J Nutr Health.  2015 Dec;48(6):496-506. 10.4163/jnh.2015.48.6.496.

Estimated dietary flavonoids intake of Korean adolescent: Based on the Korea National Health and Nutrition Examination Survey 2007~2012

• Kim SA
• Jun S
• Joung H

• KMID: 2209866
• DOI: http://doi.org/10.4163/jnh.2015.48.6.496

Abstract

PURPOSE
The purpose of this study was to estimate dietary flavonoids intake of Korean adolescents.
METHODS
Using data from the 2007-2012 Korean National Health and Nutrition Examination Survey, a total of 3,957 subjects aged 12-18 were included in this study. We estimated individual daily intake of total flavonoid and six flavonoid classes including flavonols, flavones, flavanones, flavan-3-ols, anthocyanidins, and isoflavones by linking food consumption data with the flavonoids in the commonly consumed food database. The distribution of sociodemographic, health-related, and dietary factors according to flavonoids intake was examined.
RESULTS
Average dietary flavonoids intake of the study subjects was 195.6 mg/d in girls, and 189.4 mg/d in boys. The highest flavonoids intake group consumed significantly more fiber, vitamin C, legumes, fruits, and vegetables (p < 0.01) and less fat, grains, meats and dairy foods than other lower consumption groups (p < 0.001). Dietary flavonoid intake showed negative correlation with waist circumference and systolic blood pressure (p < 0.05).
CONCLUSION
This study provided basic data for estimation of flavonoids intake of Korean adolescents. Further research will be required for analysis of the association of flavonoids intake and health-related factors such as cardiovascular risk factors.

Keyword

flavonoid; fruit; vegetable; adolescent; KNHANES

MeSH Terms

Adolescent*
Anthocyanins
Ascorbic Acid
Blood Pressure
Edible Grain
Fabaceae
Female
Flavanones
Flavones
Flavonoids*
Flavonols
Fruit
Humans
Isoflavones
Korea*
Meat
Nutrition Surveys*
Risk Factors
Vegetables
Waist Circumference
Anthocyanins
Ascorbic Acid
Flavanones
Flavones
Flavonoids
Flavonols
Isoflavones

Reference

1.Lifshitz F., Tarim O., Smith MM. Nutrition in adolescence. Endocri-nol Metab Clin North Am. 1993. 22(3):673–683.

2.Kim KW., Shin EM. A study on nutrition knowledge, nutritional attitudes, dietary behavior and dietary intake by weight control attempt among middle school female students. Korean J Community Nutr. 2002. 7(1):23–31.

3.Kwon WJ., Chang KJ., Kim SK. Comparison of nutrient intake, dietary behavior, perception of body image and iron nutritional status among female high school students of urban and rural areas in Kyunggi-do. Korean J Nutr. 2002. 35(1):90–101.

4.An GS., Shin DS. A comparison of the food and nutrient intake of adolescents between urban areas and islands in south Kyungnam. Korean J Community Nutr. 2001. 6(3):271–281.

5.Oh K., Jang MJ., Lee NY., Moon JS., Lee CG., Yoo MH., Kim YT. Prevalence and trends in obesity among Korean children and adolescents in 1997 and 2005. Korean J Pediatr. 2008. 51(9):950–955.

6.Baek SH. Effect of % body fat, physical fitness on impact on cardiovascular risk index in female middle-school students. Korean J Sports Sci. 2012. 21(2):1009–1017.

7.Chang JH., Kim DH., Kim HS., Choi IK., Cheong MY., Kim DK. Prevalence of metabolic syndrome in obese children. Korean J Pediatr. 2004. 47(11):1149–1156.

8.Ministry of Health and Welfare (KR). The third national health promotion plan (2011-2020). Seoul: Ministry of Health and Welfare;2011.

9.Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2011: Korea National Health and Nutrition Examination Survey (KNHANES V-2). Cheongwon: Korea Centers for Disease Control and Prevention;2012.

10.Doll R. An overview of the epidemiological evidence linking diet and cancer. Proc Nutr Soc. 1990. 49(2):119–131.

11.Hertog MG., van Poppel G., Verhoven D. Potentially anticarcinogenic secondary metabolites from fruit and vegetables. Tomas-Barberan FA, Robins RJ, editors. editors.Phytochemistry of Fruit and Vegetables. Oxford: Clarendon Press;1997. p. 313–330.

12.Hertog MG., Feskens EJ., Hollman PC., Katan MB., Kromhout D. Dietary antioxidant flavonoids and risk of coronary heart disease: the Zutphen elderly study. Lancet. 1993. 342(8878):1007–1011.

