Associations between dietary factors and multimorbidity pattern among adults in South Korea

다국어 초록 (Multilingual Abstract)

Associations Between Dietary Factors and Multimorbidity Pattern among adults in South Korea

Abstract

The term “multimorbidity” refers to one person with two or more diseases at the same time. This is a concept that has emerged as diseases continue to accumulate with the ongoing increases in life expectancy. It signals the need for better patient management because it increases mortality rates and the cost of medical care and affects the quality of life of individuals. Multimorbidity pattern study is necessary for understanding its complexity and designing management protocols. On the other hand, several dietary factors such as food and nutrient intake, dietary habits, and dietary quality index have been demonstrated to be associated with multimorbidity. To date, there has been a lack of investigation regarding multimorbidity in Korea. Therefore, the present study aimed to identify the common multimorbidity patterns in Korean adults and to examine the associations between dietary factors and cardiometabolic diseases pattern (CMP). This study was cross-sectional design, and multimorbidity patterns were identified by exploratory factor analysis based on nationally representative data. Dietary factors including food and nutrient intake, dietary quality index, and diet habits were evaluated. The associations between dietary factors and multimorbidity pattern was estimated by multivariable regression analysis. Three multimorbidity patterns were identified: CMP, an inflammatory diseases pattern (IP), and a cancer and other diseases pattern (COP). The three multimorbidity patterns overlapped, and CMP was the most common [52.5%]. The CMP subjects were older and were more likely to be male and less educated, have a lower income, and be laborers. A higher number of them were smokers and high-risk consumers of alcohol as compared with the other groups. Furthermore, in this group, intake of carbohydrates, calcium, fruits, sugar, and sweetener was lower than in the non-CMP group. Moreover, the intakes of calcium (OR=0.809; 95%CI=0.691-0.945), potassium (OR=0.838; 95%CI=0.704-0.998), fruits (OR=0.841 ; 95%CI=0.736-0.960), and vegetables(OR=0.857; 95%CI=0.746-0.985) were inversely associated with CMP, while the consumption of irregular meals(OR=1.164; 95%CI=1.034-1.312) and skipping breakfast(OR=1.279; 95%CI=1.078-1.518) were positively associated with CMP. In conclusion, this study revealed that CMP accounts for more than half of the multimorbidity patterns in the Korean general population and highlighted that CMP was associated with reduced calcium, potassium, fruits, and vegetables intakes. An unhealthy lifestyle including eating irregular meals, skipping breakfast, smoking, and drinking alcohol was also found to increase the risk of CMP in this study.

목차 (Table of Contents)

• CHAPTER 1. LITERATURE REVIEW 1
• Literature review 1
• 1. Multimorbidity study 2
• 1-1. Background and definition of multimorbidity 2
• 1-2. Burden of multimorbidity 4
• 1-3. Prevalence of multimorbidity 5
• 1-4. Multimorbidity pattern 6
• 2. Dietary factors related to multimorbidity 9
• 2-1. Nutrients and food related to multimorbidity 9
• 2-2. Lifestyle factors related to multimorbidity 10
• 2-3 Dietary habits related to multimorbidity 10
• REFERENCES FOR LITERATURE REVIEW 12
• CHAPTER 2. ASSOCIATIONS BETWEEN DIETARY FACTORS AND MULTIMORBIDITY PATTERN IN KOREAN ADULTS 19
• Abstract 20
• 1. Introduction 22
• 2. Subjects and Methods 24
• 1) Study population 24
• 2) Definition of multimorbidity and chronic diseases 26
• 3) Assessment of diet-related factors 27
• 4) Demographic characteristics and socioeconomic status 28
• 5) Health related behaviors 28
• 6) Statistical analysis 29
• 3. Results 30
• 4. Discussion 54
• 5. References 59