Oodles of Yumminess but Instant Noodles Can Salvage Your Heart Health

Instant Noodles: Tasty but a Hasty Decision Taken

Despite the fact that instant noodles came under the radar for its debilitating effects on human health it is back with a bang and sales too haven’t witnessed a dip in recent times. Even a 10-year-old can prepare instant noodles in a jiffy. Kids of any age group love it when it’s time for their noodle treat and parents too don’t mind giving it to their children as the dish is cheap, convenient and tasty. It’s preferred by travelers, bachelors and those staying in hostels as all that you need to prepare it is a cup of hot water. Born in Japan, this dish has gained supremacy over the entire world with its overload of preservatives and empty calories. Indeed, this so-called super dish does have its own share of disadvantages.
​
It all boils down to the food that we eat finally. Unhealthy dietary choices such as high intake of junk foods and soft drinks and inappropriate lifestyle practices decide upon our quality of life. Instant noodles is mostly consumed in higher quantities in Asian countries, especially South Korea which tops the consumption list consuming more than 4 billion packets. We do know that noodles aren’t good for health but what exactly does their consumption do to our body? Hypertension is a great risk factor for heart disease, stroke and kidney failure and South Korea has more than 29% of adults aged above 20 years suffering from it. Asians including Koreans eat more of carbohydrates. Though the consumption of rice (staple food of Asians) has decreased in the previous few years the consumption of bread and noodles has almost doubled. Maybe instant noodles do contribute towards the increased risk of hypertension as it is indeed a refined grain product.

We are well-aware that diets such as the DASH diet that comprise more of whole grains, low-fat dairy, vegetables and fruits are good for reducing hypertension. We do have studies supporting the fact that higher intake of whole grain products decreases risk of hypertension. This induced a group of researchers to analyze the relationship between refined grain intake and risk of hypertension during 8 years of follow-up data.

Cohort Study on Korean Adults
The study included 10,030 Korean adults aged between 40 and 69 years and baseline data was collected from 2001 to 2002 and then follow-up data was conducted every 2 years over an 8-year period. 5,012 participants were excluded from the study based on different criteria such as presence of hypertension, cardiovascular disease and cancer and other criteria. Finally, 5,018 individuals (2,439 men and 2,579 women) were involved in the study. Each of the participants were asked about their frequency and portion sizes of food consumption during the previous year. Frequency was classified into one of the nine categories: never/seldom, once/month, 2-3 times/month, 1-2 times/week, 3-4 times/week, 5-6 times/week, once/day, 2 times/day and 3 or more times per day. Portion sizes were classified into three categories: 1/2 serving, 1 serving and ≥2 servings. Portion sizes was multiplied by the frequency of consumption. Refined grains were classified into three groups -white rice, noodles and bread with each of them having different varieties under their consumption. Noodles consumption was divided into five categories (never, 0-<1, 1-<3, 3-<5, ≥5 servings/week).

BP measurements were taken twice and the average was considered. Systolic and diastolic blood pressure measurements (SBP and DBP respectively) were taken and hypertension was defined as having SBP ≥140 mmHg or DBP ≥90 mmHg. Participants were followed up for around 72 months and the follow-up rate was 64%. During this period, 1377 (710 men and 667 women) of the 5,018 participants were declared to be hypertensive. Comparatively, those who suffered from hypertension were those participants who were probably older, mostly men, had lower incomes, current smokers, less educated, had higher BMI and ate less of fruits and vegetables compared to those who did not acquire the problem. Results showed that:
​

1. Among women participants frequent noodles consumption (≥5 servings/week) had a 2-3-fold higher risk of hypertension
2. Consumption of rice and breads did not increase risk of hypertension
3. Consumption of noodles was inversely associated with the risk of hypertension in middle-aged and older Korean women and consumption of rice and bread did not increase the risk in any way
   
   

There are other similar studies such as the cross-sectional Tehran adult study that showed that noodle consumption increased the risk of hypertension by 69%, a South Indian study which showed refined flour consumption to increase risk of systolic pressure by as much as +2.9% and diastolic pressure by as much as +1.7%. Koreans generally eat noodles in huge quantities and these noodles are not only made of refined grains but also contain high levels of sodium that increase the risk of hypertension. One interesting fact about this study is that hypertension and refined grain intake were inversely linked to each other only in the case of women. Likewise, another study in South Korea found that increased intake of fried foods raised the risk of hypertension in women but not men.
​
Cardiometabolic Risk
Cardiometabolic risk factors are rapidly increasing in South Korea and so are overweight and metabolic syndrome rates. All these are critical risk factors for cardiovascular disease. Once again, our dietary choices affect the risk rate of these diseases. There has already been results from a study reporting increased risk of cardiometabolic risk factors associated with a dietary pattern high in consumption of instant noodles, hamburgers and pizza in the Korean men population. The study cited below tried to find a link between instant noodles consumption, dietary patterns and cardiometabolic risk factors with the help of the Korean National Health and Nutrition Examination Survey (KNHANES) cross-sectional study. Though more than 24000 participants’ data was initially collected only 10,711 of them qualified for the study based on different study criteria.