13.Hertog MG., Kromhout D., Aravanis C., Blackburn H., Buzina R., Fidanza F., Giampaoli S., Jansen A., Menotti A., Nedeljkovic S., Pekkarinen M., Simic BS., Toshima H., Feskens EJ., Hollman PC., Katan MB. Flavonoid intake and long-term risk of coronary heart disease and cancer in the seven countries study. Arch Intern Med. 1995. 155(4):381–386.

14.Hertog MG., Sweetnam PM., Fehily AM., Elwood PC., Kromhout D. Antioxidant flavonols and ischemic heart disease in a Welsh population of men: the Caerphilly study. Am J Clin Nutr. 1997. 65(5):1489–1494.

15.Chun OK., Kim DO., Smith N., Schroeder D., Han JT., Lee CY. Daily consumption of phenolics and total antioxidant capacity from fruit and vegetables in the American diet. J Sci Food Agric. 2005. 85(10):): 1715– 1724.

16.Chun OK., Chung SJ., Song WO. Estimated dietary flavonoid intake and major food sources of U.S. adults. J Nutr. 2007. 137(5):1244–1252.

17.Graf BA., Milbury PE., Blumberg JB. Flavonols, flavones, flavanones, and human health: epidemiological evidence. J Med Food. 2005. 8(3):281–290.

18.Kris-Etherton PM., Keen CL. Evidence that the antioxidant flavonoids in tea and cocoa are beneficial for cardiovascular health. Curr Opin Lipidol. 2002. 13(1):41–49.

19.O'Byrne DJ., Devaraj S., Grundy SM., Jialal I. Comparison of the antioxidant effects of Concord grape juice flavonoids alpha-tocopherol on markers of oxidative stress in healthy adults. Am J Clin Nutr. 2002. 76(6):1367–1374.

20.Vinson JA., Su X., Zubik L., Bose P. Phenol antioxidant quantity and quality in foods: fruits. J Agric Food Chem. 2001. 49(11):5315–5321.

21.Rein D., Paglieroni TG., Wun T., Pearson DA., Schmitz HH., Gosselin R., Keen CL. Cocoa inhibits platelet activation and function. Am J Clin Nutr. 2000. 72(1):30–35.

22.Vita JA. Polyphenols and cardiovascular disease: effects on endothelial and platelet function. Am J Clin Nutr. 2005. 81(1 Suppl):292S–297S.

23.Yao LH., Jiang YM., Shi J., Tomas-Barberan FA., Datta N., Singanu-song R., Chen SS. Flavonoids in food and their health benefits. Plant Foods Hum Nutr. 2004. 59(3):113–122.

24.Beatty S., Koh H., Phil M., Henson D., Boulton M. The role of oxidative stress in the pathogenesis of age-related macular degeneration. Surv Ophthalmol. 2000. 45(2):115–134.

25.Lee SA., Shu XO., Li H., Yang G., Cai H., Wen W., Ji BT., Gao J., Gao YT., Zheng W. Adolescent and adult soy food intake and breast cancer risk: results from the Shanghai Women's Health Study. Am J Clin Nutr. 2009. 89(6):1920–1926.

26.Dominguez C., Ruiz E., Gussinye M., Carrascosa A. Oxidative stress at onset and in early stages of type 1 diabetes in children and adolescents. Diabetes Care. 1998. 21(10):1736–1742.

27.Jun S., Shin S., Joung H. Estimation of dietary flavonoid intake and major food sources of Korean adults. Br J Nutr. Forthcoming. 2015.

28.Knekt P., Jarvinen R., Reunanen A., Maatela J. Flavonoid intake and coronary mortality in Finland: a cohort study. BMJ. 1996. 312(7029):478–481.

29.Mink PJ., Scrafford CG., Barraj LM., Harnack L., Hong CP., Nettleton JA., Jacobs DR Jr. Flavonoid intake and cardiovascular disease mortality: a prospective study in postmenopausal women. Am J Clin Nutr. 2007. 85(3):895–909.

30.McCullough ML., Peterson JJ., Patel R., Jacques PF., Shah R., Dwyer JT. Flavonoid intake and cardiovascular disease mortality in a prospective cohort of US adults. Am J Clin Nutr. 2012. 95(2):454–464.

31.Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2007: Korea National Health and Nutrition Examination Survey (KNHANES IV-1) [Internet]. Cheongwon: Korea Centers for Disease Control and Prevention;2008. [cited 2014 Sep 1]. Available from:. https://knhanes.cdc.go.kr/knhanes/index.do.

32.Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2008: Korea National Health and Nutrition Examination Survey (KNHANES IV-2) [Internet]. Cheongwon: Korea Centers for Disease Control and Prevention;2009. [cited 2014 Sep 1]. Available from:. https://knhanes.cdc.go.kr/knhanes/index.do.

