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Objective:To evaluate the performance of an FFQ for estimating dietary contributions of NOVA groups to individuals’ diets with a specific focus on ultra-processed foods (UPF) compared with a single 24-h dietary recall (24HR).Design:All consumed foods and beverages assess with both a 109-item FFQ and a single 24HR were classified into one of four NOVA groups: natural or minimally processed foods (MPF), processed culinary ingredients (PCI), processed foods (PF) and UPF. The contributions of each NOVA group to daily intakes of energy, protein, fat, saturated fat, carbohydrate, fibre and Na were expressed as crude intake, energy-adjusted intake and percentage intake. Mean differences, correlation coefficients and joint classification were calculated for intakes of energy and nutrients from each NOVA group between the FFQ and the 24HR.Setting:The Korea National Health and Nutrition Examination Survey 2016.Participants:Adults aged 19–64 years (n 3189).Results:The smallest group-mean differences between the two methods were observed in UPF (2–40 %). The greatest average Pearson’s correlation coefficients between the FFQ and 24HR were shown in dietary contributions of UPF (r = 0·22–0·25 for MPF; r = 0·02–0·05 for PCI; r = 0·11–0·18 for PF; r = 0·26–0·30 for UPF). The greatest agreement in quartile classification between the FFQ and the 24HR was observed in dietary contributions of UPF (70·0–71·5 % for MPF; 64·2–68·8 % for PCI; 66·9–69·2 % for PF; 71·8–73·9 % for UPF).Conclusions:The use of the FFQ for estimating absolute intake of UPF may not be encouraged in its current form, but it still may be used for relative comparisons such as quantile categorisation.

Managing alcohol consumption may be an effective way of preventing hypertension, which is an important modifiable risk factor for cardiovascular diseases. However, there is little evidence on the temporal relationship between alcohol consumption and incidence of hypertension. We investigated the prospective association between repeated measures of alcohol consumption and hypertension incidence among Korean adults aged 40 and over.This study included a total of 4989 participants that were not taking antihypertensive drugs and had normal blood pressure (BP) (systolic 140 mmHg and diastolic 90 mmHg). We used three measures of alcohol consumption (baseline, most recent, and average) as exposures and compared the three approaches. Using a modified Poisson regression model with a robust error estimator, we estimated incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for hypertension.Over a total of 17,689 person-years (average 3.5 years of follow-up), 574 incident cases of hypertension were identified. In multivariable models, consuming ≥30 ml/d of alcohol was associated with a risk of hypertension among men (IRR = 1.72, 95% CI = 1.20-2.48, p trend = 0.017 for baseline alcohol consumption; IRR = 1.69, 95% CI = 1.23-2.33, p trend = 0.005 for the most recent alcohol consumption; IRR = 1.49, 95% CI = 1.09-2.03, p trend = 0.014 for average alcohol consumption). After additional adjustment for baseline BP the positive association remained only when the most recent alcohol consumption measure was used. There was no significant association between alcohol consumption and hypertension among women, and no interaction effect between alcohol consumption and baseline BP levels on incidence of hypertension (all p interaction 0.05) existed.Alcohol consumption, especially consuming ≥30 ml/d, may be positively linked with incidence risk of hypertension among men.

Background Central obesity, characterized by high waist circumference (WC), has been independently associated with higher chronic diseases and mortality risk. To date, controversial evidence is available concerning the beneficial effects of spicy foods on central obesity. We aimed to prospectively examine the association between preference for spicy foods and incident central obesity in Korean adults aged 40 and over. Methods We included 6,042 participants free of central obesity at baseline. Central obesity was defined as having WC ≥ 90 cm for men and ≥ 85 cm for women. As an exposure, preference for spicy foods was measured using a five-scale response option from the lowest to the highest preference and a Cox proportional hazard model was used to estimate the hazard ratios (HR) with confidence intervals (CI) for central obesity. Results During 45,654 person-years (median 9 years) of follow-up, 1,778 incident central obesity cases occurred. Compared to the lowest preference for spicy foods, the highest preference for spicy foods was associated with greater central obesity risk (HR = 1.43, 95% CI = 0.99-2.05, p trend=0.002). No interaction existed between preference for spicy foods and gender on central obesity incidence (p interaction > 0.05). Conclusions Appreciated for spicy foods was associated with an excess risk of central obesity incidence in Korean adults aged 40 years and older. Key messages These findings may provide informative evidence on primary prevention of central obesity, particularly for populations with a higher preference for spicy foods.

