Chocolate consumption and the prevalence of metabolic syndrome in the Korean adult population: an analysis based on the 2014-2016 Korea National Health and Nutrition Examination Survey

Abstract

BACKGROUND/OBJECTIVES Recent studies have reported chocolate consumption has beneficial effects on blood pressure, obesity, and dyslipidemia, which are components of metabolic syndrome (MetS). However, evidence regarding these relationships in Asia is limited. The aim of this study was to investigate relations between chocolate consumption and MetS in Korea. SUBJECTS/METHODS Study subjects were 6,982 adults aged 19-64 years free of major chronic diseases that participated in the 2014–2016 Korea National Health and Nutrition Examination Survey. Information on chocolate consumption was obtained using food frequency questionnaires. For primary analysis, subjects were divided into two groups: non-consumer (n = 3,741, 53.6%); consumer (n = 3,241, 46.4%). In order to investigate dose-response effects on MetS, chocolate consumers were divided into quartiles based on amounts consumed: Q1 (n = 789, 24.3%); Q2 (n = 837, 25.8%); Q3 (n = 863, 26.6%); Q4 (n = 752, 23.2%) in second analysis. RESULTS Chocolate consumers; 1) were more physically active( P < 0.0001); 2) less likely to smoke( P < 0.0001); 3) paid more attention to food nutrition labels ( P < 0.0001), and 4) had healthier dietary patterns, that is, they consumed vegetables, fruits, and dairy products more frequently( P < 0.0001) than non-consumers. Furthermore, chocolate consumers had a 30% lower risk of MetS (odds ratio, 0.70; 95% confidence interval, 0.58–0.86; P = 0.0005). However, dose-response effects between chocolate intake and MetS was not found by secondary analysis after excluding non-consumers. CONCLUSIONS In conclusion, chocolate consumers had healthier lifestyles and dietary patterns and a lower prevalence of MetS than non-consumers, as determined by our primary analysis. Although dose-response effects were not found to be significant among chocolate consumers during secondary analysis, the patterns were partially similar. This cross-sectional finding shows chocolate consumption does not increase the risk of MetS. The prospective studies and intervention trials in Korea are needed to confirm this cross-sectional finding.

Association between drinking behaviors and components of metabolic syndrome in subjects in their 20s and 30s: data obtained from the Korea National Health and Nutrition Examination Survey (2016–2018)

“…Although the pathological cause of MetS remains unclear, it is known to be associated with the relation between genetic and lifestyle-related environmental risk factors [ 24 ]. Previous studies have shown that various socio-demographics, such as gender, age, marital status, education level, income level, and occupation, are related to factors that affect drinking [ 3 25 ].…”

“…MetS is a cluster of risk factors including cardiovascular disease and diabetes, and is characterized by abdominal obesity, high FBG, high TG, low HDL-C, and high BP [ 24 28 ]. Each MetS component is a known risk factor for increased blood vessel occlusion, and incidence and mortality due to diabetes, cardiovascular disease, and stroke [ 28 ].…”

“…According to the criteria set by the adult treatment program III of the National Cholesterol Education Program (NCEP ATP III, 2005), abdominal obesity is defined and used by the Korean Society for The Study of Obesity as the standard for WC [ 23 ]. MetS risk factors are determined by the above selected 5 components, and are defined as the presence of 3 or more of the following components [ 24 ]: WC determines ‘Abdominal obesity’ (over 90 cm for men and 85 cm for women) [ 23 ]; TG levels are associated with ‘High TG’ (over 150 mg/dL), and HDL-C is classified as ‘Low HDL-C’ (less than 40 mg/dL for men and 50 mg/dL for women); ‘High BP’ is defined as SBP/DBP greater than 130/85 mmHg; FBG is classified as ‘High FBG’ at values over 100 mg/dL.…”

“…To determine the independence of the association between drinking behaviors and components of MetS, related variables identified as risk factors of MetS were included in the analysis. Variables of general characteristics (gender, age, marital status, income level, education), health related status (BMI, obesity status, smoking status, walking hours), and macronutrients intakes status have previously been identified as risk factors for MetS, and were included in the analysis [ 24 ]. These variables were analyzed as covariates in model 2, using variables with proven significance for each drinking behavior ( Tables 1 , 2 , 3 ).…”