An association between diet quality index for Koreans (DQI-K) and total mortality in Health Examinees Gem (HEXA-G) study

Lim, Jiyeon; Lee, Yunhee; Shin, Sangah; Lee, Hwi Won; Kim, Claire E.; Lee, Jong Koo; Lee, Sang Ah; Kang, Daehee

doi:10.4162/nrp.2018.12.3.258

Cited by 14 publications

(15 citation statements)

References 46 publications

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“…We did not have sufficient dietary information to evaluate overall diet quality, which is also an important lifestyle factor. Several studies have demonstrated that healthy dietary patterns were associated with lower risk of coronary heart disease and mortality in Korean adults [32][33][34] . Our findings (i.e., lifestyle risk score) do not fully capture the additional benefits of maintaining healthy diets.…”

Section: Discussionmentioning

confidence: 99%

Lifestyle risk score and mortality in Korean adults: a population-based cohort study

Lee

Nam

Kwon

et al. 2020

Sci Rep

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Individual lifestyle risk factors have been associated with an increased risk of mortality. However, limited evidence is available on the combined association of lifestyle risk factors with mortality in non-Western populations. The analysis included 37,472 participants (aged ≥19 years) in the Korea National Health and Nutrition Examination Surveys (2007-2014) for whom the data were linked to death certificates/medical records through December 2016. A lifestyle risk score was created using five unhealthy behaviors: current smoking, high-risk alcohol drinking, unhealthy weight, physical inactivity, and insufficient/prolonged sleep. Cox proportional hazards models were used to estimate hazard ratio (HR) and 95% confidence interval (CI). During up to 9 years of follow-up, we documented 1,057 total deaths. Compared to individuals with zero lifestyle risk factor, those with 4-5 lifestyle risk factors had 2.01 times (HR = 2.01, 95% CI = 1.43-2.82) and 2.59 times (HR = 2.59, 95% CI = 1.24-5.40) higher risk of all-cause and cardiovascular mortality, respectively. However, higher lifestyle risk score was not significantly associated with cancer mortality (p-trend >0.05). In stratified analyses, the positive associations tended to be stronger in adults aged <65 years, unemployed, and those with lower levels of education. In conclusion, combined unhealthy lifestyle behaviors were associated with substantially increased risk of total and cardiovascular mortality in Korean adults. Individual lifestyle risk factors such as obesity, physical inactivity, smoking, heavy alcohol use and poor diet have been associated with increased risk of various chronic diseases and premature death 1-4. More recently, insufficient or prolonged sleep has been identified as a predictor of adverse health outcomes 5,6. Generally, lifestyle behaviors have complex relationships and they tend to cluster in specific combinations within populations 7,8. Moreover, having multiple lifestyle risk factors can have synergistic effects on diseases. Thus, it is important to evaluate the combined effects of lifestyle factors on health outcomes to quantify disease burden and provide valuable public health messages for disease prevention. A number of epidemiological studies have examined the combined association of major lifestyle factors including obesity, smoking, alcohol, and physical activity in relation to mortality. A systematic review and meta-analysis of 15 cohort studies showed that adherence to at least four healthy lifestyle behaviors was associated with a 66% reduced risk of all-cause mortality, although high heterogeneity (I 2 = 94%) was observed between study populations 9. Subsequent studies consistently suggested the importance of healthy lifestyle behaviors for the prevention of diseases 10-18. However, majority of the studies were conducted in Western populations (e.g., US and Europe). Limited data are available for non-Caucasians, especially Asians 16,19-21 including Koreans 10,12,18 whose lifestyle patterns are different from Western populations...

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Section: Discussionmentioning

confidence: 99%

Lifestyle risk score and mortality in Korean adults: a population-based cohort study

Lee

Nam

Kwon

et al. 2020

Sci Rep

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“…In Korea, the DQI-K, a modified version of the DQI, was developed to reflect the specific nutrition reference intakes of Koreans. An increase in DQI-K has been correlated with an increase in mortality [ 13 ]. Therefore, it is necessary to evaluate diet quality according to specific groups or diseases in Korea.…”

Section: Discussionmentioning

confidence: 99%

“…Dietary intake data were collected during KNHANES using the 24-hour recall method and the DQI-K [ 13 ]. The DQI-K includes eight diet-related components: 1) daily protein intake, 2) percent energy from fat, 3) percent energy from saturated fat, 4) daily cholesterol intake, 5) daily whole-grain intake, 6) daily fruit intake, 7) daily vegetable intake, and 8) daily sodium intake.…”