33.Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2009: Korea National Health and Nutrition Examination Survey (KNHANES IV-3) [Internet]. Cheongwon: Korea Centers for Disease Control and Prevention;2010. [cited 2014 Sep 1]. Available from:. https://knhanes.cdc.go.kr/knhanes/index.do.

34.Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2010: Korea National Health and Nutrition Examination Survey (KNHANES V-1) [Internet]. Cheongwon: Korea Centers for Disease Control and Prevention;2011. [cited 2014 Sep 1]. Available from:. https://knhanes.cdc.go.kr/knhanes/index.do.

35.Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2012: Korea National Health and Nutrition Examination Survey (KNHANES V-3) [Internet]. Cheongwon: Korea Centers for Disease Control and Prevention;2013. [cited 2014 Sep 1]. Available from:. https://knhanes.cdc.go.kr/knhanes/index.do.

36.Knaze V., Zamora-Ros R., Luján-Barroso L., Romieu I., Scalbert A., Slimani N., Riboli E., van Rossum CT., Bueno-de-Mesquita HB., Trichopoulou A., Dilis V., Tsiotas K., Skeie G., Engeset D., Quirós JR., Molina E., Huerta JM., Crowe F., Wirfäl E., Ericson U., Peeters PH., Kaaks R., Teucher B., Johansson G., Johansson I., Tumino R., Boeing H., Drogan D., Amiano P., Mattiello A., Khaw KT., Luben R., Krogh V., Ardanáz E., Sacerdote C., Salvini S., Overvad K., Tjønneland A., Olsen A., Boutron-Ruault MC., Fagherazzi G., Perquier F., González CA. Intake estimation of total and individual flavan-3-ols, proan-thocyanidins and theaflavins, their food sources and determinants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Br J Nutr. 2012. 108(6):1095–1108.

37.Casagrande SS., Wang Y., Anderson C., Gary TL. Have Americans increased their fruit and vegetable intake? The trends between 1988 and 2002. Am J Prev Med. 2007. 32(4):257–263.

38.Kim JH., Lee MJ., Yang IS., Moon SJ. Analysis of factors affecting Korean eating behavior. Korean J Diet Cult. 1992. 7(1):1–8.

39.Galleano M., Calabro V., Prince PD., Litterio MC., Piotrkowski B., Vazquez-Prieto MA., Miatello RM., Oteiza PI., Fraga CG. Flavonoids and metabolic syndrome. Ann N Y Acad Sci. 2012. 1259:87–94.

40.Steffen Y., Gruber C., Schewe T., Sies H. Mono-O-methylated flava-nols and other flavonoids as inhibitors of endothelial NADPH oxi-dase. Arch Biochem Biophys. 2008. 469(2):209–219.

41.Schroeter H., Heiss C., Balzer J., Kleinbongard P., Keen CL., Hollenberg NK., Sies H., Kwik-Uribe C., Schmitz HH., Kelm M. (-)-Epicat-echin mediates beneficial effects of flavanol-rich cocoa on vascular function in humans. Proc Natl Acad Sci U S A. 2006. 103(4):1024–1029.

42.Cassidy A., O'Reilly ÉJ., Kay C., Sampson L., Franz M., Forman JP., Curhan G., Rimm EB. Habitual intake of flavonoid subclasses and incident hypertension in adults. Am J Clin Nutr. 2011. 93(2):338–347.

43.Yang YJ., Kim YJ., Yang YK., Kim JY., Kwon O. Dietary flavan-3-ols intake and metabolic syndrome risk in Korean adults. Nutr Res Pract. 2012. 6(1):68–77.

44.Holt EM., Steffen LM., Moran A., Basu S., Steinberger J., Ross JA., Hong CP., Sinaiko AR. Fruit and vegetable consumption and its relation to markers of inflammation and oxidative stress in adolescents. J Am Diet Assoc. 2009. 109(3):414–421.

45.Kim SH., Cho SW., Hwang SS., Ahn M., Lee D., Kang SW., Park YK. Increased whole grain, fruits and vegetable intake reduced oxidative stress in high school students. Korean J Nutr. 2012. 45(5):452.

46.Ness AR., Maynard M., Frankel S., Smith GD., Frobisher C., Leary SD., Emmett PM., Gunnell D. Diet in childhood and adult cardiovascular and all cause mortality: the Boyd Orr cohort. Heart. 2005. 91(7):894–898.

47.The Korean Nutrition Society. Dietary reference intakes for Koreans. 1st revision. Seoul: The Korean Nutrition Society;2010.

48.Kim JH., Kim YS., Kim Y., Kang MS. Fruit and vegetable consumption and factors affecting fruit and vegetable consumption of school children and adolescents: findings from focus-group interviews with school nutrition teachers and nutritionists. Korean J Community Living Sci. 2013. 24(4):567–581.