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Original article
Sex-specific associations between dietary legume subtypes and type 2 diabetes in a prospective cohort study
Hye Won Woo, Sangmo Hong, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Yu-Mi Kim, Mi Kyung Kim
Epidemiol Health. 2024;e2024083.   Published online October 17, 2024
DOI: https://doi.org/10.4178/epih.e2024083    [Accepted]
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  • 39 Download
AbstractAbstract PDF
Abstract
OBJECTIVES
Dietary soy, known for its high phytoestrogen content, has been suggested to exhibit a sex-specific association with type 2 diabetes. However, evidence regarding the sex-specific associations of different legume subtypes with type 2 diabetes remains scarce. We aimed to evaluate whether habitual consumption of soy and non-soy legumes (beans and peanuts) was prospectively and sex-specifically associated with the risk of type 2 diabetes incidence, taking into considering significant sex-specific genetic factors beyond legume consumption.
METHODS
A total of 16,666 participants (96,945 person-years) were followed and 945 incident cases were observed. Cumulative intake of legume subtypes was calculated using a food frequency questionnaire administered at baseline and during the revisit surveys.
RESULTS
Non-soy legumes are inversely associated with type 2 diabetes in both men and women. Dietary soy intake, however, demonstrated a unilaterally interacting sex-specific association with type 2 diabetes risk (pinteraction for sex=0.0173). Specifically, there was a significant inverse association with type 2 diabetes risk in women (incidence rate ratio, 0.66; 95% confidence interval, 0.48 to 0.80; ptrend=0.0066), but no such association was observed in men. This sex-specific association persisted and even appeared antagonistic in minor allele carriers of 2 novel single nucleotide polymorphisms, rs10196939 (LRRTM4) and rs11750158 (near GFPT2) (pinteraction for sex=0.0014 and 0.0112, respectively).
CONCLUSIONS
Habitual consumption of legumes shows protective impacts against type 2 diabetes, although these benefits vary by sex. Non-soy legumes provide health advantages for both men and women, whereas soy consumption seems to be beneficial exclusively for women.
Summary
Methods
Expansion of a food composition database for the food frequency questionnaire in the Korean Genome and Epidemiology Study (KoGES): a comprehensive database of dietary antioxidants and total antioxidant capacity
Jiseon Lee, Ji-Sook Kong, Hye Won Woo, Mi Kyung Kim
Epidemiol Health. 2024;46:e2024050.   Published online May 10, 2024
DOI: https://doi.org/10.4178/epih.e2024050
  • 3,582 View
  • 72 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study constructed a comprehensive database of dietary antioxidants and total antioxidant capacity (TAC) to facilitate the estimation of daily antioxidant intake using a food frequency questionnaire (FFQ). This database was applied to 3 general population-based cohorts (n=195,961) within the Korean Genome and Epidemiology Study (KoGES).
METHODS
To establish a database of 412 foods derived from recipes of a 106-item FFQ, we followed a pre-established standardized protocol. This included the selection of source databases, matching of foods, substitution of unmatched items with identical foods and input of values, and assessment of coverage. For each food, the TAC was estimated by summing the individual antioxidant capacities, calculated by multiplying the amount of each antioxidant by its vitamin C equivalent antioxidant capacity.
RESULTS
We identified 48 antioxidants across 5 classes: retinol, carotenoids, vitamins C and E, and flavonoids, with flavonoids divided into 7 subclasses. TAC values were then established. Coverage exceeded 90.0% for retinol, carotenoids, vitamin C, and vitamin E, while coverage for flavonoids was 60.9%. The daily intakes of 4 antioxidant classes—all but vitamin E—were higher in women than in men. The Ansan-Ansung cohort exhibited the highest levels of dietary TAC, vitamin E, and flavonoids, while the Health Examinees Study cohort displayed the highest values for retinol, carotenoids, and vitamin C.
CONCLUSIONS
We customized a comprehensive antioxidant database for the KoGES FFQ, achieving relatively high coverage. This expansion could support research investigating the impact of dietary antioxidants on the development of chronic diseases targeted by the KoGES.
Summary
Korean summary
본 연구는 한국인유전체역학조사사업(KoGES) 식품섭취빈도조사(FFQ)에 특화된 항산화 데이터베이스를 확장하여 개발한 첫 번째 연구로, 48종의 항산화제와 TAC 값을 포함하여 기존 연구의 부족한 부분을 채웠습니다. 코호트 별로 식이 항산화제 섭취량에서 큰 차이가 나타났으며, 지역사회 기반 코호트에서는 비타민 E와 플라보노이드 섭취가 가장 높았고, 도시 기반 코호트에서는 레티놀, 카로티노이드, 비타민 C 섭취에서 가장 높았습니다. 반면, 농촌 기반 코호트에서는 대부분의 항산화제 섭취량이 가장 낮았습니다. 또한 성별, 연령, 및 교육 수준에 따른 섭취량의 차이도 확인되었으며, 주로 여성, 젊은 연령층, 그리고 교육 수준이 높은 사람들이 더 많은 항산화제를 섭취한 반면, 고령자와 흡연자는 섭취량이 적게 나타났습니다.
Key Message
This study is the first to develop an expanded antioxidant database specifically for the Korean Genome and Epidemiology Study (KoGES) FFQ, addressing a critical gap in research by including a broad range of 48 antioxidants and total antioxidant capacity (TAC). Significant differences in dietary antioxidant intake were observed across different cohorts, with participants in the Ansan and Ansung (ASAS) study consuming the most vitamin E and flavonoids, while those in the Health Examinee (HEXA) study had the highest intake of retinol, carotenoids, and vitamin C. In contrast, the Cardiovascular Disease Association Study (CAVAS) showed the lowest intake of most antioxidants. Demographic differences were also evident, with women, younger individuals, and those with higher education levels consuming more antioxidants, while older adults and smokers consumed less.

