Abstract P295: Dietary Pattern Mediates the Association Between Education Level and Metabolic Syndrome in Korean Adults

Abstract

Introduction: Emerging evidences have inconsistently reported that dietary components mediate the relationship between low socioeconomic status (SES) and higher cardiometabolic risk, but the findings are limited in Korean. Hypothesis: We tested the hypothesis whether the education level as a proxy for SES is associated with the prevalence of metabolic syndrome and this association is mediated by dietary pattern. Methods: We used nationally representative data from the Korea National Health and Nutritional Examination Survey (2008-2011) for cross-sectional analyses (Total number of subjects=22 607, 30-64 yrs). Dietary data were assessed using food frequency questionnaire including 63 food items and were categorized into seven food groups based on the Korea nutrient database. Metabolic syndrome was defined using revised National Cholesterol Education Program criteria. The possible mediating effect of dietary components (fruit, vegetable, red meat, milk, and soft-drink) on the association between education level and metabolic syndrome was tested using a multiple mediation model. Results: Education levels had direct and indirect effects via dietary consumption patterns on the prevalence of metabolic syndrome. Higher education level was directly associated with lower prevalence of metabolic syndrome (Odds ratio [OR]: 0.854, 95% Confidence Intervals [CIs]: 0.817-0.894). Regarding the medicating effect of dietary patterns, higher education level was indirectly associated with decreased prevalence of metabolic syndrome by high in fruit intake (OR: 0.983, 95% CIs: 0.947-0.992), red meat intake (OR: 0.991, 95% CIs: 0.985-0.996), milk intake (OR: 0.994, 95% CIs: 0.992-0.998), and by low in soft-drink intake (OR: 0.995, 95% CIs: 0.992-0.998). Gender modified the association between education level and metabolic syndrome prevalence. In women, there was significant inverse relationship between education level and the prevalence of metabolic syndrome with significant mediating effect of dietary pattern on metabolic syndrome. Conversely, mediating effect of dietary pattern was not observed in men. Conclusions: In conclusion, there was inverse association between education level and prevalence of metabolic syndrome, which is partially explained by specific dietary components in Korean adults. Our results provide information for establishing dietary guideline and nutrition policy to prevent and manage metabolic syndrome.