Korean Journal of Health Promotion

Lee and Lee: The Association between Dietary Fiber Intake and Prevalence of Metabolic Syndrome in Middle-aged Adults in Gyeonggi Province

Original Article: Published online: December 19, 2015

DOI: https://doi.org/10.15384/kjhp.2015.15.2.75; The Association between Dietary Fiber Intake and Prevalence of Metabolic Syndrome in Middle-aged Adults in Gyeonggi Province; You-Sin Lee, Sim-Yeol Lee; Department of Home Economics Education, Dongguk University, Seoul, Korea; ￭ Corresponding author：Sim-Yeol Lee, PhD Department of Home Economics Education, Dongguk University, 30 Pildong-ro 1-gil, Jung-gu, Seoul 100-715, Korea
Tel: +82-2-2260-3413, Fax: +82-2-2265-1170 E-mail: slee@dongguk.edu; Received March 02, 2015 Accepted April 23, 2015; Copyright © 2015 The Korean Society of Health Promotion and Disease Prevention

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background: The aim of this study was to assess the dietary fiber intake of middle-aged adults in Gyeonggi and to evaluate its relation with the metabolic syndrome.

Methods: From April 2013 to October 2014, 279 (60 men, 210 women) middle-aged adults subject older than 30 years of age were recruited. Two-day dietary intake data were collected from each subject using the 24-hour recall method. Metabolic syndrome was diagnosed by anthropometric measurements, blood pressure, and blood analysis.

Results: When the subjects were divided into tertile groups by dietary fiber intake per 1,000 kcal, the middle tertile group showed higher fiber intake of 118.8% above the reference intake of 12 g/1,000 kcal, and the highest tertile group showed a higher fiber intake of 165.0% above the reference intake. The group with greater dietary fiber intake showed more mineral and vitamin intake but less energy, fat, and cholesterol intake. The major food groups that contributed to the dietary fiber in the lowest and the middle tertiles were vegetables, grains, fruits, and legumes, but in the highest tertile, legumes contributed more than fruits. The risk of metabolic syndrome (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.18-0.77), abdominal obesity (OR 0.45, 95% CI 0.23-0.85,) and hypertriglyceridemia (OR 0.42, 95% CI 0.21-0.83) were significantly reduced in the middle tertile compared to the lowest tertile.

Conclusions: The results suggest that there is a correlation between dietary fiber intake and risk factors for metabolic syndrome. It is highly expected that consuming sufficient amount of fruits and vegetables as a major source of dietary fiber can prevent and manage metabolic syndrome and chronic disease.

Key words: Dietary fiber; Metabolic syndrome; Middle-aged adults

Table 1.

Comparisons of subject characteristics by sex^a

Characteristics	Male (n=69)	Female (n=210)	Total (n=279)	P
Age, y	53.7±10.1	55.0±9.6	54.7±9.7	0.343^b
Education
≤Middle school	6 (8.7)	37 (17.6)	43 (15.4)	0.002^c
High school	25 (36.2)	106 (50.5)	131 (46.9)
≥College	38 (55.1)	67 (31.9)	105 (37.6)
Current drinking
Yes	62 (89.9)	115 (54.8)	177 (63.4)	<0.001
Current smoking
Yes Regular exercise	22 (31.9)	5 (2.4)	27 (9.7)	<0.001
Yes	60 (87.0)	165 (78.6)	225 (80.6)	0.126
Components of metabolic syndrome risk factors^d
Elevated fasting blood glucose	22 (31.9)	51 (24.3)	73 (26.2)	0.213
Elevated blood pressure	39 (56.5)	67 (31.9)	106 (38.0)	0.001
Low HDL-cholesterol Hypertriglyceridemia	18 (26.1) 37 (53.6)	60 (28.6) 45 (21.4)	78 (28.0) 82 (29.4)	0.690 <0.001
Abdominal obesity	32 (46.4)	63 (30.0)	95 (34.0)	0.013
Metabolic syndrome	29 (42.0)	42 (20.2)	71 (25.4)	0.001

Abbreviation: HDL, high density lipoprotein.

^aValues are presented as N (%) or mean±SD.

^bP from t-test.

^cP from chi-square test.

^dSerum fasting blood glucose ≥100 mg/dL; Systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥85 mmHg; Low serum HDL cholesterol <50 mg/dL for women or <40 mg/dL for men; Serum TG ≥150 mg/dL; Waist circumference ≥85 cm for women or ≥90 cm for men.

Table 2.

