Relationship Between Fermented Food Consumption Patterns, hs-CRP, and Chronic Diseases Among Middle-Aged Koreans: Data from the 2015-2018 Korea National Health and Nutrition Examination

Abstract

Background/Objectives: Fermented foods promote digestion and may help prevent chronic diseases. However, studies on their relationship with health indicators in Korea remain limited. This study aimed to identify fermented food consumption patterns among middle-aged Korean adults and to analyze their association with high-sensitivity C-reactive protein (hs-CRP) and chronic disease. Methods: This study analyzed 7111 adults aged 40-64 years from the 6th-7th Korea National Health and Nutrition Examination Survey (KNHANES, 2015-2018). hs-CRP values were categorized as <1 mg/L, 1-3 mg/L, and ≥3 mg/L. Latent profile analysis (LPA) classified fermented foods into 10 categories using Mplus 8.11, with LMR-LRT significance and entropy ≥ 0.7 determining the number of classes. Logistic regression analysis using SPSS 29.0 was conducted to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for hs-CRP and chronic disease (p < 0.05). Results: LPA identified four consumption patterns: <Low Fermented-Food Pattern> (LFP), <Fermented Alcohol- and Beverage-Centered Pattern> (FABP), <Fermented Dairy-Centered Pattern> (FDP), and <Fermented Grain-Centered Pattern> (FGP). hs-CRP was highest in LFP (1.0 ± 1.2 mg/L), followed by FABP (0.8 ± 1.1 mg/L) and FDP and FGP (0.9 ± 1.2 mg/L) (p < 0.001). Compared to LFP, FGP had ORs of 0.810 (95% CI: 0.690-0.950, p < 0.005) for hypertension and 0.586 (95% CI: 0.459-0.747, p < 0.001) for diabetes. For dyslipidemia, ORs were 0.832 (95% CI: 0.720-0.962, p < 0.005) for FABP and 0.832 (95% CI: 0.719-0.962, p < 0.005) for FDP. Conclusions: This study classified fermented food consumption patterns and analyzed their association with hs-CRP and chronic disease. FGP and FDP showed lower inflammation and reduced odds of hypertension, diabetes, and dyslipidemia compared to LFP. These findings highlight the potential of healthy fermented food consumption patterns to support inflammation control and chronic disease prevention.

Keywords: chronic diseases; dietary patterns; fermented foods; high-sensitivity c-reactive protein; inflammation.

Figure 1

Flow chart representing the selection of study participants. KNHANES, Korea National Health and Nutrition Examination Survey; hs-CRP, high sensitivity C-reactive protein; BMI, body mass index.

Figure 2

Latent profile analysis (LPA).