Korean Journal of Family Medicine

"Metabolic Risk"

Original Articles

Association of Types of Meal Skipping with Cardio-metabolic Risk Factors in Korean Adults: The 7th Korea National Health and Nutrition Examination Survey (2016–2018): Jiyoon Tae, Junhee Park, Hyeonjin Cho, Dong Wook Shin; Korean J Fam Med 2024;45(5):290-298. Published online April 5, 2024; DOI: https://doi.org/10.4082/kjfm.23.0158

Abstract
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Background
This study aimed to examine the effects of different types of skipped meals on cardiometabolic risk factors (CMRF) in Korean adults.
Methods
We analyzed 14,062 adults from the Korea National Health and Nutrition Examination Survey conducted between 2016 and 2018. The irregularity of breakfast, lunch, and dinner consumption was assessed using 24-hour recall data, and we categorized the habit of skipping regular meals into eight types. Multiple linear regression was used to estimate the association between each type of meal skipping and the CMRF. We also presented the estimated effects of individual types of meal skipping on the CMRF based on their predicted values and mean differences.
Results
Korean adults tended to have irregular meal consumption habits when they had one or more of the following characteristics: female sex, under the age of 50 years, middle-high to high household income, high school or college or higher education levels, alcohol consumption, and current smoking. Compared to regular eaters, we have observed significantly higher total cholesterol in the following types of meal skipping: irregular breakfast (IB) (P<0.001), irregular lunch (P=0.005), irregular breakfast and lunch (IBL) (P=0.001), irregular breakfast and dinner (P=0.001); higher low-density lipoprotein-cholesterol in IB (P=0.009); higher triglyceride in IB (P=0.005) and IBL (P=0.034); and higher fasting glucose in IB (P=0.046).
Conclusion
Different types of meal skipping were associated with CMRF. Regular breakfast and lunch consumption should be emphasized to prevent and manage cardiometabolic disorders. However, skipping dinner showed no significant association with CMRF.

Citations

Citations to this article as recorded by

A Biochemical View on Intermittent Fasting’s Effects on Human Physiology—Not Always a Beneficial Strategy
Willian F. Zambuzzi, Marcel Rodrigues Ferreira, Zifan Wang, Maikel P. Peppelenbosch
Biology.2025; 14(6): 669. CrossRef
Past Meal-Skipping Habits Associate With Physical Frailty in Later Life: A Retrospective Cohort Study
Chiharu Nishijima, Kenji Harada, Satoshi Kurita, Masanori Morikawa, Kazuya Fujii, Daisuke Kakita, Hiroyuki Shimada
Journal of the American Medical Directors Association.2025; 26(12): 105893. CrossRef
Primary Care Physicians’ Important Role: Lifestyle Modification for Chronic Disease Management
Su-Min Jeong
Korean Journal of Family Medicine.2024; 45(5): 237. CrossRef

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Association between Physical Fitness and Cardiometabolic Risk of Children and Adolescents in Korea: Hyun-Suk Lee, Won-Wook Jeong, Yu-Jeong Choi, Young-Gyun Seo, Hye-Mi Noh, Hong-Ji Song, Yu-Jin Paek, Yoon-Myung Kim, Hyun-Jung Lim, Hye-Ja Lee, Han-Byul Jang, Sang-Ick Park, Kyung-Hee Park; Korean J Fam Med 2019;40(3):159-164. Published online November 23, 2018; DOI: https://doi.org/10.4082/kjfm.17.0085

Abstract
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Background
This study aimed to investigate the association between physical fitness and cardiometabolic health of Korean children and adolescents.
Methods
In total, 168 participants (89 boys and 79 girls) aged 10–16 years were recruited for the Intervention for Childhood and Adolescent Obesity via Activity and Nutrition Study in 2016. The subjects were categorized into two groups using the definition of metabolic syndrome by the International Diabetes Federation: metabolically unhealthy (with at least two of the five criteria) and healthy groups (with less than one criterion). Correlation analysis of the participants’ general characteristics was performed. Odds ratios (ORs) of physical fitness for cardiometabolic risk were evaluated via logistic regression.
Results
Metabolically unhealthy children showed greater weight, height, and body mass index, higher Children’s Depression Inventory score, and longer screen time than did the metabolically healthy children. Metabolically healthy children showed greater upper and lower extremity muscular strength than did the metabolically unhealthy children (P=0.04 and P<0.001, respectively). In the multiple logistic regression analysis, lower extremity muscle strength was inversely related to the clustered cardiometabolic risk of the children and adolescents with or without adjustment for confounders (OR, 4.32; 95% confidence interval [CI], 1.87–9.97; OR, 7.64; 95% CI, 1.55– 37.74, respectively).
Conclusion
Physical fitness, especially lower extremity muscle strength, is significantly inversely associated with individual and clustered cardiometabolic risks in Korean children and adolescents.