Different approaches for analyzing repeated dietary measurements may yield differences in the magnitude and interpretation of findings. We aimed to compare 3 dietary measurements (baseline, most recent, and cumulative average) in terms of the association between plant-based diet indices (PDIs) and incident abdominal obesity in Korean adults aged 40-69 years.This study included 6,054 participants (54% women) free of abdominal obesity (defined as waist circumference ≥90 cm for men and ≥85 cm for women) at baseline. As exposures, baseline, most recent, and cumulative average measurements for PDI, healthy-PDI (hPDI), and unhealthy-PDI (uPDI) were created. A Cox proportional-hazard model was used to estimate the hazard ratios (HRs) for abdominal obesity.During 45,818 person-years of follow-up (median, 9 years), we identified 1,778 incident cases of abdominal obesity. In the multivariable-adjusted analysis, a higher uPDI was associated with a higher risk of abdominal obesity in both total and stratified analyses. The findings were consistent across all approaches (Q5 vs. Q1: HRbaseline=1.70; 95% confidence interval [CI], 1.46 to 1.98; HRmost recent=1.52; 95% CI, 1.30 to 1.78; HRcumulative average=1.76; 95% CI, 1.51 to 2.06 in the total set). PDI showed no meaningful association with abdominal obesity risk in any analyses. hPDIaverage had a suggestive inverse association with abdominal obesity risk in men, and hPDIbaseline had a positive association with abdominal obesity risk in women.Greater adherence to unhealthy plant-based diets may increase the risk of developing abdominal obesity in Korean adults. The findings were generally consistent across all approaches.

Maintaining optimal blood pressure (BP) levels can be an effective preventive strategy for reducing disease burden. Nut consumption may play a preventive role against hypertension, which is a lifelong condition. We aimed to prospectively examine the association between cumulative average nut consumption and the incidence of hypertension in Korean adults aged 40 years and older.A total of 10,347 participants who were free of hypertension at baseline, were included. Hypertension was defined as having a physician diagnosis and taking antihypertensive medications or having abnormal BP (systolic ≥ 140 mmHg or diastolic ≥ 90 mmHg). As an exposure, cumulative average nut consumption was calculated using repeated food-frequency questionnaires (mean: 2.1). We used a modified Poisson regression model with a robust error estimator to estimate the incidence rate ratios (IRRs) with 95% confidence intervals (CIs) for hypertension.We identified 2047 incident cases of hypertension during 44,614 person-years of follow-up. Among both men and women, an average nut consumption of ≥ 1 serving/week (15 g/week]) was inversely associated with hypertension incidence (IRR = 0.74, 95% CI = 0.58-0.96, p for trend = 0.013 for men; IRR = 0.72, 95% CI = 0.59-0.88, p for trend = 0.002 for women) and these significant associations were consistently observed across the strata of potential confounders.An average consumption of at least one serving (15 g) per week of peanuts, almonds, and/or pine nuts may be inversely associated with the risk of hypertension among Korean adults aged 40 years and older, in a dose-response manner.

