Abstract
OBJECTIVES: Using data from the 2019‒2021 Korea National Health and Nutrition Examination Survey, we examined the association between dietary quality and metabolic syndrome by self-reported weight change among adult Korean cancer survivors. METHODS: We analyzed 340 cancer survivors (≥ 5 years post-diagnosis) by one-year weight change (stable, loss, and gain). Dietary quality was assessed using the Korean Healthy Eating Index (KHEI), and metabolic syndrome was defined according to standard criteria. Relative risks (RR) were estimated using a modified Poisson regression. RESULTS: The weight loss group was older than the weight gain group (P < 0.001). Females were more prevalent in the loss and gain than in the maintenance group (P = 0.008). Hypertension prevalence was highest in the loss and lowest in the gain group (P = 0.028); other risk factors were similar. The gain group had the highest body mass index (P = 0.011). KHEI scores were highest in the maintenance (66.59 ± 0.76) and lowest in the gain group (60.42 ± 1.77; P = 0.006), with significantly lower whole grain (P = 0.036) and fruit intake (P = 0.014). Compared with the maintenance group, the gain group demonstrated higher risks of metabolic syndrome (RR: 2.07, 95% confidence interval [CI]: 1.40-3.06; P < 0.001), abdominal obesity (RR: 1.93, 95% CI: 1.36-2.74; P < 0.001), and impaired fasting glucose (RR: 1.70, 95% CI: 1.23-2.34; P < 0.01). Within the gain group, participants in the lowest KHEI quartile had increased risks of metabolic syndrome (RR: 2.81, 95% CI: 1.06-7.43; P < 0.05) and hypertriglyceridemia (RR: 7.29, 95% CI: 1.54-34.61; P < 0.05). CONCLUSION: Accordingly, weight change and dietary quality may critically affect the metabolic health of cancer survivors. Lifestyle management, including weight control and tailored diets, may help prevent metabolic disorders and support long-term health.