Citations

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Profiles of Physical Fitness Among Youth with Intellectual Disabilities: A Longitudinal Person-Centered Investigation
Christophe Maïano, Alexandre J. S. Morin, Olivier Hue, Danielle Tracey, Rhonda G. Craven
Journal of Autism and Developmental Disorders.2025;[Epub] CrossRef
Identification of biomarkers related to metabolically healthy or unhealthy obesity in children and adolescents with depressive disorders: a cross-sectional study
Zhiwei Liu, Liang Sun, Fengshun Li, Tengjiao Liu, XingLong Yin, Jingjing Zhang, Nana Sun, Yulong Zhang, Gaofeng Yao, Yun Liu
Scientific Reports.2025;[Epub] CrossRef
Supervised Machine Learning Algorithms for Fitness-Based Cardiometabolic Risk Classification in Adolescents
Rodrigo Yáñez-Sepúlveda, Rodrigo Olivares, Pablo Olivares, Juan Pablo Zavala-Crichton, Claudio Hinojosa-Torres, Frano Giakoni-Ramírez, Josivaldo de Souza-Lima, Matías Monsalves-Álvarez, Marcelo Tuesta, Jacqueline Páez-Herrera, Jorge Olivares-Arancibia, To
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Accelerometer-Measured Physical Activity, Fitness and Indicators of Cardiometabolic Risk among Rural Adolescents: A Cross-Sectional Study at 15-Year Follow-up of the MINIMat Cohort
Mohammad Redwanul Islam, Christine Delisle Nyström, Maria Kippler, Eero Kajantie, Marie Löf, Syed Moshfiqur Rahman, Eva-Charlotte Ekström
Journal of Epidemiology and Global Health.2024; 14(3): 987. CrossRef
Metabolic syndrome and its association with physical activity in Sudanese early adolescents – Khartoum state, Sudan: An observational study
Fatima A. Elfaki, Aziza I. G. Mukhayer, Mohamed E. Moukhyer, Rama M. Chandika, Husameldin E. Khalafalla, Stef P. J. Kremers
Medicine.2024; 103(23): e38242. CrossRef
Effect of a physical exercise program supported by wearable technology in children with drug-resistant epilepsy. A randomized controlled trial
Salvador Ibañez-Micó, Rosa Gil-Aparicio, Antonia Gómez-Conesa
Seizure: European Journal of Epilepsy.2024; 121: 56. CrossRef
Correlation of anthropometric characteristics and movement behavior with lower extremity muscle power and dynamic knee valgus in adolescent basketball athletes
Aleksandar STOJILJKOVIC, Eleni KARAGIANNI, Antoniou VARSAMO, Ladislav BATALIK, Garyfallia PEPERA
The Journal of Sports Medicine and Physical Fitness.2024;[Epub] CrossRef
Analysis of gross motoric analysis of elementary school students: A comparative study of students in hill and coastal areas
Y Touvan Juni Samodra, Didi Suryadi, Isti Dwi Puspita Wati, Eka Supriatna, I Gusti Putu Ngurah Adi Santika, Mikkey Anggara Suganda, Putu Citra Permana Dewi
Pedagogy of Physical Culture and Sports.2023; 27(2): 139. CrossRef
Muscular Fitness and Cardiometabolic Variables in Children and Adolescents: A Systematic Review
Tiago Rodrigues de Lima, Priscila Custódio Martins, Yara Maria Franco Moreno, Jean-Philippe Chaput, Mark Stephen Tremblay, Xuemei Sui, Diego Augusto Santos Silva
Sports Medicine.2022; 52(7): 1555. CrossRef
Neck circumference and cardiometabolic risk in children and adolescents: the moderator role of cardiorespiratory fitness
Ana Paula Sehn, Caroline Brand, Letícia Welser, Anelise Reis Gaya, Cesar Agostinis-Sobrinho, Carlos Cristi-Montero, Elza Daniel de Mello, Cézane Priscila Reuter
BMC Pediatrics.2021;[Epub] CrossRef
Physical fitness as a moderator in the relationship between adiposity and cardiometabolic risk factors in children and adolescents
Caroline Brand, Ana P. Sehn, Anelise R. Gaya, Jorge Mota, Javier Brazo-Sayavera, Jane D. Renner, Cézane P. Reuter
The Journal of Sports Medicine and Physical Fitness.2020;[Epub] CrossRef

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Association between Metabolic Components and Subclinical Atherosclerosis in Korean Adults: In Cheol Hwang, Sang-Yeon Suh, Ah-Ram Seo, Hong Yup Ahn, Eunji Yim; Korean J Fam Med 2012;33(4):229-236. Published online July 25, 2012; DOI: https://doi.org/10.4082/kjfm.2012.33.4.229

Abstract
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Background

Many studies have attempted to develop relatively simple and easy noninvasive measurements of atherosclerosis (NIMA), and each NIMA assesses different atherosclerotic properties. We, therefore, investigated the association between metabolic syndrome (MetS) components and different NIMAs.