The association between nutritional status and health-related quality of life (HRQoL) among patients with type 2 diabetes mellitus (T2DM) is not fully understood. This study was conducted to understand the role of nutritional status on HRQoL among people with and without T2DM.Structured survey and direct measurement of anthropometric data were conducted among people with and without T2DM. Nutritional status was measured with Mini Nutritional Assessment tool and HRQoL was measured with a 36-item Short Form Healthy Survey. Data collection was conducted in Chuncheon, South Korea with 756 participants who are older than 40 yrs of age.This study found that overall HRQoL were significantly lower in people with T2DM than people without T2DM after controlling for key covariates. When stratified by nutritional status, a greater degree of negative impact of T2DM on overall physical HRQoL was observed among well-nourished or at risk of malnutrition, whereas significant and more evident negative impact of diabetes on overall psychological HRQoL was observed only among malnourished.The study results suggest the role of nutritional status among people with T2DM on overall, especially psychological aspects of HRQoL. Future longitudinal or intervention studies are warranted to test the impact of nutritional status on HRQoL among people with T2DM.

Background and aims Low-grade inflammation, represented by minor C-reactive protein (CRP) elevation, has a critical role in the early stages of atherosclerosis, and pantothenic acid (PA) may have an antioxidant effect in inflammatory process. However, the long-term relationship between PA intake and CRP has not yet been studied. The objective of the present study was to evaluate the long-term relationship of PA intake to CRP concentration in healthy adults aged 40 years or older living in a rural area of South Korea. Methods and Results A total of 908 subjects (349 men, 559 women) with repeated data on dietary PA intake and CRP concentration were included in the final analysis. To represent the long-term effect of PA intake, both PA intake at the baseline and average PA intake were used as the exposure, and CRP concentration at the third visit and its change from the baseline to the third visit were used as the outcome. After adjustment for potential confounders, a significant inverse relationship between PA intake and CRP concentration at the third visit was observed ( P for trend = 0.001, β = −0.07 ( P -value = 0.001) for PA baseline ; P for trend = β = −0.11 ( P -value = 0.0004) for PA average (baseline, 2nd, 3rd) ). Higher PA intake was significantly related to lower or attenuated increase in CRP concentration ( P for trend = 0.002, β = −0.24 ( P -value = 0.002) for PA baseline ; P for trend = 0.001, β = −0.35 ( P -value = 0.001) for PA average (baseline, 2nd, 3rd) ). Conclusions In conclusion, dietary PA intake was inversely related to subsequent CRP concentration in both men and women aged 40 years or older in South Korea.

Subclinical vascular damage is a chronic intermediate process in cardiovascular disease (CVD) and high sodium (Na) has been regarded as an adverse factor in subclinical vascular health; however, the longitudinal relationship between Na intake and subclinical vascular damage has not been studied. We aimed to evaluate the longitudinal relationship of dietary Na intake and sodium to potassium ratio (Na:K) with brachial-ankle pulse wave velocity (baPWV) and carotid intima media thickness (cIMT) in healthy adults aged 40 years and older in Korea. The present study was based on participants (n = 2145 for baPWV analysis and n = 2494 for cIMT analysis) who visited three times during 2005–2013 (median 5.3 years of follow-up). We used both dietary Na intake and Na:K at baseline and its average (baseline, 2nd, 3rd), which was obtained from food frequency questionnaire (FFQ) as exposure at every visit. baPWV and cIMT levels at the third visit and change from baseline to the third visit were used to represent the level of subclinical vascular damage. After adjustment for potential confounders, significant positive relationships between dietary Na intake and both baPWV3rd and cIMT3rd were observed (baPWV: p for trend ≤ 0.0001 for Naaverage; cIMT: p for trend = 0.013 for Naaverage). Compared with Na:Ks less than 1.0, the levels of both baPWV and cIMT were higher for participants with Na:Ks over 1.0 (baPWV: p for trend = 0.0002 for Na:Kaverage; cIMT: p for trend = 0.005 for Na:Kaverage). Similar significant trends were shown in relationships between dietary Na intake and Na:K and changes in baPWV and cIMT levels. In conclusion, dietary Na intake and Na:K may be positively linked to subsequent baPWV and cIMT levels in adults aged 40 years and older in Korea. Our findings may provide informative evidence on subclinical vascular damage, particularly for populations with relatively high dietary Na intake and low dietary K intake.

