Association between Soft Drink Consumption and Metabolic Syndrome among Korean Adults: Data from the 2007-2011 Korea National Health and Nutrition Examination Survey

Abstract

As consumption of processed foods has increased, consumption of sugar-sweetened beverage (SSB) including soft drinks has increased worldwide. Accordingly, a positive relationship between SSB consumption and metabolic disease has been consistently reported in Western populations. In Korea, it has been reported that SSB is a major source of sugar intake from processed foods and sugar intake from soft drinks is the highest among all types of beverages. However, few studies have assessed to investigate the association between SSB intake and metabolic disease in Korean populations. To examine the association between SSB consumption and metabolic syndrome risk factors in Korean adults, this study used data from 13,972 participants (5,432 men and 8,540 women) aged ≥30 years, from the 2007?2011 Korea National Health and Nutrition Examination Survey. The subjects were divided into six groups based on their soft drink consumption levels from a food frequency questionnaire. In addition, total sugar intake from 24-hour dietary recall data was categorized into quintiles for comparison of associations of soft drink consumption and total sugar intake with metabolic syndrome. Nutrient intake was compared among groups using the 24-hour dietary recall data. The highest soft drink consumption frequency category was ≥4 times per week, observed in 4.6% of men and 1.7% of women. The percentage of energy from sugar in processed foods increased with increased soft drink consumption. In the highest soft drink consumption group, the percentage of energy from sugar in processed foods was 8.9% in men and 11.0% in women. The percentage of energy from sugar in milk and fruits significantly decreased with increased soft drink consumption in women. In contrast, the percentage of energy from sugar in different food sources significantly increased with total sugar intake in both men and women. After adjusting for potential confounding variables, greater consumption of soft drinks was positively associated with all of the components of metabolic syndrome, except the high density lipoprotein (HDL) cholesterol level, in women only. Women who consumed soft drinks ≥4 times per week had a 74% higher risk of metabolic syndrome compared to those who consumed soft drinks infrequently (OR: 1.74

95% CI: 1.00-3.03

P for trend <0.0001). However, total sugar intake was negatively associated with metabolic syndrome components in men and women. In conclusion, high levels of soft drink consumption might constitute an important determinant of metabolic syndrome and its components in Korean adult women.