한국 성인 비만 집단의 탄수화물 급원 식품 섭취 분포 및 노출 위험도: 대규모 한국인유전체 역학 자료 활용

Objectives: The purpose of this study was to estimate the distribution and exposure prevalence of total carbohydrate intake and the carbohydrate-based foods such as rice, noodles, sweet potatoes, sweet drinks, milk and fruits and to characterize intake patterns among obese Korean adults. Methods: Subjects included 137,363 adults aged 40 years or older who participated in a Health Examinees (HEXA) Study. Multiple regression analysis of data from Semi-Quantitative Food Frequency Questionnaire (SQFFQ) identified food sources of carbohydrates. Weight, height and waist circumstance (WC) were measured, and the body mass index (BMI) was calculated. Obesity was defined as $BMI{\geq}25kg/m^2$ and abdominal obesity as $WC{\geq}90cm$ and ${\geq}85cm$ for males and females, respectively. Results: Obese adults appeared to have a higher total carbohydrate intake in the univariate analysis but had eaten less after adjustment for general and lifestyle factors, compared to normal weight adults (OR 0.78, 95% CI 0.73-0.82 for general obesity; OR 0.79, 95% CI 0.74-0.85, for abdominal obesity; P trend < 0.0001, respectively). Based on advance analysis for the food sources of carbohydrates, obese subjects had lower intake of rice (OR 0.86, 95% CI 0.68 -1.09 for general obesity; OR 0.87, 95% CI 0.67-1.13, for abdominal obesity; P trend < 0.0001, respectively) and higher intake of noodles (OR 1.21, 95% CI 1.16-1.27 for general obesity; OR 1.25, 95% CI 1.19-1.32, for abdominal obesity; P trend < 0.0001 respectively). With regard to other food sources of carbohydrates such as milk and fruits, intake was lower among obese compared to normal weight subjects. Conclusions: In the Korean middle-aged and older obesity groups, the intake of carbohydrates and the related foods was lower than in normal weight subjects, except for noodles. We conclude that a higher intake of noodles may enhance weight-gain. Therefore, this study suggested that the guidelines should consider the types of carbohydrate sources and the amount consumed from foods in order to provide proper guidance with regard to control and prevent obesity among Korean adults.