This study is aimed to examine the association between macronutrient intake and lung function in healthy adults (n = 5880) using the Ansan-Ansung cohort study. To identify the index of lung function, we used the percentage difference of predicted Forced Expiratory Volume (%FEV1_diff) between baseline and follow-up. Based on the median %FEV1_diff, subjects were classified by two groups as “decreased vs. unchanged/improved”. The dietary macronutrients were estimated and validated using the food-frequency questionnaire. Multiple logistic regression models were used to evaluate the association after adjusting for confounders. Advanced analysis examined the association after stratifying by age and obesity. The average of %FEV1 is 114.1 and 112.5 at baseline and follow-up, respectively. The positive association of protein and fiber intake with lung function was observed in men. Low fat and high carbohydrate intake decreased the lung function in women only. After stratification by age, the association of protein, fat, and carbohydrate intake with lung function was observed in young men and old women only. Otherwise, the association of protein and fiber with lung function was influenced by abdominal obesity. In conclusion, the lung function was positively associated with high protein and fat intake, but was negatively associated with high carbohydrate intake, which could be influenced by age and obesity.

The relationship between ultra-processed food (UPF) intake and mortality is unknown in Asian countries, yet the intake of UPF is on the rise in these countries. This study examined the association of UPF intake with all-cause, cancer and cardiovascular disease (CVD) mortality. Participants were 113,576 adults who responded to a 106-item food frequency questionnaire during recruitment of the 2004–2013 Health Examinees (HEXA) study, a prospective cohort study in Korea. UPF were defined using the NOVA classification and evaluated as quartiles of the proportion of UPF in the diet (% total food weight). Multivariable Cox regression and restricted cubic spline models were used to examine the association of UPF intake with all-cause and cause specific mortality. A total of 3456 deaths were recorded during a median follow-up of 10.6 (interquartile range, 9.5–11.9) years. There was no evidence of an association of UPF intake with all-cause, cancer or CVD mortality comparing the highest with the lowest quartiles of UPF intake (all-cause mortality, men: hazard ratio [HR] 1.08, 95% confidence interval [CI] 0.95–1.22; women: HR 0.95, 95% CI 0.81–1.11; cancer mortality, men: HR 1.02, 95% confidence interval [CI] 0.84–1.22; women: HR 1.02, 95% CI 0.83–1.26; CVD mortality, men: HR 0.88, 95% CI 0.64–1.22; women: HR 0.80, 95% CI 0.53–1.19). However, the risk of all-cause mortality increased in both men and women with high consumption of ultra-processed red meat and fish (men, HR 1.26, 95% CI 1.11–1.43); women, HR 1.22 95% CI 1.05–1.43); and in men with high consumption of ultra-processed milk (HR 1.13, 95% CI 1.01–1.26); and soymilk drink (HR 1.12, 95% CI 1.00–1.25). We found no evidence of an association between total UPF intake and all-cause, cancer or CVD mortality, but ultra-processed red meat and fish in both sexes, and milk and soymilk drinks in men were positively associated with all-cause mortality.

ObjectivesThis study aimed to examine the association of high-sensitivity C reactive protein (hsCRP) with mortality risk and the attenuated effect of non-communicable disease history (NCDhistory) on the association.DesignProspective cohort study.SettingHealth Examinees cohort.ParticipantsA total of 41 070 men and 81 011 women aged ≥40 years were involved (follow-up: 6.8 years).Outcome measuresData and cause of death occurring until 31 December 2015 were confirmed by death statistics from the National Statistical Office. We conducted advanced analysis after stratification by NCDhistory and sensitivity analysis after excluding death before 1 or 2 years from recruitment. Cox proportional hazard and restricted cubic spline models were used to assess the association.ResultsThe association between serum hsCRP and risk of all-cause mortality was observed with strong linearity in both genders and was not influenced by NCDhistory. The association of serum hsCRP with risk of cancer mortality was not observed in women with NCDhistory, but the association with risk of cardiovascular disease (CVD) mortality was predominantly observed in men with NCDhistory.ConclusionsThis study suggests a dose–response association of hsCRP with mortality risk, including cancer and CVD mortality, in Koreans with low serum hsCRP, although the association with cancer and CVD mortality risk could be influenced by gender and NCDhistory.