Food frequency questionnaires (FFQs) were given to participants asking them to choose between 10 frequency responses ranging from ‘almost never’ to ‘3 times a day’ for 38 different food items. Waist circumference, blood pressure, mean systolic and diastolic pressures, total cholesterol, fasting glucose, LDL and HDL cholesterol levels were also measured. Using the guidelines from the International Diabetes Federation metabolic syndrome was defined as abdominal obesity (waist circumference ≥90 cm in men and ≥ 80 cm in women) along with any of the two criteria among these-elevated blood pressure levels, low HDL cholesterol, hyperglycemia and hypertriglyceridemia. Intake of instant noodles was divided into five categories (<1 time/month, 1 time/month, 2-3 times/month, 1 time/week and ≥2 times/week).

Two different dietary patterns were observed in both men and women-traditional dietary pattern (TP) that is rich in fruits, vegetables, fish, legumes, potatoes, grains, mushrooms and seaweed and meat and fast-food pattern (MP) consisting of less rice and cereal but more of meat, soda, fried food, instant noodles, bread, cookies, fish, pasta, ice cream, hamburgers and pizza. Those with the highest quintiles of MP also had a higher frequency of instant noodle intake (2 times/week in men and 1.2 times/week in women) compared to the highest quintiles of the TP (mean of 1.1 times/week in men and 0.7 times/week in women). Results showed that:
​

1. Mean sodium intake was extremely high across all categories
2. Those who frequently consumed instant noodles (≥2 times/week) and those in the highest quintile of MP were younger, smokers, drank alcohol, less physically active and consumed less carbs (both men and women). Despite the fact that those in the highest quintile of MP had high education levels than participants in the lowest quintile those participants who frequently consumed instant noodles had lower educational/income levels than those who rarely consumed noodles. Highest MP quintile was not associated with metabolic syndrome. Quintiles 2-5 in MP had higher risk for metabolic syndrome compared to the lowest MP quintile in men but not women
3. Highest TP quintile was not associated with metabolic syndrome
4. The highest MP quintile was associated with higher prevalence of abdominal obesity and LDL cholesterol levels compared to the lowest quintile in men
5. Highest TP quintile was associated with a lower occurrence of BP and abdominal obesity levels in comparison to the lowest quintile
6. Increased consumption of instant noodles (≥2 times/week or even ≥once/week) was associated with a higher prevalence of metabolic syndrome in women and abdominal obesity in women but not in men.
   ​

Hence, the TP has been linked to decreased prevalence of abdominal obesity and elevated blood pressure while MP is linked to high prevalence of abdominal obesity and high LDL cholesterol levels but decreased HDL cholesterol levels. Consuming instant noodles alone was associated with an increased prevalence of metabolic syndrome and marginally associated with abdominal obesity irrespective of the major dietary patterns in women. It also increases cardiometabolic risk irrespective of the dietary pattern.

Effect on Young Individuals
Yet another study was conducted on 3,397 (1,782 males and 1,615 females) students aged between 18 and 29 years. They were all asked to fill a questionnaire comprising of details on the age, height, weight, income, smoking, drinking and physical activity levels. The questionnaire also included a question on the frequency of instant noodles consumption over a 1-year period and frequency of other foods consumption such as processed meats, high-fat fish, sweets and confectionary.

Results showed that males were likelier to frequently consume instant noodles (≥3 times/week) than females. Such individuals smoked more, drank more alcohol, ate more fried foods and confectionary and earned a lesser family income. These people also suffered from increased blood pressure and fasting blood glucose levels. In females, triglyceride levels and diastolic blood pressure levels were higher among frequent consumers of instant noodles. Also, college students who frequently consumed noodles were associated with an increased risk of cardiometabolic risk factors.
​
Researchers at Harvard University reported a 68% higher risk of metabolic syndrome among women who consumed instant noodles more than twice a week but this was applicable to women. Most of the instant noodles are deep-fried contributing to increased calorie counting and carbohydrate consumption.

Regular noodles are bad but instant noodles are worse as they are mostly prepared using palm oil and full of salt, artificial flavors and preservatives. It might be delicious compared to your regular noodles but it is also equally harmful. While it is recommended to avoid noodles if you must eat them please choose regular ones as they are not as bad as the instant ones though it might take an extra 5 minutes or so.

References
Noodle consumption is positively associated with incident hypertension in middle-aged and older Korean women: https://e-nrp.org/Synapse/Data/PDFData/0161NRP/nrp-13-141.pdf
​
Instant Noodles Intake and Dietary Patterns are Associated with Distinct Cardiometabolic Risk Factors in Korea: https://academic.oup.com/jn/article/144/8/1247/4637708

Instant Noodle Consumption is Associated with Cardiometabolic Risk Factors among College Students in Seoul: https://pdfs.semanticscholar.org/9d31/c5dd2bd02bcb4a02da4da168c2d75fc9440f.pdf