Section: Methodsmentioning

confidence: 99%

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Relationship between diet quality and sarcopenia in elderly Koreans: 2008–2011 Korea National Health and Nutrition Examination Survey

Kim

Chung

et al. 2020

Nutr Res Pract

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BACKGROUND/OBJECTIVES Given the increasing proportion of the Korean population that is aged 65 years and older, the present study analyzed the relationship between diet quality and sarcopenia in elderly persons by using data from the 2008–2011 Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS Data for 3,373 persons aged 65 years and over (men: 1,455, 43.1%) were selected from the 2008–2011 KNHANES. Sarcopenia assessments are based on a formula that divides a subject's appendicular skeletal muscle mass (ASM) by their weight (wt) and multiplies that result by 100 ([ASM/wt] × 100). Sarcopenia is present if the subject's result was less than one standard deviation (SD) below the sex-specific mean for a young reference group. For evaluation of diet quality, data obtained via the 24-hour recall method were used to calculate the Diet Quality Index for Koreans (DQI-K). A general linear model was applied in order to analyze general information and nutritional intake according to sarcopenia status. For analysis of the relationship between diet quality and sarcopenia, a binominal logistic regression analysis was undertaken. RESULTS The sarcopenia prevalence rate among the study subjects aged 65 years and over was 37.6%. The DQI-K of those without sarcopenia was 3.33 ± 0.04 points, while that of those with sarcopenia was 3.45 ± 0.04 points ( P < 0.05). The relationship between diet quality and sarcopenia revealed that subjects aged 75 and older had a poor diet quality, and their odds ratio (OR) of sarcopenia presence was significantly higher (OR: 1.807, 95% confidence interval: 1.003–3.254, P < 0.05). CONCLUSIONS This study revealed that poor diet quality was related to sarcopenia presence in Koreans aged 75 and older. In order to improve the diet quality of the elderly (aged 75 and older), it is necessary to develop dietary improvement guidelines.

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“…Third, although we have adjusted for various confounding factors such as age, physical activity, chronic diseases and engagement in social activities, we cannot exclude the possibility of residual confounding from other relevant covariates which remains unaccounted for in our analyses. For example, previous studies have indicated that nutrient intake is associated with the risk of mortality45 and handgrip strength 46 47. However, we were unable to control for nutritional status due to lack of nutrition data in KLoSA.…”

Section: Discussionmentioning

confidence: 93%

Impact of handgrip strength on cardiovascular, cancer and all-cause mortality in the Korean longitudinal study of ageing

et al. 2019

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ObjectiveTo examine whether reduced handgrip strength, as a marker of muscle weakness, is linked with the risk of cardiovascular, cancer and all-cause mortality among older adults.DesignWe used data from the 2006 to 2014 Korean longitudinal study of ageing study. Estimates of handgrip strength were collected using a handheld dynamometer. Cox proportional hazard models with time-varying covariates were used to estimate HRs and their 95% CIs for all-cause mortality. The cause-specific hazards regression analysis was also used to model cardiovascular and cancer mortality, by treating deaths from the cause of interest as events and other causes of death as censored.Participants5859 participants aged 50 years or older were followed up until death or until the date of censoring (31 December 2014).Primary outcome measuresThe study outcomes of interest were all-cause, cardiovascular and cancer mortality.ResultsOf the participants included in analyses, 515 individuals (8.8%) died, reflecting an overall crude mortality rate of 11.0 deaths per 1000 person-years. Participants in the lowest handgrip strength tertile showed an increased risk of all-cause and cardiovascular mortality evidenced by a multivariable adjusted HRs of 1.90 (95% CI 1.33 to 2.73) and 1.59 (95% Cl 1.08 to 2.34), respectively. However, there were no significant differences in the rates of cancer-related death, with HR of 1.29 (95% CI 0.92 to 1.81 [lowest vs highest tertile; p trend=0.21]).ConclusionThese results demonstrate that lower handgrip strength is an independent predictor of mortality among a population-based sample of Korean elderly; highlighting the importance of interventions targeted at enhancing muscle strength for improvements in survival at older ages.

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An association between diet quality index for Koreans (DQI-K) and total mortality in Health Examinees Gem (HEXA-G) study

Cited by 14 publications

References 46 publications

Lifestyle risk score and mortality in Korean adults: a population-based cohort study

Lifestyle risk score and mortality in Korean adults: a population-based cohort study

Relationship between diet quality and sarcopenia in elderly Koreans: 2008–2011 Korea National Health and Nutrition Examination Survey

Impact of handgrip strength on cardiovascular, cancer and all-cause mortality in the Korean longitudinal study of ageing

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