Nutrient intakes by tertile of dietary fiber intake g/1,000 kcal^a

	T₁ (lowest) (<12.2)	T₂ (12.2-16.0)	T₃ (highest) (≥16.0)	P for trend
Dietary fiber, g	16.3±5.8	21.2±5.5	28.0±8.6	<0.001^b
Fiber density, g/1,000 kcal % of AI	9.6±2.0 79.9±16.6	14.3±1.0 118.8±8.6	19.8±3.0 165.0±24.7	<0.001 <0.001
Energy, kcal	1,749.6±678.0	1,486.7±360.1	1,420.7±416.7	0.017
Carbohydrates, g	236.2±73.4	235.0±56.9	236.3±72.1	0.327
Fat, g	46.5±26.0	35.1±14.2	33.8±18.0	0.017
Protein, g	62.9±28.6	58.1±18.7	55.0±16.3	0.201
Vitamin A, ug RE	617.7±328.8	830.6±486.5	1,039.7±621.6	<0.001
Vitamin B₁, mg	1.2±0.7	1.1±0.4	1.3±1.1	0.148
Vitamin B₂, mg	1.0±0.4	1.0±0.4	1.1±0.4	0.006
Vitamin B₆, mg	1.5±0.7	1.5±0.5	1.6±0.6	0.028
Vitamin C, mg	79.0±40.9	114.8±48.8	143.8±87.6	<0.001
Niacin, mg	14.0±7.2	13.1±4.0	12.7±4.0	0.979
Folic acid, ug	395.4±169.5	463.4±159.5	530.4±230.7	<0.001
Calcium, mg Phosphrous, mg	373.3±145.5 893.5±357.0	427.6±175.5 932.4±271.6	460.4±199.7 966.4±283.2	0.001 0.012
Iron, mg	11.3±4.5	13.8±4.4	15.5±6.7	<0.001
Zinc, mg	8.9±4.1	9.0±3.0	9.4±6.6	0.398
Sodium, mg	3,198.7±1,282.7	3,147.8±1,164.5	2,868.3±930.0	0.949
Potassium, mg	2,301.7±823.0	2,890.1±923.6	3,266.2±1,056.3	<0.001
Cholesterol, mg	264.7±147.3	224.8±145.8	167.3±111.3	0.001

Abbreviation: AI, adequate intake.

^aValues are presented as mean±SD.

^bStatistical difference of variables between tertile of dietary fiber intake g/1,000 kcal calculated by General linear model (GLM) and variables were adjusted by age, sex.

Table 3.

Nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR) of diets by tertile of dietary fiber intake g/1,000 kcal^a

Variables	T₁ (lowest)	T₂	T₃ (highest)	P
NAR
Protein	0.92±0.15	0.95±0.10	0.95±0.12	0.172^b
Calcium	0.51±0.20^A	0.59±0.23^B	0.63±0.23^B	0.002
Phosphorus	0.93±0.14^A	0.97±0.09^B	0.97±0.09^B	0.007
Iron	0.87±0.19^A	0.97±0.09^B	0.98±0.07^B	<0.001
Vitamin A	0.75±0.24^A	0.87±0.19^B	0.92±0.17^B	<0.001
Vitamin B₁	0.84±0.20^A	0.87±0.15^B	0.90±0.14^B	0.015
Vitamin B₂	0.70±0.22^A	0.74±0.20^B	0.78±0.19^B	0.011
Niacin	0.81±0.21	0.84±0.18	0.82±0.18	0.361
Vitamin C	0.70±0.28^A	0.87±0.19^B	0.92±0.15^B	<0.001
MAR	0.78±0.16^A	0.85±0.11^B	0.87±0.10^B	<0.001

^aValues are presented as mean±SD.

^bStatistical difference of variables between tertile of dietary fiber intake g/1,000 kcal calculated by General linear model (GLM) and variables were adjusted by age, sex. Means with different letter (A, B) in the same row by Duncan's multiple range test are significantly different.

Table 4.

