)90112-V
  17. He K, Liu K, Daviglus ML, Mayer-Davis E, Jenny NS, Jiang R, Ouyang P, Steffen LM, Siscovick D, Wu K, Barr RG, Tsai M, Burke GL (2008) Intakes of long-chain n-3 polyunsaturated fatty acids and fish in relation to measurements of subclinical atherosclerosis. Am J Clin Nutr 88: 1111- 1118. https://doi.org/10.1093/ajcn/88.4.1111
  18. Hegsted DM, Ausman LM, Johnson JA, Dallal GE (1993) Dietary fat and serum lipids: an evaluation of the experimental data. Am J Clin Nutr 57: 875-883. https://doi.org/10.1093/ajcn/57.6.875
  19. Heiss G, Johnson NJ, Reiland S, Davis CE, Tyroler HA (1980) The epidemiology of plasma high-density lipoprotein cholesterol levels: The lipid research clinics program prevalence study. Circulation 62: IV116-136. https://doi.org/10.1161/01.CIR.62.1.116
  20. Hino A, Adachi H, Toyomasu K, Yoshida N, Enomoto M, Hiratsuka A, Hirai Y, Satoh A, Imaizumi T (2004) Very long chain N-3 fatty acids intake and carotid atherosclerosis: An epidemiological study evaluated by ultrasonography. Atherosclerosis 176: 145-149. https://doi.org/10.1016/j.atherosclerosis.2004.04.020
  21. Hu D, Hannah J, Gray RS, Jablonski KA, Henderson JA, Robbins DC, Lee ET, Welty TM, Howard BV (2000) Effects of obesity and body fat distribution on lipids and lipoproteins in nondiabetic American Indians: The strong heart study. Obesity Research 8: 411-421. https://doi.org/10.1038/oby.2000.51
  22. Kay RM, Sabry ZI, Crisma A (1980) Multivariate analysis of diet and serum lipids in normal men. Am J Clin Nutr 33: 2565-2572.
  23. Korea Center for Disease Control and Prevention, Korean Ministry of Health and Welfare (2008) 2007 Korea Health Statistics, the 4th Korea Health and Nutrition Examination survey. pp 54-55.
  24. Korea Centers for Disease Control and Prevention, Korean Ministry of Health and Welfare (2010) Korea Health Statistics 2009;Korea National Health and Nutrition Examination Survey(KNHANES IV-3). pp 52-53.
  25. Korea Health Industry Development Institute (2001) Development of Nutrient Database: Fatty acid composition of foods; http://foodnara.go.kr/calculator/index.jsp.
  26. Korean Society of Lipidology and Atherosclerosis (2009) Committee for Establishing Treatment Instruction for Dyslipidemia of the Korean Society of Lipidology and Atherosclerosis Guidelines for management of dyslipidemia. 2nd ed. pp 39-47.
  27. Kris-Etherton PM, Pearson TA, Ying Wan, Hargrove RL, Moriarty K, Fishell V, Etherton TD (1999) High-monounsaturated fatty acid diets lower both plasma cholesterol and triacylglycerol concentrations. Am J Clin Nutr 70: 1009-1015. https://doi.org/10.1093/ajcn/70.6.1009
  28. Kromhout D (1992) Dietary fats: Long-term implications for health. Nutr Rev 50: 49-50.
  29. Li Z, McNamara JR, Fruchart JC, Luc G, Bard JM, Ordovas JM, Wilson PW, Schaefer EJ (1996) Effects of gender and menopausal status on plasma lipoprotein subspecies and particle sizes. J Lipid Res 37: 1886-1896.
  30. Luc D, Steven CH, Donna KA, Michael AP, John HE, Curtis RE (2003). Dietary linolenic acid is inversely associated with plasma triacylglycerol: The national heart, lung, and blood institute family heart study. Am J Clin Nutr 78: 1098-1102. https://doi.org/10.1093/ajcn/78.6.1098
  31. Mahan LK, Escott-Stump S (1996) Krause's food, nutrition & diet therapy, 9th ed.
  32. Mata P, Garrido JA, Ordovas JM, Blazques E, Alonso R, Oya MD(1992) Effects of dietary monounsaturated fatty acids on plasma lipororteins an apolipoproteins in women. Am J Clin Nutr 56: 77-83. https://doi.org/10.1093/ajcn/56.1.77
  33. Mattson FH, Grundy SM (1985) Comparison of effects of dietary saturated, monounsaturated, and polyunsaturated fatty acids on plasma lipids and lipoproteins in man. J Lipid Res 26: 194-202
  34. Mensink RP, Katan MB (1989) Effect of a diet enriched with monounsaturated or polyunsaturated fatty acids on levels of low-density an high-density lipoprotein cholesterol in healthy women and men. N Engl J Med 3219: 436-441.