The objective of this study is to find single nucleotide polymorphisms (SNPs) associated with a risk of Type 2 diabetes (T2D) in Korean adults and to investigate the longitudinal association between these SNPs and T2D and the interaction effects of iron intake and average hemoglobin level. Data from the KoGES_ Ansan and Ansung Study were used. Gene-iron interaction analysis was conducted using a two-step approach. To select candidate SNPs associated with T2D, a total of 7,935 adults at baseline were included in genome-wide association analysis (step one). After excluding T2D prevalent cases, prospective analyses were conducted with 7,024 adults aged 40-69 (step two). The association of selected SNPs and iron status with T2D and their interaction were determined using a Cox proportional hazard model. A total of 3 SNPs [rs9465871 (CDKAL1), rs10761745 (JMJD1C), and rs163177 (KCNQ1)] were selected as candidate SNPs related to T2D. Among them, rs10761745 (JMJD1C) and rs163177 (KCNQ1) were prospectively associated with T2D. High iron intake was also prospectively associated with the risk of T2D after adjusting for covariates. Average hemoglobin level was positively associated with T2D after adjusting for covariates in women. We also found significant interaction effects between rs10761745 (JMJD1C) and average hemoglobin levels on the risk of T2D among women with normal inflammation and without anemia at baseline. In conclusion, KCNQ1 and JMJD1C may prospectively contribute to the risk of T2D incidence among adults over the age of 40 and JMJD1C, but CDKAL1 may not, and iron status may interactively contribute to T2D incidence in women.

The present study investigated the effects of thermal pre-treatment on the enhancement of anaerobic biodegradability of waste activated sludge at varied TS concentration levels. The activated sludges were thermally oxidized for 30 minutes at with varied TS concentrations (2%, 4% and 6%). and then, sludge characteristics, solubilization efficiency and methane production yield of thermally pre-treated sludges were analyzed. The higher the temperature in the thermal pre-treatment, the higher the concentration levels of dissolved matters such as , and VFAs, which indicates that the thermal pre-treatment facilitates the hydrolysis and acid fermentation. Furthermore, the solubilization efficiency was increased in proportion to the temperature rise at all TS concentrations and was reached at 68.9%, 55.6% and 53.1%, respectively, at . In the BMP test of the pre-treated sludges, higher methane production yields were observed as 0.313. 0.314 and at the condition of TS 2% (), 4% () and 6% (), respectively, and degradation rate was increased by 84%, 79% and 65% compared with non-pretreated waste activated sludge. These findings suggest the effectiveness of thermal pre-treatment of waste activated sludge for anaerobic biodegradable process.

The main object of this study was to offer information about incoming waste in landfill and to evaluate biochemical methane and hydrogen sulfide potentials of landfill wastes. We examined brick, soil, mixed waste (C&D waste and MSW) samples for the study. The leaching experiments showed that BOD, COD and sulfate were determined in the range of 0~18,816 mg/kg, 85~21,100 mg/kg and 160~1,205 mg/kg, respectively in 6hr extraction test. An accumulated extraction tests for 140day were determined BOD 226~197,219 mg/kg, COD 436~242,588 mg/kg and Sulfate 1,090~25,140 mg/kg. Also, BMP (biochemical methane potential) tests were carried out to examine methane and hydrogen sulfide yields for the 3 different wastes. As a result, methane yield was determined to 262.68 mL CH 4 /g VS of MSW and 0~17.75 mL CH 4 /g VS in brick, soil and C&D waste. Higherhydrogen sulfide yield was observed to 0.079mL H 2 S/g VS in C&D waste. This result indicate that brick and soil could be sourcesof sulfate, and higher production of hydrogen sulfide could be odor problem and inhibitor of methane production.

