Abstract
BACKGROUND: Obesity, sarcopenia, and sarcopenic obesity require effective nutritional strategies in public health. METHODS: This cross-sectional study analyzed 535 adults aged 40-60 years in rural Korea. Participants were grouped by abdominal obesity (waist circumference ≥90 cm for men, ≥85 cm for women) and probable sarcopenia (handgrip strength ≤28 kg for men, ≤18 kg for women). Dietary intake was assessed using a semi-quantitative food frequency questionnaire and NOVA classification. Associations between food group intake and each phenotype were analyzed using multinomial logistic regression, adjusting for confounders. RESULTS: Compared with healthy controls, the probable sarcopenia group reported lower intakes of total protein (p = 0.041), vitamin A (p = 0.041), and carotenoids (p = 0.046), and higher intake of processed culinary ingredients (p = 0.012). The sarcopenic obesity group had lower intake of minimally processed foods (p = 0.046) and higher intake of ultra-processed foods (p = 0.010). In regression models, higher protein intake was associated with lower odds of probable sarcopenia (OR = 0.73, 95% CI: 0.56-0.95). Higher ultra-processed food intake was associated with increased odds of abdominal obesity (OR = 1.26, 95% CI: 1.03-1.54) and sarcopenic obesity (OR = 1.37, 95% CI: 1.02-1.84). CONCLUSION: Higher protein and minimally processed food intakes were associated with lower odds of probable sarcopenia, whereas higher ultra-processed food intake was associated with higher odds of abdominal and sarcopenic obesity in middle-aged adults in rural Korea. These observational findings may inform hypothesis generation and public health planning, but prospective studies are needed to confirm these associations and assess causality.