Estimating change in cardiovascular disease and diabetes burdens due to dietary and metabolic factors in Korea 1998–2011: a comparative risk assessment analysis

Abstract

ObjectivesOver the past 10 years, the burden of chronic diseases in Korea has increased. However, there are currently no quantitative estimates of how changes in diet and metabolic factors have contributed to these shifting burdens. This study aims to evaluate the contributions of dietary and metabolic risk factors to death from cardiometabolic diseases (CMDs) such as cardiovascular conditions, strokes and diabetes in Korea, and to estimate how these contributions have changed over the past 10 years (1998–2011).Design and methodsWe used data on 6 dietary and 4 metabolic risk factors by sex, age and year from the Korea National Health and Nutrition Examination Survey. The relative risks for the effects of the risk factors on CMD mortality were obtained from meta-analyses. The population-attributable fraction attributable to the risk factors was calculated by using a comparative risk assessment approach across sex and age strata (males and females, age groups 25–34, 35–44, 45–54, 55–64, 65–74 and 75+ years) from 1998 to 2011.ResultsThe results showed that a suboptimal diet and high blood pressure were the main risk factors for CMD mortality in Korea. High blood pressure accounted for 127 096 (95% uncertainty interval (UI): 121 907 to 132 218) deaths from CMD. Among the individual dietary risk factors, a high intake of sodium (42 387 deaths; 95% UI: 42 387 to 65 094) and a low intake of fruit (50 244 deaths; 95% UI: 40 981 to 59 178) and whole grains (54 248 deaths; 95% UI: 47 020 to 61 343) were responsible for the highest number of CMD deaths in Korea.ConclusionsIndicating the relative importance of risk factors in Korea, the results suggest that metabolic and dietary risk factors were major contributors to CMD mortality.

The dietary transition and its association with cardiometabolic mortality among Chinese adults, 1982–2012: a cross-sectional population-based study

“…18 Adherence to a healthier dietary pattern has also been associated with a lower mortality risk in Koreans, Japanese and Singapore Chinese. [19][20][21] Compared with Japan and Korea, the average consumption levels that we observed in China were much lower for fish, marine omega-3 fatty acid, and fruit and were higher in vegetables and PUFA. We also found that the Chinese population had lower intakes of SSBs and processed meat than Japanese or Koreans.…”

Impact of dietary risk factors on cardiometabolic and cancer mortality burden among Korean adults: results from nationally representative repeated cross-sectional surveys 1998–2016

“…A recent study from China [ 13 ] reported moderate improvements in consumption of refined grains, fruits, and nuts and seeds and unfavorable changes in consumption of processed meat and sugar-sweetened beverages from 1982 to 2012, suggesting a shift in nutrition intervention and policy priorities for chronic disease prevention over time in China. We previously reported the associations between six dietary factors (fruits, vegetables, whole grains, processed meat, red meat, and sodium) and the burden of cardiometabolic disease mortality from 1998 to 2011 in Korea [ 14 ]. In that study, high intake of sodium and low intakes of fruits and whole grains were found to be responsible for the highest number of deaths from cardiometabolic diseases during the study period [ 14 ].…”

“…We previously reported the associations between six dietary factors (fruits, vegetables, whole grains, processed meat, red meat, and sodium) and the burden of cardiometabolic disease mortality from 1998 to 2011 in Korea [ 14 ]. In that study, high intake of sodium and low intakes of fruits and whole grains were found to be responsible for the highest number of deaths from cardiometabolic diseases during the study period [ 14 ]. Extending earlier studies [ 14 15 ], the present study examined the impact of nine dietary risk factors (fruits, vegetables, whole grains, processed meat, red meat, nuts and seeds, milk, sugar-sweetened beverages, and calcium), individually and collectively, on the burden of cardiometabolic disease and cancer mortality among Korean adults using nationally representative, repeated cross-sectional survey data from 1998 to 2016.…”

“…In that study, high intake of sodium and low intakes of fruits and whole grains were found to be responsible for the highest number of deaths from cardiometabolic diseases during the study period [ 14 ]. Extending earlier studies [ 14 15 ], the present study examined the impact of nine dietary risk factors (fruits, vegetables, whole grains, processed meat, red meat, nuts and seeds, milk, sugar-sweetened beverages, and calcium), individually and collectively, on the burden of cardiometabolic disease and cancer mortality among Korean adults using nationally representative, repeated cross-sectional survey data from 1998 to 2016. This study differs from the previous reports [ 14 15 ] by extending the CRA analysis to more comprehensively examine the secular trends of nine dietary factors over a longer period.…”

“…Extending earlier studies [ 14 15 ], the present study examined the impact of nine dietary risk factors (fruits, vegetables, whole grains, processed meat, red meat, nuts and seeds, milk, sugar-sweetened beverages, and calcium), individually and collectively, on the burden of cardiometabolic disease and cancer mortality among Korean adults using nationally representative, repeated cross-sectional survey data from 1998 to 2016. This study differs from the previous reports [ 14 15 ] by extending the CRA analysis to more comprehensively examine the secular trends of nine dietary factors over a longer period. We also quantified the mortality from cancer, as well as cardiometabolic diseases, attributable to nine selected dietary factors to provide evidence to inform nutritional policy priorities and identify the principal drivers of the burden.…”