The Sudokwon landfill site in Korea, is one of the largest landfill sites in the world, and consists of a first landfill site and second landfill site. The second landfill site generates 3&ndash, 30 times more H2S than that of the first landfill site. However, the cause of the increase in H2S has not been identified. In this study, the main causes of H2S concentration increase were investigated in the second landfill site in the Sudokwon landfill site. We classified wastes at the Sudokwon landfill site into seven types including Construction and demolition (C&amp, D) debris waste. A lysimeter reactor was designed as a similar environment to the Sudokwon landfill site for simulation. In addition, the experiment was conducted under the same conditions. Three components and elements were analyzed to identify the composition of waste in the landfill site. Leachate was analyzed through a chemical oxygen demand and SO42&minus, standard method. For landfill gas, a gas analyzer was used. The trend in the generation of leachate and landfill gas depending on waste composition at the landfill site was observed and the cause of the increase in H2S was examined. As a result, landfilling of C&amp, D debris waste is recommended as a single landfill.

Light-to-moderate alcohol consumption has been proposed to raise serum adiponectin levels, but this view is controversial. There is little information on the effect of heavy drinking. The aim of this study was to examine the relationship between alcohol consumption and serum adiponectin levels in healthy Koreans.The design of the study was cross-sectional, using data from the Korean Multi-Rural Communities Cohort Study (MRCohort), which is a part of the Korean Genome Epidemiology Study (KoGES). The subjects were 1542 individuals (635 men and 907 women) aged ≥ 40 years who were recruited in Yangpyeong-Gun, Kyunggi province, South Korea, in 2005 and 2006. Daily alcohol consumption was calculated from average frequency of alcohol consumption and the amount of alcohol consumed per occasion using a structured questionnaire and serum adiponectin levels were measured.Although adiponectin levels appeared to be higher in those consuming moderate levels of alcohol than in nondrinkers, the difference was not statistically significant. Heavy drinking (≥ 90.0 g/day) was significantly related to reduced serum adiponectin levels (P=0.003), although the significance of the relationship was reduced after adjusting for potential confounders (P=0.061) such as age, waist/hip ratio, blood pressure, fasting blood glucose, current smoker, higher education, protein intake, vitamin C intake and vitamin E intake in men. The relation seemed to be stronger in individuals consuming alcohol in the form of takju (Korean rice wine; P=0.022).Heavy alcohol drinking (≥ 90.0 g/day) may be related to lower serum adiponectin levels in Korean men.

Thyroid cancer is the most common cancer among Korean women. However, there are few data on dietary factors related to thyroid cancer risk. The objective of the present study was to evaluate the association between raw vegetables and fruits intake and thyroid cancer in a case–control study. We included 111 histologically confirmed malignant thyroid cancer cases and 115 benign cases. Controls who did not have nodules in thyroid ultrasonography were matched to cases by age ( ± 2 years). Food and nutrient intakes were estimated using a quantitative FFQ with 121 items. Conditional logistic regression analysis was used to obtain OR and corresponding 95 % CI. The intake of total vegetables was not associated with malignant thyroid cancer, but inversely associated with benign cases. High raw vegetable intake was inversely associated with thyroid cancer risk both in malignant and benign cases (P for trend = 0·01 in both malignant and benign cases). Among fruits, persimmon intake had an inverse association with thyroid cancer risk in both malignant and benign cases (P for trend = 0·06 in malignant cases; P for trend = 0·01 in benign cases) and tangerine intake had an inverse association in malignant cases (P for trend = 0·03). The frequency of consumption of raw vegetables and persimmon also had a consistent inverse association in both malignant and benign cases. These results suggest that high consumption of raw vegetables, persimmons and tangerines may decrease thyroid cancer risk and help prevent early-stage thyroid cancer.

