Research
Original Research
Frequency of Consumption of Whole Fruit, Not Fruit Juice, Is Associated with Reduced Prevalence of Obesity in Korean Adults

https://doi.org/10.1016/j.jand.2019.04.015Get rights and content

Abstract

Background

Fruit consumption is known to be beneficial to health. However, the health benefits of fruit juice are controversial due to its high sugar content.

Objectives

To examine the associations of frequency of consumption of whole fruit and fruit juice with obesity and metabolic syndrome.

Design

This cross-sectional study used data from the 2012-2015 Korea National Health and Nutrition Examination Survey.

Participants

A total of 10,460 adults (4,082 men and 6,378 women) aged 19 to 64 years were included in the study.

Main outcome measures

Frequency of consumption of whole fruit and fruit juice was evaluated using a food frequency questionnaire, and dietary sugar intake was calculated using a 24-hour recall. Obesity and abdominal obesity were determined using body mass index and waist circumference, respectively. Metabolic syndrome was defined on the basis of the National Cholesterol Education Program Adult Treatment Panel III.

Statistical analyses performed

Multiple logistic regression analysis was performed to examine the associations between frequency of whole fruit or fruit juice consumption and obesity and metabolic syndrome abnormalities.

Results

The percentage of participants who consumed whole fruit daily was 32.6%, whereas 52.3% consumed fruit juice rarely. The average intake of total sugars was 14.9% of total energy, which was within the recommend range (<20% of total energy) for Koreans. Consuming whole fruit ≥1 time/day was associated with reduced prevalence of obesity, abdominal obesity, and elevated blood pressure compared with consuming whole fruit ≤1 time/wk. However, frequency of fruit juice consumption showed no association with obesity, abdominal obesity, and metabolic syndrome.

Conclusions

Frequency of whole fruit consumption was associated with reduced prevalence of obesity and metabolic syndrome abnormalities among Korean adults with average total sugar intake within the recommended range.

Section snippets

Study Design and Subjects

The KNHANES is a cross-sectional, nationwide survey conducted by the Korea Centers for Disease Control and Prevention (KCDC). The KNHANES recruits a representative sample of noninstitutionalized Koreans based on a complex, multistage probability sampling design and has three components: health interview, health examination, and nutrition survey.21

Participants in this study were Korean adults aged 19 to 64 years who participated in the 2012-2015 KNHANES (n=24,327). Participants with incomplete

Results

The distribution of frequencies of whole fruit consumption and fruit juice consumption is shown in Figure 1. The percentage of participants who consumed whole fruit ≥1 time/day was 32.6%, whereas the percentage of participants who consumed fruit juice rarely was 52.3%.

The general characteristics of study participants according to frequency of whole fruit and fruit juice consumption are shown in Table 2. Whole fruit was more frequently consumed by women than by men, whereas fruit juice was more

Discussion

In this large-scale cross-sectional study based on a national survey of Koreans, frequency of consumption of whole fruit was inversely associated with obesity and metabolic syndrome abnormalities. However, frequency of fruit juice consumption was not associated with obesity, abdominal obesity, and metabolic syndrome.

Because people tend to consume whole fruits, fruit juice, or both daily, differentiating between the effects of whole fruit and fruit juice is difficult. Therefore, in the present

Conclusions

Frequency of whole fruit consumption was associated with reduced prevalence of obesity as well as metabolic syndrome abnormalities among Korean adults with average total sugar intake within the recommended range. Frequency of fruit juice consumption was not associated with obesity and metabolic syndrome.

A. Choi is a master's student, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.

References (38)

  • K.J. Joshipura et al.

    The effect of fruit and vegetable intake on risk for coronary heart disease

    Ann Intern Med

    (2001)
  • S.P. Sharma et al.

    Paradoxical effects of fruit on obesity

    Nutrients

    (2016)
  • J. Vioque et al.

    Intake of fruits and vegetables in relation to 10-year weight gain among Spanish adults

    Obesity (Silver Spring)

    (2008)
  • World Health Organization

    Guideline: Sugars Intake for Adults and Children

    (2015)
  • L. Hebden et al.

    Fruit consumption and adiposity status in adults: A systematic review of current evidence

    Crit Rev Food Sci Nutr

    (2017)
  • L.A. Bazzano et al.

    Intake of fruit, vegetables, and fruit juices and risk of diabetes in women

    Diabetes Care

    (2008)
  • A. Pan et al.

    Changes in water and beverage intake and long-term weight changes: Results from three prospective cohort studies

    Int J Obes (London)

    (2013)
  • F. Imamura et al.

    Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: Systematic review, meta-analysis, and estimation of population attributable fraction

    BMJ

    (2015)
  • K. Liu et al.

    Effect of fruit juice on cholesterol and blood pressure in adults: A meta-analysis of 19 randomized controlled trials

    PloS ONE

    (2013)

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    A. Choi is a master's student, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.

    K. Ha is a doctoral student, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.

    H. Joung is a professor, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.

    Y. Song is an associate professor, Major of Food Science and Nutrition, School of Human Ecology, The Catholic University of Korea, Gyeonggi-do, Republic of Korea.

    Supplementary materials: Tables 1 and 6 are available at www.jandonline.org

    STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.

    FUNDING/SUPPORT This study was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean Government (NRF-2017R1A2B1008420).

    AUTHOR CONTRIBUTIONS A. Choi analyzed all the data. A. Choi and Y. Song wrote the first draft. K. Ha and H. Joung critically revised the manuscript and provided essential comments. Y. Song supervised all the work and had primary responsibility for the final content. All authors reviewed and commented on subsequent drafts of the manuscript.

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    © 2019 by the Academy of Nutrition and Dietetics.