Contribution of each food groups to dietary fiber intakes by tertile^a

Food groups	T₁ (lowest)		T₂		T₃ (highest)		P
Food groups	g	%	g	%	g	%	P
Vegetables	5.5±2.9^A	34.2	6.9±3.3^B	32.4	9±4.0^C	32.1	<0.001^b
Cereals & grains	4.7±2.6	29.2	5.0±2.4	23.5	4.8±2.8	17.1	0.417
Fruits	1.6±1.6^A	9.9	3.1±2.6^B	14.6	4.1±4.8^C	14.6	<0.001
Legumes	1.1±1.7^A	6.8	1.9±2.1^A	8.9	4.5±5.3^B	16.1	<0.001
Seasonings	1.1±0.8^A	6.8	1.5±1.1^B	7.0	1.4±1.1^B	5.0	0.004
Potatoes & starches	0.6±1.2^A	3.7	1.2±2.3^A	5.6	2.0±3.5^B	7.1	0.018
Seeds & nuts	0.4±0.8	2.5	0.5±0.9	2.3	0.7±1.3	2.5	0.092
Seaweeds	0.3±0.8^A	1.9	0.4±0.8^B	1.9	0.7±1.1^B	2.5	0.020
Mushrooms	0.1±0.4^A	0.6	0.3±0.7^B	1.4	0.5±1.0^B	1.8	0.001
Milk & milk products	0.1±.0.9	0.6	0.2±0.2	0.9	0.1±0.4	0.4	0.433
Beverages	0.3±1.2	1.9	0.3±0.9	1.4	0.1±0.5	0.4	0.385
Meats & meat products	0.2±0.7	1.2	0.0±0.0	0.0	0.0±0.0	0.0	0.073
Sweets	0.0±0.0	0.0	0.0±0.0	0.0	0.1±0.2	0.4	0.154
Fish & shellfish	0.1±0.5	0.6	0.0±0.0	0.0	0.0±0.0	0.0	0.118
Other food items	0.0±0.0	0.0	0.0±0.0	0.0	0.0±0.0	0.0	0.389

^aValues are presented as mean±SD unless otherwise indicated.

^bStatistical difference of variables between tertile of dietary fiber intake g/1,000 kcal calculated by General linear model (GLM) and variables were adjusted by age, sex. Means with different letter (A, B, C) in the same row by Duncan's multiple range test are significantly different.

Table 5.

The major foods contributing to dietary fiber by tertile of dietary fiber intake g/1,000 kcal

Rank	T₁ (lowest)		T₂		T₃ (highest)
Rank	Food	%	Food	%	Food	%
1	Kimchi	6.9	Kimchi	4.8	Sweet potato	4.7
2	Rice	5.7	Rice	4.0	Soybean	4.1
3	Red pepper powder	3.6	Apple	3.8	Pepper	3.5
4	Pepper	2.7	Red pepper powder	3.5	Apple	3.5
5	Ra myon	2.6	Sweet potato	3.3	Kimchi	3.4
6	Barley	2.4	Pepper	3.2	Black beans	3.2
7	Potato	2.3	Brown rice	2.9	Adzuki beans	3.1
8	Tofu	2.1	Barley	2.7	Barley	3.0
9	Apple	2.0	Tomato	2.1	Persimmon	2.8
10	Korean raddish	1.8	Oriental melon	2.0	Red pepper powder	2.4
Total		32.2		32.5		33.7

Table 6.

Association between metabolic syndrome and its components and tertile of dietary fiber intake g/1,000 kcal

Tertile (T)	Odds ratio (95% CI)			P for trend
Tertile (T)	T1 (lowest)	T2	T3 (highest)	P for trend
Fasting blood glucose
Crude	1	1.19 (0.61-2.34)	1.48 (0.76-2.85)	0.244
Age, sex adjusted	1	1.10 (0.54-2.22)	1.34 (0.65-2.75)	0.414
Triglyceride
Crude	1	0.38 (0.20-0.72)	0.45 (0.24-0.85)	0.011
Age, sex adjusted	1	0.42 (0.21-0.83)	0.59 (0.29-1.19)	0.127
HDL-cholesterol
Crude	1	0.54 (0.28-1.05)	0.95 (0.51-1.76)	0.870
Age, sex adjusted	1	0.51 (0.25-1.01)	0.87 (0.44-1.70)	0.718
Blood pressure
Crude	1	0.87 (0.49-1.57)	0.60 (0.33-1.09)	0.097
Age, sex adjusted	1	0.98 (0.53-1.82)	0.73 (0.38-1.41)	0.346
Waist circumference
Crude	1	0.47 (0.25-0.86)	0.57 (0.31-1.05)	0.064
Age, sex adjusted	1	0.45 (0.23-0.85)	0.56 (0.29-1.09)	0.718
Metabolic syndrome^a
Crude	1	0.36 (0.18-0.71)	0.51 (0.27-0.96)	0.030
Age, sex adjusted	1	0.38 (0.18-0.77)	0.59 (0.29-1.19)	0.123

Abbreviations: CI, confidence interval; HDL, high density lipoprotein.

^aSerum fasting blood glucose ≥100 mg/dL; Systolic blood pressure ≥130 mmHg or diastolic blood pressure ≥85 mmHg; Low serum HDL cholesterol <50 mg/dL for women or <40 mg/dL for men; Serum TG ≥150 mg/dL; Waist circumference ≥85 cm for women or ≥90 cm for men.

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