Background Obesity is protective of bone health; however, abdominal obesity is associated with a higher fracture risk. Little is known about whether body composition protects or adversely affects osteoporotic fractures because of practical issues regarding assessment tools. This study aimed to evaluate the association of predicted body composition with fracture risk to determine the distinctive and differing effects of muscle or fat mass on bone health outcomes in the general population. Methods This population‐based, longitudinal cohort study used 2009–2010 Korean National Health Insurance Service data and follow‐up data from 1 January 2011 to 31 December 2013, to determine the incidence of osteoporotic fracture (total, spine, and non‐spine) defined using the International Classification of Diseases, Tenth Revision codes. The study participants were aged ≥50 years (men, 158 426; women, 131 587). The predicted lean body mass index (pLBMI), appendicular skeletal muscle index (pASMI), and body fat mass index (pBFMI) were used to assess body composition, using anthropometric prediction equations. Results Over a 3 year follow‐up, we identified 2350 and 6175 fractures in men and women, respectively. The mean age of the participants was 60.2 ± 8.3 and 60.7 ± 8.4 years in men and women, respectively. In a multivariable‐adjusted Cox proportional hazards regression model, increasing pLBMI or pASMI was significantly associated with a decreased risk of total fractures in men and women. When comparing individuals in the lowest pLBMI and pASMI (reference groups), men with the highest pLBMI and pASMI had adjusted hazard ratios of 0.63 [95% confidence interval (CI) 0.47–0.83] and 0.62 (95% CI 0.47–0.82), and women with the highest pLBMI and pASMI had adjusted hazard ratios of 0.72 (95% CI 0.60–0.85) and 0.71 (95% CI 0.60–0.85), respectively, for total fractures. The pBFMI had no significant association with total fractures in men or women. Regarding sex‐specific or site‐specific differences, the protective effects of the pLBMI and pASMI on fractures were greater in men and reduced the risk of spinal fractures. An increased pBFMI was associated with an increased risk of spinal fractures in women. Conclusions An increased pLBMI or pASMI was significantly associated with decreased total osteoporotic fracture risk; however, the pBFMI showed no statistically significant association. Muscle mass was more important than fat mass in preventing future osteoporotic fractures based on anthropometric prediction equations.

BACKGROUND/OBJECTIVES Sugar-sweetened beverages (SSBs) are regarded as modifiable risk factors for mental health in several populations. Although the consumption of SSBs is steadily increasing in Korea, there is scant evidence regarding the impact of SSB consumption on depression and suicidal ideation. The aim of this study was to investigate the association of SSB consumption with depression and suicidal ideation among adults in Korea. SUBJECTS/METHODS We used the data for 5,465 participants (2,170 men and 3,295 women) aged ≥ 20 years from the 2014 and 2016 Korea National Health and Nutrition Examination Survey. The subjects were divided into four groups according to SSB consumption using a food frequency questionnaire. Logistic regression analyses were conducted to examine the association of SSB consumption with depression and suicidal ideation, adjusting for sociodemographic, health behavior, and dietary variables. RESULTS Participants consuming ≥ 1 SSB/day had a significantly higher risk of depression (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.08–2.18; P < 0.001) and suicidal ideation (OR, 2.20; 95% CI, 1.13–4.28; P < 0.001) compared with those in the non-SSB group after adjusting for potential confounding factors. CONCLUSIONS Our results suggest that SSB consumption is positively associated with depression and suicidal ideation in Korean adults.

Background: Previous studies have shown that body composition is associated with chronic kidney disease (CKD), and perimenopause is associated with increased fat mass and decreased lean body mass. Muscle wasting is common among patients with CKD. Sarcopenic obesity (SO) refers to excess adiposity with decreased muscle mass. However, little is known about the relationship between SO and renal function decline. Here, we identified the relationship between SO and decreased estimated glomerular filtration rate (eGFR) in postmenopausal women. Methods: We conducted a cross-sectional study based on the data from the Korea National Health and Nutrition Examination Survey (2008-2011). We analyzed 4,560 postmenopausal women who underwent dual energy X-ray absorptiometry. Sarcopenia was defined based on weight-adjusted appendicular skeletal muscle mass. Obesity was defined based on body mass index. The eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Subjects were classified into four groups: normal, obese, sarcopenic, and sarcopenic obese. Logistic regression analysis was performed to examine the association between SO and decreased eGFR. The results were adjusted for variable confounders. Results: In the unadjusted model, the odds ratio (OR) of decreased eGFR for SO was 1.67 (95% confidence interval [CI], 1.23-2.26). The obese and sarcopenic groups had ORs of 0.67 (95% CI, 0.44-1.03) and 0.70 (95% CI, 0.44-1.10), respectively. After controlling for confounding variables, there was also a significant association between SO and decreased eGFR (adjusted OR, 1.48; 95% Cl, 1.05-2.07). Conclusion: SO was independently associated with decreased eGFR in postmenopausal Korean women.