Abstract
BACKGROUND: Dietary patterns are an important research focus for evaluating associations with disease risk. However, studies investigating secular trends in dietary patterns among Korean adults remain limited. Therefore, we aimed to identify the major dietary patterns in the Korean population and to assess how these patterns have changed over the past 16 years. METHODS: This study included 33,408 men and 46,628 women aged 19 years or older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2022. Dietary intake was assessed using a single 24-hour dietary recall. Dietary patterns were derived using cluster analysis based on the percentage contribution of 28 food groups to total energy intake. Subgroup analyses were conducted to examine secular trends in dietary patterns by sex and age group. Survey-weighted multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for cardiometabolic risk factors according to dietary patterns. RESULTS: Three dietary patterns were identified through cluster analysis: (1) Traditional, (2) Red Meat & Alcohol, and (3) Flour-based Foods & Sweets. The overall trend in dietary patterns among Korean adults has undergone a gradual transition from traditional to Westernized dietary patterns. Since 2013, the Flour-based Foods & Sweets pattern has become the most prevalent (p < .0001), and this pattern was more commonly observed aged 19-29 years and among women. After multivariate adjustment, men adhering to the Red Meat & Alcohol pattern had the highest odds of cardiometabolic risk factors, including hyperglycemia (OR = 1.35, 95% CI: 1.24-1.48), high blood pressure (1.33, 1.23-1.45), hypertriglyceridemia (1.16, 1.07-1.26), hypercholesterolemia (1.17, 1.07-1.27), abdominal obesity (1.18, 1.05-1.32), and overall obesity (1.28, 1.18-1.38). In women, adherence to the Flour-based Foods & Sweets Pattern was associated with higher odds of hypercholesterolemia (1.14, 1.08-1.20) and high LDL-cholesterol (1.08, 1.03-1.15). CONCLUSIONS: A transition from traditional to Westernized dietary patterns occurred among Korean adults from 2007 to 2022, which may have differential impacts on cardiometabolic health according to sex and age, underscoring the need for tailored nutritional interventions and sex-specific public health strategies.