Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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The effect of high-carbohydrate diet and low-fat diet for the risk factors of metabolic syndrome in Korean adolescents: Using the Korean National Health and Nutrition Examination Surveys (KNHANES) 1998-2009

우리나라 청소년의 고탄수화물 식사와 고지방 식사가 대사증후군 위험요인에 미치는 영향: 1998~2009년 국민건강영양조사 자료를 이용하여

  • Han, Mi-Rhan (Major of Food & Nutrition, School of Human Ecology, The Catholic University of Korea) ;
  • Lim, Jeong Hyun (Department of Food Service and Nutrition Care, Seoul National University Hospital) ;
  • Song, YoonJu (Major of Food & Nutrition, School of Human Ecology, The Catholic University of Korea)
  • 한미란 (가톨릭대학교 생활과학부 식품영양학과) ;
  • 임정현 (서울대학교병원 급식영양과) ;
  • 송윤주 (가톨릭대학교 생활과학부 식품영양학과)
  • Received : 2014.02.21
  • Accepted : 2014.05.21
  • Published : 2014.06.30
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Abstract

Purpose: The prevalence of metabolic syndrome has increased in both the adult population and in adolescents. However, few studies have been conducted for adolescents. The aim of this study was to examine the association of metabolic syndrome and its risk factors with high carbohydrate diet and high fat diet using data from the Korea National Health and Nutrition Examination Survey (1998-2009). Methods: Using the Acceptable Macronutrient Distribution Range for Korean Dietary Reference Intakes, subjects whose energy intake from carbohydrate was greater than 70% and from fat was less than 15% were classified as the 'High-carbohydrate & low-fat diet (HCLF)' group and subjects whose energy intake from carbohydrate was less than 60% and from fat was 25% or more were classified as the 'Low-carbohydrate & high-fat Diet (LCHF)' group. Among 5,931 eligible subjects, HCLF included 853 subjects and LCHF included 1,084 subjects. Results: The mean age in both groups was 14 years and significant difference in age, BMI, sex, physical activity, and household income was observed between the HCLF and LCHF groups. Regarding the energy intake compared to Estimated Energy Requirement, the HCLF group met 79.0% and the LCHF group met 100.3%. Regarding nutrient intake per 1,000 kcal, carbohydrate, iron, potassium, and vitamin C intake in the HCLF group were significantly higher, but protein, fat, calcium, phosphorus, vitamin A, thiamin, riboflavin, and niacin intakes were significantly lower in the HCLF group compared to the LCHF group. After adjusting for age, sex, BMI, study year, household income, physical activity, and energy intake, the serum triglycerides level and systolic blood pressure were slightly higher, while the serum HDL-cholesterol level was significantly lower in HCLF than LCHF. The odds ratio of metabolic syndrome did not differ significantly between HCLF and LCHF. Conclusion: Our findings indicate an association of a high carbohydrate diet with increased risks for metabolic syndrome components. Conduct of future studies would be necessary in order to explore the underlying mechanism and to confirm our findings in a prospective study.

본 연구는 제1기~제4기 국민건강영양조사 (1998~2009) 자료를 이용하여 10~18세 청소년을 대상으로 고탄수화물 식사 그룹 (HCLF)과 고지방 식사 그룹 (LCHF)의 식사 특성이 대사증후군 위험요인에 미치는 영향에 대해 분석하였다. 1) 에너지 섭취비율은 HCLF 그룹의 경우 탄수화물 : 단백질 : 지질이 76.3 : 12.6 : 11.1 인 반면, LCHF 그룹의 경우 52.9 : 14.7 : 32.4 로 두 그룹 간 유의적 차이가 났으며, 에너지 섭취는 HCLF 그룹이 1,733.1 kcal로 LCHF 그룹의 2,233.0 kcal에 비해 유의적으로 낮았다. 2) 두 그룹 간 에너지 섭취를 연령별 에너지 필요 추정량에 대비해 평가해보니 HCLF 그룹은 평균 79.0%를 충족하였고, LCHF 그룹은 100.3%를 충족하였다. 3) 에너지 섭취 보정을 위해 1,000 kcal 당의 영양소 밀도로 평가해보면 HCLF 그룹은 탄수화물, 나트륨, 철, 칼륨, 비타민 C의 섭취량은 유의적으로 높았으나, 단백질, 지방, 칼슘, 인, 비타민 A, 티아민, 리보플라빈, 나이아신의 섭취량은 유의적으로 낮았다. 4) 대사증후군 위험요인을 비교해보면, HCLF 그룹에서 LCHF 그룹에 비해 혈청 중성지질 농도와 수축기 혈압은 유의적으로 높았고, 혈청 HDL-콜레스테롤은 유의적으로 낮았다. 다른 지표들은 두 그룹 간 차이가 없었다. 5) HCLF 그룹과 LCHF 그룹 간에 대사증후군 위험요인의 위험도와 대사증후군의 교차비는 유의적 차이가 없었다. 본 연구의 결과를 통해 청소년 시기에도 고탄수화물 섭취가 대사증후군 지표에 영향을 미친다는 것을 살펴볼 수 있었다. 우리나라 탄수화물 섭취는 매우 높은 편이어서 앞으로 이 시기의 탄수화물의 질적, 양적 섭취 수준과 대사질환과의 관련성 연구가 더 이루어져야 하며, 성인기 만성질환으로의 이행에도 관련이 있으므로 장기적인 연구가 필요하다고 사료된다.

Keywords

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