The consumption of live microbes, beyond probiotics, is associated with health benefits. This study aimed to quantify live microbe intake in 2016-2020 Korea National Health and Nutrition Examination Survey (KNHANES) and to investigate the associations between live microbe intake and cardiometabolic health outcomes. We developed a KNHANES live microbe classification system based on the Sanders system and divided KNHANES food codes that overlapped with NHANES into four categories: no live microbe or low (10 7 CFU/g) levels. Microbe data on various types of kimchi were obtained from the World Kimchi Institute, and data on other non-overlapping food codes were determined based on literature and authoritative reviews. We performed descriptive analyses on live microbe intakes among adults aged 19 years and older. We then conducted survey-weighted adjusted regression analyses to evaluate the relationship between live microbe intake and cardiometabolic health outcomes (cholesterols, triglyceride, blood pressure, fasting blood sugar, C-reactive protein CRP, and waist circumference), controlling for age, sex, body mass index, household income, physical activity level, current smoking status, and alcohol intake. The mean daily intake of medium live microbe foods was 180.24 g in the Korean population, while high live microbe foods averaged 122.89 g. Kimchi contributed a significant portion, with a mean intake of 102.76 g. Although no significant association was found between total live microbe intake and CRP levels, the association was significant for kimchi foods in that higher intake was associated with a greater reduction in CRP (coefficient: -0.037; 95% CI: -0.043, -0.032 mg/dL). The association with total cholesterol was positive and statistically significant, albeit small in magnitude so not considered clinically significant. No significant associations were found with other outcomes. This study provides new data on dietary intakes of live microbes and their potential health benefits in a nationally representative data of Korean adults.
Zhao et al. (Sun,) studied this question.