Objective There has been increasing interest in non-skeletal interactions between vitamin D insufficiency, which is common, and cardiovascular event and cardiovascular disease (CVD) risk factors. Methods To evaluate cross-sectional associations between dietary and serum vitamin D status and metabolic abnormalities and arterial changes among 1054 adults aged ≥40 y (404 men and 650 women) in a rural area of South Korea. Study subjects were divided into three groups according to dietary vitamin D intake (tertiles) measured by food frequency questionnaire and serum 25(OH)D levels (≤20, 21–29, and ≥30 ng/mL). Metabolic components (blood pressure, lipid profiles, and glycemic index) and arterial changes (brachial ankle pulse wave velocity [baPWV] and carotid artery intima-media wall thickness [cIMT]) were measured. Results Dietary vitamin D was inversely associated with diastolic blood pressure (DBP) and baPWV among men, but the association disappeared after multinutrient supplement users were excluded. Among women, there was an inverse association between dietary vitamin D and triacylglycerol (TG) levels. However, serum 25(OH)D showed a significant positive relationship with HDL cholesterol in both men and women, while a positive linear trend or nonlinear trend with serum 25(OH)D levels was shown in TG levels among men and in systolic blood pressure (SBP), DBP, total cholesterol, and baPWV among women. The positive relationship between serum 25(OH)D with baPWV disappeared after adjustment for blood pressure. Conclusions Serum 25(OH)D may be favorably related to HDL cholesterol. However, serum 25(OH)D may not favorably related to subclinical atherosclerosis and arterial stiffness measured by cIMT and baPWV. The positive relationship between 25(OH)D and baPWV is likely to be mediated by blood pressure.

Summary Background & aim Understanding the lifestyle and genetic factors that affect pulse wave velocity (PWV) may provide clues to preventing atherosclerotic cardiovascular events. The aim of this study is to investigate genome-wide genetic and dietary calcium (Ca) intake interaction effects on brachial–ankle pulse wave velocity (baPWV). Methods The baPWV was measured, and Ca intake was quantified by administering a food frequency questionnaire (FFQ) to 3198 participants, which included men and women (≥40 years) from the Korean Multi-Rural communities Cohort study (MRCohort). The interaction effects of dietary Ca intake and 19 single-nucleotide polymorphisms (SNPs) on baPWV were assessed using the general linear models. Results Dietary Ca intake was not significantly associated with baPWV or any type of SNP among the subjects herein. In men, however, the adducin1 (ADD1) rs4961_C SNP had a significant dietary Ca intake–dependent effect on mean baPWV (pinteraction = 0.002). In women, the interaction of zinc finger proteins 618 (ZNF618) rs10817542_A with dietary Ca intake played a significant and key role in mean baPWV (pinteraction = 0.001). In the results of ADD1 rs4961_C in men and ZNF618 rs10817542_A in women, the minor allele-lowest Ca intake tertile (T1) group had significantly higher mean baPWV value than other subgroups of Ca intake tertile-genotype cross-classification whereas genotype was not a significant effector on mean baPWV values among highest Ca intake subgroups (T3). Conclusions The baPWV, a phenotype of arterial stiffness, can be modulated in subjects through regulation of dietary Ca intake, particularly in subjects with more vulnerable genotypes.

