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Associations of minimally processed and ultra-processed food intakes with cardiovascular health in Korean adults: the Korea National Health and Nutrition Examination Survey (KNHANES VI), 2013–2015

Journal of Exposure Science & Environmental Epidemiology (2024)Cite this article

Abstract

Background

Although recent studies have suggested the adverse effects of processed foods on cardiovascular disease, few studies have been conducted on the effects of food processing on cardiovascular health (CVH) in Koreans.

Objective

This study aimed to investigate the associations of minimally processed foods (MPF) and ultra-processed foods (UPF) intakes with CVH.

Methods

We used the data of 6945 adults (≥19) from the sixth Korea National Health and Nutrition Examination Survey. MPF and UPF intakes were based on the NOVA food classification. Using Life’s simple 7 (LS7) proposed by the American Heart Association, the CVH indicator was estimated as the sum (0–12) of the scores of six components. Multiple linear and multinomial logistic regressions were used to estimate the associations between processed food intakes and CVH.

Results

The mean (standard error) of MPF and UPF intake was 61.28 (0.28) and 20.27 (0.24) %kcal/day, respectively. After adjusting for sex, age, household income, educational attainment, family history of CVD, and stress, we found significant positive associations between MPF intake and CVH (p value < 0.001), while associations between UPF intake and CVH were significantly negative (p value < 0.001). Moreover, the magnitude of the observed association was more distinctive in females (p-interaction < 0.01) and with increasing age (p-interaction < 0.001).

Conclusions

A high intake of MPF is associated with improved CVH, while a high intake of UPF is associated with poorer CVH in Korean adults. Therefore, public health policies should be established to promote the choice of less processed foods to improve CVH among South Korean adults.

Impact Statement

  • In modern society, processed foods have become ubiquitous and South Korea’s consumption of processed foods is very high. This study had shown that the more processed a food is, the more negative impact it can have on cardiovascular health. Therefore, researching the effects of processed foods on the human body can increase understanding of population health and aid in the development of prevention and treatment strategies.

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Fig. 1
Fig. 2: The ORs (95% CIs) for the associations of MPF and UPF intake with CVH by subgroups of demographic characteristics.

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Data availability

Data described in the manuscript, code book, and analytic code will be made available upon request pending application and approval by the Korea Disease Control and Prevention Agency (https://knhanes.kdca.go.kr/knhanes/eng/index.do).

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Acknowledgements

This research was supported by Environmental Health Center of Korean Society of Environmental Health (KSEH) through the researcher training program, funded by Korea Ministry of Environment (MOE).

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Health and Safety Convergence Science, Korea University, Anam-ro 145, Seongbuk-gu, Seoul, 02841, Korea

    Lita Kim & Yun-Hee Choi

  2. BK21 FOUR R&E Center for Learning Health System, Korea University, Anam-ro 145, Seongbuk-gu, Seoul, 02841, Korea

    Lita Kim, Yun-Hee Choi & Kyong Whan Moon

  3. Institute of Health Sciences, Korea University, Anam-ro 145, Seongbuk-gu, Seoul, 02841, Korea

    Da-An Huh

  4. School of Health and Environmental Science, Korea University, Anam-ro 145, Seongbuk-gu, Seoul, 02841, Korea

    Kyong Whan Moon

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Contributions

LK: Conceptualization, methodology, writing – original draft preparation, data curation; YHC: Writing – review & editing, data curation, visualization; DAH: Writing – review & editing, supervision; KWM: Methodology, validation. All authors read and approved the final manuscript.

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Correspondence to Da-An Huh.

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Ethics

The Institutional Review Board (IRB) of the Korea Centers for Disease Control and Prevention (KCDC) approved the study (IRB No. 2013-07CON-03-4C, 2013-12EXP-03-5C), and all participants provided written informed consent.

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Kim, L., Choi, YH., Huh, DA. et al. Associations of minimally processed and ultra-processed food intakes with cardiovascular health in Korean adults: the Korea National Health and Nutrition Examination Survey (KNHANES VI), 2013–2015. J Expo Sci Environ Epidemiol (2024). https://doi.org/10.1038/s41370-024-00646-1

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