Citations

Citations to this article as recorded by  
  • Diet-Wide Association Study for the Incidence of Type 2 Diabetes in Three Population-Based Cohorts
    Hye Won Woo, Manh Thang Hoang, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Yu-Mi Kim, Mi Kyung Kim
    Nutrients.2024; 16(22): 3798.     CrossRef
Original Articles
A prospective association between dietary mushroom intake and the risk of type 2 diabetes: the Korean Genome and Epidemiology Study–Cardiovascular Disease Association Study
Yu-Mi Kim, Hye Won Woo, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Mi Kyung Kim
Epidemiol Health. 2024;46:e2024017.   Published online January 8, 2024
DOI: https://doi.org/10.4178/epih.e2024017
  • 4,273 View
  • 115 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Mushrooms, known for their nutritious and functional components, are considered healthy and medicinal. This study investigated the prospective association between dietary mushroom consumption and the incidence of type 2 diabetes among Korean adults aged ≥40 years.
METHODS
In total, 16,666 participants who were not taking anti-diabetic medication or insulin and had normal fasting blood glucose (FBG; <126 mg/dL) were included. We used the cumulative average dietary consumption of mushrooms as an exposure metric, calculated from food frequency questionnaires at every follow-up, along with covariates collected during a baseline survey. To estimate incidence rate ratios (IRRs) for type 2 diabetes, a modified Poisson regression model with a robust error estimator was applied.
RESULTS
In multivariable models, dietary mushroom consumption was inversely associated with type 2 diabetes incidence in both genders (men: IRR, 0.65; 95% confidence interval [CI], 0.47 to 0.90; p<sub>linearity</sub>=0.043 in the highest quartile (Q4) vs. the lowest quartile (Q1); women: IRR, 0.70; 95% CI, 0.54 to 0.93; p<sub>linearity</sub>=0.114 in Q4 vs. Q1). The inverse association remained after adjustment for dietary factors instead of dietary quality index, the baseline FBG, and the exclusion of incidence within the first year. Additionally, no significant interaction was found regarding the risk of type 2 diabetes between dietary mushroom consumption and participants’ gender or other factors.
CONCLUSIONS
Dietary mushroom consumption was inversely linked with the risk of type 2 diabetes incidence in both genders, indicating the beneficial role of mushrooms in preventing the disease.
Summary
Korean summary
- 흔히 사용하는 버섯의 식이 섭취량이 증가함에 따라 한국 40세 이상 성인에서 제2형 당뇨병 발생 위험이 낮았다. - 이러한 역관계는 성별과 다양한 식이 배경에서도 일관성을 유지하였고, 이는 버섯이 제2형 당뇨병 예방에 있어 잠재적인 식이요소로서의 가능성을 보여주는성을 보여주는 보여주는 결과이다.
Key Message
• Increased dietary consumption of commonly used mushrooms is associated with a lower risk of type 2 diabetes incidence among adults aged 40 years or older in Korea. • This inverse relationship remains consistent across genders and various dietary backgrounds, underscoring the potential of mushrooms as a preventive dietary component against.
Associations of cumulative average dietary total antioxidant capacity and intake of antioxidants with metabolic syndrome risk in Korean adults aged 40 years and older: a prospective cohort study (KoGES_CAVAS)
Ji-Sook Kong, Jiseon Lee, Youngjun Kim, Hye Won Woo, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Yu-Mi Kim, Mi Kyung Kim
Epidemiol Health. 2023;45:e2023067.   Published online July 28, 2023
