Association of Cardiometabolic Multimorbidity Pattern with Dietary Factors among Adults in South Korea

Abstract

Globally, cardiometabolic multimorbidity pattern (CMP) is a complex chronic health status that negatively effects the life expectancy of adults globally, even more than single diseases. We aimed to identify multimorbidity patterns in Korean adults to clarify the associations between dietary factors and CMP. Nationally representative data of 9011 Korean adults aged 19–64 years were obtained from the Korean National Health and Nutrition Examination Survey (KNHANES) from the period 2013 to 2015. Multimorbidity patterns for CMP, inflammatory disease, cancer and other disease patterns were identified by exploratory factor analysis. Dietary factors including food and nutrient intake and dietary habits were evaluated. Multivariable-adjusted logistic regression models examined the associations between dietary factors and CMP. More than half of the multimorbidity patterns were CMP (n = 4907, 54.5%); CMP subjects were more likely to be older, male, less educated, lower income, laborers, smokers, and high-risk consumers of alcohol than those of non-CMP subjects. A higher intake of calcium (OR = 0.809, 95% CI = 0.691–0.945), potassium (OR = 0.838, 95% CI = 0.704–0.998), and fruits (OR = 0.841, 95% CI = 0.736–0.960) were inversely associated with the prevalence of CMP, while the consumption of irregular meals (OR = 1.164, 95% CI = 1.034–1.312) and skipping breakfast (OR = 1.279, 95% CI = 1.078–1.518) was positively related to a 16% and 28% higher likelihood of CMP, respectively. CMP accounts for more than half of the multimorbidity patterns in the Korean population, and lower intake of calcium, potassium, fruits, and skipping meals have strong associations with CMP.

Alternative Healthy Eating Index-2010 and Incident Non-Communicable Diseases: Findings from a 15-Year Follow Up of Women from the 1973–78 Cohort of the Australian Longitudinal Study on Women’s Health

“…Regarding the relationship between dietary factors and NCD multimorbidty, the literature is limited and inconclusive [ 50 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 ]. Inverse associations between vegetable and fruits consumption and NCD multimorbidity have been documented in cross-sectional [ 130 , 131 ] and longitudinal [ 132 , 133 , 134 ] studies. The harmful effect of soft drink consumption on multimorbidity was reported in an Australian study (n = 36,663, aged ≥ 16 years, 51.1% women) [ 129 ].…”

Diet Quality and Incident Non-Communicable Disease in the 1946–1951 Cohort of the Australian Longitudinal Study on Women’s Health

“…There are few studies investigating the association between dietary factors and multimorbidity [ 94 , 95 , 96 , 97 , 98 ], particularly in middle-aged women. Shi et al (2014) reported that the relative odds of multimorbidity were increased for those who consumed soft drink > 0.5 litre per day compared with those who did not consume soft drinks (OR: 2.03; 95% CI: 1.68, 2.45) [ 94 ].…”

“…Shi et al (2014) reported that the relative odds of multimorbidity were increased for those who consumed soft drink > 0.5 litre per day compared with those who did not consume soft drinks (OR: 2.03; 95% CI: 1.68, 2.45) [ 94 ]. Protective effects of fruit and vegetable consumption on multimorbidity have been observed in cross-sectional [ 95 , 96 ] and prospective [ 97 , 98 , 99 ] studies. Among European participants, the relative odds of multimorbidity decreased for those who adhered to modified MDS compared with who did not [ 40 , 100 ].…”

Analysis of the Effects of Nutrient Intake and Dietary Habits on Depression in Korean Adults

“…Furthermore, we performed multiple linear regressions on the three reduced factors that were derived from the 23 nutrient intake variables by factor analysis. The objective of the factor analysis was to convert sets of correlated variables into a few non-correlated variables, which allows for more accurate models [43,44]. The multiple linear regression models along with the three factors were applied to the men, women, and overall groups.…”