Methods

This study included 1,132 Korean subjects over 20 years of age who had visited a Health Promotion Center in Korea. Carotid injury (increased carotid intima-media thickness or plaques) was evaluated by ultrasonography and arterial stiffness by brachial-ankle pulse wave velocity. The MetS components were assessed according to the Asian criteria of the American Heart Association/National Heart, Lung, and Blood Institute.

Results

Both arterial stiffness and carotid injury gradually deteriorated with increase in the number of MetS components. Arterial stiffness and carotid injury were associated with different MetS components, each of which had varying impact. After adjustment for all possible confounders such as age, sex, and lifestyle, elevated blood pressure (BP) was found to have the strongest association with arterial stiffness, whereas central obesity, impaired fasting plasma glucose, and elevated BP had comparable connection with carotid atherosclerosis.

Conclusion

Individual MetS components were related with subclinical atherosclerosis in different ways. Elevated BP showed the strongest association with arterial stiffness, while central obesity, impaired fasting plasma glucose, and elevated BP showed good correlation with carotid atherosclerosis.

Citations

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Is Obesity a Risk Factor for Carotid Atherosclerotic Disease?—Opportunistic Review
Joana Ferreira, Pedro Cunha, Alexandre Carneiro, Isabel Vila, Cristina Cunha, Cristina Silva, Adhemar Longatto-Filho, Amílcar Mesquita, Jorge Cotter, Margarida Correia-Neves, Armando Mansilha
Journal of Cardiovascular Development and Disease.2022; 9(5): 162. CrossRef
Cardiac, Macro-, and Micro-Circulatory Abnormalities in Association With Individual Metabolic Syndrome Component: The Northern Shanghai Study
Fang Zhao, Rong Yang, Rusitanmujiang Maimaitiaili, Jiamin Tang, Song Zhao, Jing Xiong, Jiadela Teliewubai, Chen Chi, Jacques Blacher, Jue Li, Yawei Xu, Yan Jiang, Yi Zhang, Weiming Li
Frontiers in Cardiovascular Medicine.2021;[Epub] CrossRef
Assessment of Arterial Stiffness in Metabolic Syndrome Related to Insulin Resistance in Apparently Healthy Men
Ali Reza Khoshdel, Radina Eshtiaghi
Metabolic Syndrome and Related Disorders.2019; 17(2): 90. CrossRef
Recent approaches to ameliorate selectivity and sensitivity of enzyme based cholesterol biosensors: a review
Anjum Gahlaut, Vinita Hooda, Vikas Dhull, Vikas Hooda
Artificial Cells, Nanomedicine, and Biotechnology.2018; 46(3): 472. CrossRef
The role of abnormal metabolic conditions on arterial stiffness in healthy subjects with no drug treatment
Hyo-Sang Hwang, Kwang-Pil Ko, Myeong Gun Kim, Sihun Kim, Jeonggeun Moon, Wook Jin Chung, Mi Seung Shin, Seung Hwan Han
Clinical Hypertension.2016;[Epub] CrossRef
Enhanced electrochemical biosensing efficiency of silica particles supported on partially reduced graphene oxide for sensitive detection of cholesterol
Shiju Abraham, Saurabh Srivastava, Vinod Kumar, Shobhit Pandey, Pankaj Kumar Rastogi, Narsingh R. Nirala, Sunayana Kashyap, Sunil K. Srivastava, Vidya Nand Singh, Vellaichamy Ganesan, Preeti S. Saxena, Anchal Srivastava
Journal of Electroanalytical Chemistry.2015; 757: 65. CrossRef
Neck circumference and early stage atherosclerosis: the cardiometabolic risk in Chinese (CRC) study
Jun Liang, Yu Wang, Hongyan Li, Xuekui Liu, Qinqin Qiu, Lu Qi
Cardiovascular Diabetology.2014;[Epub] CrossRef
Association of metabolically abnormal but normal weight (MANW) and metabolically healthy but obese (MHO) individuals with arterial stiffness and carotid atherosclerosis
Hye Jin Yoo, Soon Young Hwang, Ho Cheol Hong, Hae Yoon Choi, Ji A. Seo, Sin Gon Kim, Nan Hee Kim, Dong Seop Choi, Sei Hyun Baik, Kyung Mook Choi
Atherosclerosis.2014; 234(1): 218. CrossRef
Comparison of Predictive Value of Cardiometabolic Indices for Subclinical Atherosclerosis in Chinese Adults
Ying Xu, Fang-fang Zeng, Li-ping He, Wen-hua Ling, Wei-qing Chen, Yu-ming Chen, Marta Letizia Hribal
PLoS ONE.2014; 9(4): e93538. CrossRef