The interaction between genetics and diet may explain the present disagreement in the protective role of vitamin intake on cardiovascular disease. We cross-sectionally assessed the interaction of habitual dietary intake of β-carotene, vitamin C, folate, and vitamin E with single nucleotide polymorphisms (SNPs) on brachial–ankle pulse wave velocity (baPWV), a measure of arterial stiffness. Dietary intakes of β-carotene, vitamin C, folate, and vitamin E were quantified by a food frequency questionnaire in 3198 healthy men and women (≥40 years) from the Korea Multi-Rural communities Cohort study. baPWV was measured, and 19 SNPs were genotyped. The associations and interactions between dietary vitamin intake, SNP genotype, and baPWV were assessed using general linear models. In both men and women, dietary intake of β-carotene, vitamin C, folate, or vitamin E and baPWV were not directly associated. Vitamin C, folate, and vitamin E intake had an interaction with rs4961 (ADD1) genotype on baPWV in men. rs4961 also interacted with folate intake on baPWV in women. In women, rs10817542 (ZNF618) and rs719856 (CD2AP) had an interaction with β-carotene and folate intake and rs5443 (GNB3) had an interaction with vitamin E intake on baPWV. In general, minor allele homozygotes with low vitamin intake had higher baPWV than other subgroups. Results were similar when supplement users were excluded. Higher intake of dietary vitamin C, folate, and vitamin E may be related to high baPWV in healthy Korean men who are minor allele homozygotes of rs4961. In healthy Korean women, dietary folate, β-carotene, and vitamin E intake may affect baPWV differently according to rs4961, rs10817542, rs719856, or rs5443 genotype. Greater dietary intake of these nutrients may protect those that are genetically vulnerable to stiffening of the arteries.

Background Serum cytokines and C-reactive protein (CRP) are known as one of the major risk factors in atherosclerosis. The antioxidant and anti-inflammatory properties of zinc have been suggested, but few data are available on the relationship between zinc status and inflammatory markers in epidemiological studies. Objective The present study aims to investigate the cross-sectional relationships of serum cytokines and CRP with dietary zinc intake and serum zinc levels in healthy men and women aged 40 and older in rural areas of South Korea. Materials and Methods A group of 1,055 subjects (404 men, 651 women) was included in dietary zinc analysis while another group of 695 subjects (263 men, 432 women) was included in serum zinc analysis. Serum IL-6, TNF-α, and CRP were measured as inflammatory markers. Results There was no significant inverse relationship between dietary zinc intake and inflammatory markers. We found a significant inverse relationship between serum zinc levels and all three inflammatory markers in women (P for trend = 0.0236 for IL-6; P for trend = 0.0017 for TNF-α; P for trend = 0.0301 for CRP) and between serum zinc levels and a single inflammatory marker (IL-6) in men (P for trend = 0.0191), although all R2 values by regression were less than 10%. Conclusion In conclusion, serum zinc levels may be inversely related to inflammatory markers (IL-6, TNF-α, and CRP), particularly in women.

Background There is a proposed link between dietary zinc intake and atherosclerosis, but this relationship remains unclear. Phytate may contribute to this relationship by influencing zinc bioavailability. Objective The aim of this study is to examine the relationship between zinc bioavailability and subclinical atherosclerosis in healthy Korean adults. Materials and Methods The present cross-sectional analysis used baseline data from the Korean multi-Rural Communities Cohort Study (MRCohort), which is a part of The Korean Genome Epidemiology Study (KoGES). A total of 5,532 subjects (2,116 men and 3,416 women) aged 40 years and older were recruited from rural communities in South Korea between 2005 and 2010. Phytate:zinc molar ratio, estimated from a food-based food frequency questionnaire (FFQ) of 106 food items, was used to determine zinc bioavailability, and carotid intima media thickness (cIMT) and pulse wave velocity (PWV) were measured to calculate the subclinical atherosclerotic index. Results We found that phytate:zinc molar ratio is positively related to cIMT in men. A higher phytate:zinc molar ratio was significantly related to an increased risk of atherosclerosis in men, defined as the 80th percentile value of cIMT (5th vs. 1st quintile, OR = 2.11, 95% CI 1.42-3.15, P for trend = 0.0009), and especially in elderly men (5th vs. 1st quintile, OR = 2.58, 95% CI 1.52-4.37, P for trend = 0.0021). We found a positive relationship between phytate:zinc molar ratio and atherosclerosis risk among women aged 65 years or younger. Phytate:zinc molar ratio was not found to be related to PWV. Conclusions Lower zinc bioavailability may be related to higher atherosclerosis risk.