The association of incident abdominal obesity with diet and unfavorable lifestyle factors in Korean adults: A prospective cohort study

Unhealthy lifestyles are strongly associated with the development of cardiometabolic diseases and the risk of all-cause mortality. We hypothesized that unhealthy lifestyles including poor diet contribute to the development of cardiometabolic diseases. This study aimed to investigate the incidence of metabolic syndrome (MetS) and its clustering components in relation to diet and lifestyle risk factors in Korean population. At baseline, all participants (n = 2000) completed a general health-related questionnaire, provided blood samples, and underwent health examinations. Lifestyle factors were investigated including smoking, alcohol consumption, physical activity, sleep, dietary quality, and weight status. Cox proportional hazard regression was used to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of primary endpoints: MetS events and their clustering components. A total of 1697 participants (mean age: 43.8 ± 0.2 years) were included, of whom 72.4% (n = 1228) were women. Compared to the healthy group, unhealthy participants had a significant HR value of abdominal obesity for lifestyle factors (HRs: 1.937, 95% CI: 1.335-2.810). No significant differences were observed between MetS and other clustering components. After adjusting for covariates, the lowest quintile of vitamin C (HRs: 1.553, 95% CI: 1.153-2.091), fiber (HRs: 1.409, 95% CI: 1.035-1.919) and vegetable intake (HRs: 1.300, 95% CI: 1.008-1.678) were significantly associated with abdominal obesity incidence compared with the highest quintile. Adherence to healthy lifestyle factors and dietary factors, such as high intakes of vitamin C and vegetables, were negatively associated with the incidence of abdominal obesity among the MetS components in Korean adults.