  35. National Statistical Office (2010) 2009 Annual report of the cause for death statistics.
  36. Nestel PJ (1987) Polyunsaturated fatty acids (n-3, n-6). Am J Clin Nutr 45: 1161-1167. https://doi.org/10.1093/ajcn/45.5.1161
  37. Ng TKW, Hays KC, Dewitt GF (1992) Dietary palmitic and oleic exert similar effects on serum cholesterol and lipoprotein profiles in normocholesterolemic men and women. J Am Clin Nutr 11: 383-390.
  38. Nordy A, Hatcher LF, Ullmann DL, Connor WE (1993) Indivisual effects of dietary saturated fatty acids and fish oil on plasma lipids and lipoproteins in normal men. Am J Clin Nutr 57: 634-639. https://doi.org/10.1093/ajcn/57.5.634
  39. Oh KW, Lee SI, Song KS, Nam CM, Kim YO, Lee YC(1995) Fatty acid intake patterns and the relation of fatty acid intake to serum lipids of the Korean adults, Koroean J Lipidology 5: 167-181
  40. Oh SY, Monaca PA (1985) Effect of dietary cholesterol and degree of fat unsaturated on plasma lipid levels, lipoprotein composition, and fecal steroid excretion in normal young adult men. Am J Clin Nutr 42: 399-413. https://doi.org/10.1093/ajcn/42.3.399
  41. Paniagua JA, AG de la Sacristana, Sanchez E, Romero I, Vidal- Puig A, Berral FJ, Escribano A, Moyano MJ, Perez- Martinez P, Lopez-Miranda J, Perez-Jimenez F (2007) A MUFA-Rich diet improves posprandial glucose, lipid and GLP-1 responses in insulin-resistant subjects. J Am Coll Nutr 26: 434-444. https://doi.org/10.1080/07315724.2007.10719633
  42. Penny MK, Yu S (1997) Individual fatty acid effects on plasma lipids and lipoptroteins human studies. Am J Clin Nutr 65(suppl): 1628s-1644s. https://doi.org/10.1093/ajcn/65.5.1628S
  43. Rural Nutrition Institute & Rural Development Administration (2006) Food composition tables, 7th revision, Seoul: Rural Nutrition Institute, The Government of the Republic of Korea. pp 278-379.
  44. Russ EM, Eder HA, Barr DP (1951) Protein-lipid relationships in human plasma. I. In normal individuals. Am J Med 11: 468-479. https://doi.org/10.1016/0002-9343(51)90182-9
  45. Schatzkin A, Kipnis V, Carroll RJ, Midthune D, Subar AF, Bingham S, Schoeller DA, Troiano RP, Freedman LS (2003) A comparison of a food frequency questionnaire with a 24-hour recall for use in an epidemiological cohort study: Results from the biomarker-based observing protein and energy nutrition (OPEN) study. International Journal of Epidemiology 32: 1054-1062. https://doi.org/10.1093/ije/dyg264
  46. Shepherd J, Packard CJ, Patsch JR, Gotto AM Jr, Taunton OD (1978) Effects of dietary polyunsaturated and saturated fat on the properties of high density lipoproteins and the metabolism of apolipoprotein A-I. J Clin Invest 61: 1582- 1592. https://doi.org/10.1172/JCI109078
  47. The Korean Nutrition Society (2010). Dietary reference intakes for Koreans 2010. pp 78-83.
  48. Tricia L Psota, Sarah K Gebauer, Penny Kris-Etherton (2006) Dietary omega-3 fatty acid intake and cardiovascular risk. Am J Cardiol 98(suppl): 3-18. https://doi.org/10.1016/S0002-9149(06)01104-0
  49. Walsh BW, Schiff I, Rosner B, Greenberg L, Ravnikar V, Sacks FM (1991) Effects of postmenopausal estrogen replacement on the concentrations and metabolism of plasma lipoproteins. N Engl J Med 325: 1196-1204 https://doi.org/10.1056/NEJM199110243251702
  50. Whitney EN, Rolfes SR (2002) Understanding nutrition. 9th ed. Wadsworth Thomson Learning, CA, USA. pp 144-147.
  51. Wilson PW (2004) Assessing coronary heart disease risk with traditional and novel risk factors. Clin Cardiol 27: III7-11. https://doi.org/10.1002/clc.4960271504
  52. Wood PD, Haskell W, Klein H, Lewis S, Stern MP, Farquhar JW(1976) The distribution of plasma lipoproteins in middleaged male runners. Metabolism 25: 1249-1257. https://doi.org/10.1016/S0026-0495(76)80008-X
  53. Zambon A, Sartore G, Passera D, Francini-Pesenti F, Bassi A, Basso C, Zambon S, Manzato E, Crepaldi G (1999) Effects of hypocaloric dietary treatment enriched in oleic acid on LDL and HDL subclass distribution in mildly obese women. J Intern Med 246: 191-201. https://doi.org/10.1046/j.1365-2796.1999.00550.x