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Fasting Plasma Glucose Levels and Metabolic Syndrome in Normoglycemic Adults.: Jae Kyung Choi, Youl Lee Lym, Seung Won Oh, Jin Ho Park, Cheol Min Lee, Sang Ho Yoo, Yeol Kim; J Korean Acad Fam Med 2008;29(9):651-657. Published online September 10, 2008

Abstract
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Background: Metabolic syndrome has been introduced to increase the incidence of cardiovascular diseases and type 2 diabetes mellitus. Our aim of this study was to investigate the association of fasting plasma glucose levels and metabolic syndrome in normoglycemic adults. Methods: We examined lifestyle factors, anthropometric and laboratory measurement of adults with no personal history of diabetes and normal fasting glucose from the Korean National Health and Nutrition Examination Survey 2001. We categorized the fasting plasma glucose levels below 100 mg/dl into the quintiles and assessed the association of metabolic syndrome with increasing glycemia in normoglycemic adults. Results: Quintiles of normal fasting plasma glucose levels showed a positive trend with metabolic risk factors including abdominal obesity, high blood pressure, and obesity in normoglycemic adults (P＜0.001). Hypertriglyceridemia, low HDL-cholesterolemia, smoking, heavy drinking, and physical activity were of no significance. A multivariate model, adjusted for age, sex, smoking status, physical activity, and heavy drinking, revealed a progressively increased odds ratio of metabolic syndrome, 1.05 (95% CI, 0.76∼1.44), 1.15 (95% CI, 0.84∼1.58), 1.33 (95% CI, 0.99∼1.80), 1.55 (95% CI, 1.14∼2.10), with increasing fasting plasma glucose levels, as compared with fasting plasma glucose level of 81 mg/dl or less (P＜0.001). Conclusion: Higher fasting plasma glucose levels within the normoglycemic range may constitute a risk of metabolic syndrome in normoglycemic adults. (J Korean Acad Fam Med 2008;29:651-657)

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Regional Fat Measured by DEXA and Metabolic Risk Factors among Women with Central Obesity.: Jin Seung Kim, Kayoung Lee, Jun Su Kim, Tae Jin Park, Sangyeoup Lee, Young Joo Kim, Yun Jin Kim; J Korean Acad Fam Med 2008;29(7):506-512. Published online July 10, 2008

Abstract
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Background: This study was carried out to determine the usefulness of regional body fat measured by dual energy X-ray absorptiometry (DEXA) by examining the relationship between regional body fat and metabolic risk factors. Methods: A total of 98 women aged 18∼65 years with central obesity (waist circumference ≥80 cm) took the evaluation for metabolic risk factors (blood pressure, fasting glucose, insulin, high sensitive c-reactive protein (hs-CRP), lipid profile, homeostasis model assessment of insulin resistance (HOMA-IR)) and the anthropometric measurement, and regional body fat measurement using DEXA. The relationship of regional body fat with the metabolic risk factors, the metabolic syndrome (MS) defined by the International Diabetes Federation and insulin resistance (IR, defined by HOMA-IR≥2.48) were assessed. The analyses were conducted using regression and logistic regression analyses. Results: After adjustment for age and total body fat (%), legs fat (%) was significantly and negatively associated with LDL-C, triglyceride, HOMA-IR, and hs-CRP, while positively with HDL-C. The 1% increase of legs fat was associated with the MS by odds ratio of 0.82 (95% C.I 0.71∼0.96) and with the IR by odds ratio of 0.80 (95% C.I. 0.67∼0.95). Trunk fat (%) was significantly and positively associated with LDL-C, triglycerides, and HOMA-IR. The 1% increase of trunk fat was associated with the MS by odds ratio of 1.32 (95% C.I. 1.03∼1.71) and with the IR by odds ratio of 1.33 (95% C.I. 1.01∼1.77). The ratio of android fat to gynoid fat was significantly and positively associated with LDL-C, triglycerides, glucose, and HOMA- IR, while negatively with HDL-C. The 0.1 increase of the ratio was associated with the MS by odds ratio of 1.66 (95% C.I. 1.07∼2.60). Conclusion: The trunk fat, and legs fat, the ratio of android fat to gynoid fat assessed by DEXA seemed to be useful indicators to predict the metabolic risk factors in women with central obesity. (J Korean Acad Fam Med 2008;29:506-512)