DOI: https://doi.org/10.4178/epih.e2023067
  • 6,577 View
  • 138 Download
  • 3 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Limited and inconsistent prospective evidence exists regarding the relationship of dietary total antioxidant capacity (dTAC) and antioxidant intake with metabolic syndrome (MetS) risk. We evaluated the associations of the cumulative averages of dTAC and antioxidant intake (in 5 classes: retinol, vitamin C, vitamin E, carotenoids, and flavonoids, as well as 7 flavonoid subclasses) with the risk of MetS.
METHODS
This study included 11,379 participants without MetS, drawn from the Korean Genome and Epidemiology Study_CArdioVascular disease Association Study (KoGES_CAVAS). The cumulative average consumption was calculated using repeated food frequency questionnaires. Incidence rate ratios were estimated using a modified Poisson regression model with a robust error estimator.
RESULTS
The median follow-up period was 5.16 years, and 2,416 cases of MetS were recorded over 58,750 person-years. In men, significant inverse associations were observed in all 5 antioxidant classes, except for the highest quartile of dTAC. In women, dTAC and total flavonoids were not significantly associated with MetS; however, significant L-shaped associations were found for the remaining 4 antioxidant classes. Of the 7 flavonoid subclasses, only flavones in the highest quartile for men and flavan-3-ols in women lacked significant associations with MetS. The inverse associations were not sex-specific, but they were particularly pronounced among participants with a body mass index (BMI) of 23 kg/m<sup>2</sup> or higher.
CONCLUSIONS
The findings suggest that most antioxidant classes and flavonoid subclasses, unlike dTAC, exhibit a clear beneficial association with MetS in an L-shaped pattern in both men and women, particularly those with a high BMI.
Summary
Korean summary
농촌코호트 조사 참여자를 대상으로 식이 총항산화능, 총항산화능 하위분류, 플라보노이드 하위분류와 대사증후군 발생 위험의 전향적 연관성을 평가한 결과, 대부분의 항산화물(5개항산화물 분류:4개 항산화 비타민과 플라보노이드; 플라보노이드 7개 하부분류)에서 대사증후군과 음의 상관성을 확인할 수 있었으며 총항산화능(남자와 여자)과 플라보노이드(여자)에서 약한 연관성을 보였다. 남녀간 유의한 상호작용은 없었고 특히 BMI가 높은 집단에서 두드러졌다. 이 연구의 결과는 특히 식이 총항산화능을 구성하는 하위 유형을 적절히 섭취하는 것이 특히 비만한 성인에서 대사증후군 위험을 낮추는 예방전략으로 효과가 있을 수 있음을 시사한다.
Key Message
We observed that the cumulative average of dietary antioxidant vitamins and most flavonoids may be have pivotal roles in prevention of MetS, although there may be weak associations of dTAC and flavonoids in women. Moreover, these inverse associations were more pronounced in high BMI individuals. Our results suggest that the consumption of antioxidants and flavonoid may mitigate the MetS risk, particularly in overweight/obese individuals at high risk of developing chronic diseases.

Citations

Citations to this article as recorded by  
  • The association of dietary total flavonoids and their subclasses with the risk of type 2 diabetes: a prospective cohort study
    Hye Won Woo, Mi Kyung Kim, Kong Ji-Sook, Jiseon Lee, Min-Ho Shin, Sang Baek Koh, Hyeon Chang Kim, Yu-Mi Kim
    European Journal of Nutrition.2024; 63(4): 1339.     CrossRef
  • A Systematized Review of the Relationship Between Obesity and Vitamin C Requirements
    Julia K Bird, Edith JM Feskens, Alida Melse-Boonstra
    Current Developments in Nutrition.2024; 8(5): 102152.     CrossRef

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