DOI QR코드

DOI QR Code

Association between Eating Alone Patterns and Mental Health Conditions by Region among Korean Adults

한국 성인의 지역유형별 혼밥 패턴과 정신건강의 연관성

  • Lee, Kyung Won (Department of Home Economics Education, Korea National University of Education) ;
  • Shin, Dayeon (Department of Food and Nutrition, Inha University)
  • 이경원 (한국교원대학교 가정교육과) ;
  • 신다연 (인하대학교 식품영양학과)
  • Received : 2021.09.25
  • Accepted : 2021.11.10
  • Published : 2021.12.31

Abstract

Objectives: This study investigated the association between the frequency and pattern of eating alone and the mental health status according to region in Korean adults. Methods: The data of 10,040 Korean adults aged ≥ 19 years from the Korea National Health and Nutrition Examination Survey (KNHANES) 2017 and 2019 were used. Participants were divided into 4 groups based on their frequency of eating alone: none (all meals together), 1, 2, and 3 meals/day alone. The regions were divided into urban and rural areas. Mental health status was assessed by stress recognition, depressive symptoms, and suicidal ideation. Multivariable logistic regressions were conducted to estimate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) on the association of the frequency and pattern of eating alone with poor mental health after controlling for covariates. Results: Among Korean adults, 74.1% ate more than one meal a day alone. Individuals having 3 meals a day alone tended to be less educated, single, single person households, or living in urban areas (all P < 0.05). In rural areas, those having 3 meals/day alone had higher odds of stress recognition (AOR: 1.55, 95% CI: 1.02-2.35) than those having all meals together. In urban areas, individuals eating alone 3 times/day had higher odds of stress recognition (AOR: 1.60, 95% CI: 1.31-1.96), depressive symptoms (AOR: 1.61, 95% CI: 1.23-2.12), and suicidal ideation (AOR: 2.14, 95% CI: 1.42-3.22) compared to those having all meals together. Urban residents having dinner alone had higher odds of depressive symptoms (AOR: 1.29, 95% CI: 1.05-1.58) and suicidal ideation (AOR: 1.66, 95% CI: 1.19-2.33) than those having dinner with others. Conclusions: Our findings showed that the frequency and patterns of eating alone were differentially associated with increased odds of poor mental health according to region of residence. Nutrition education is needed for those frequently eating alone, particularly those living in urban areas, to highlight the advantages of eating together and to ensure that they have balanced and healthy meals even if they eat alone.

Keywords

Acknowledgement

This study was supported by the Korean Society of Community Nutrition funded by the Korea Disease Control and Prevention Agency (No. ISSN 2733-5488).

References

  1. World Health Organization. Strengthening mental health promotion (fact sheet no. 220). Geneva: World Health Organization; 2001.
  2. Hong JP, Lee DW, Hahm BJ. 2016 Survey of Mental Disorders in Korea. Ministry of Health and Welfare, Samsung Medical Center; 2017 [cited 2021 Jul 20]. Available from: http://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=032901&CONT_SEQ=339138&page=1.
  3. Health Insurance Review & Assessment Service, National Health Insurance Service. 2018 National Health Insurance Statistical Yearbook. Health Insurance Review & Assessment Service, National Health Insurance Service; 2019 [cited 2021 Jul 27]. Available from: https://www.hira.or.kr/bbsDummy.do?pgmid=HIRAA020045020000&brdScnBltNo=4&brdBltNo=2312&pageIndex=1#none.
  4. James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392 (10159): 1789-1858. https://doi.org/10.1016/s0140-6736(18)32279-7
  5. Kim GE, Jo MW, Shin YW. Increased prevalence of depression in South Korea from 2002 to 2013. Sci Rep 2020; 10(1): 1-9. https://doi.org/10.1038/s41598-019-56847-4
  6. Ahn YM, Park JI, Jee SH. 2013 National Survey on Suicide. Ministry of Health and Welfare, Seoul National University; 2014 [cited 2020 Aug 31]. Available from: http://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=032901&CONT_SEQ=338662&page=1.
  7. Jeon JA, Lee NH, Kim JH. Recent changes in mental health policy in Korea. Health Soc Welf Forum 2017; 4: 51-63.
  8. Byeon S, Shin Y, Yoon J, Kim S, Kim Y. Stress is associated with nutritional intake and metabolic syndrome in urban middle-aged women. J Korean Soc Food Sci Nutr 2019; 48(8): 802-810. https://doi.org/10.3746/jkfn.2019.48.8.802
  9. Bae YJ. Nutrient and food intakes of Korean female adults depending on perceived stress-based on the 2014~2015 Korea National Health and Nutrition Examination Survey. Korean J Food Nutr 2017; 30(4): 759-770. https://doi.org/10.9799/KSFAN.2017.30.4.759
  10. Chu JE, Lee JM, Cho HI, Park YJ. Relationships between obesity, blood and urinary compositions, and dietary habits and depressed mood in Koreans at the age of 40, a life transition period. J Nutr Health 2013; 46(3): 261-275. https://doi.org/10.4163/jnh.2013.46.3.261
  11. Lee KW, Shin D. Association of night eating with depression and depressive symptoms in Korean Women. Int J Environ Res Public Health 2019; 16(23): 4831. https://doi.org/10.3390/ijerph16234831
  12. Vesnaver E, Keller HH. Social influences and eating behavior in later life: A review. J Nutr Gerontol Geriatr 2011; 30(1): 2-23. https://doi.org/10.1080/01639366.2011.545038
  13. Cason KL. Family mealtimes: More than just eating together. J Am Diet Assoc 2006; 106(4): 532-533. https://doi.org/10.1016/j.jada.2006.01.012
  14. Eloise-kate VL, Campbell KJ, Spence AC. Family meals with young children: An online study of family mealtime characteristics, among Australian families with children aged six months to six years. BMC Public Health 2017; 17(1): 1-9. https://doi.org/10.1186/s12889-016-3954-4
  15. Yang JS, Bae EJ, Hong JE, Kang J, Jeon WJ. Eating alone among Korean elderly association with depressive symptoms: The Korean National Health and Nutrition Examination, 2013. Korean J Fam Pract 2017; 7(6): 904-908. https://doi.org/10.21215/kjfp.2017.7.6.904
  16. Ishikawa M, Takemi Y, Yokoyama T, Kusama K, Fukuda Y, Nakaya T et al. "Eating together" is associated with food behaviors and demographic factors of older Japanese people who live alone. J Nutr Health Aging 2017; 21(6): 662-672. https://doi.org/10.1007/s12603-016-0805-z
  17. Kwon AR, Yoon YS, Min KP, Lee YK, Jeon JH. Eating alone and metabolic syndrome: A population-based Korean National Health and Nutrition Examination Survey 2013-2014. Obes Res Clin Pract 2018; 12(2): 146-157. https://doi.org/10.1016/j.orcp.2017.09.002
  18. Heo JH. The effects of familism on subjective wellbeing in the mediation of self esteem. Korean J Counsel 2009; 10(4): 1769-1782. https://doi.org/10.15703/kjc.10.4.200912.1769
  19. Jung T. Historical and cultural analyses of collective features of Korean society. Korean J Soc Pers Psychol 2010; 24(3): 53-76.
  20. Lee KW, Shin D. Comparison of dietary behaviors and the prevalence of metabolic syndrome in single-and multi-person households among Korean adults. Healthcare 2021; 9(9): 1116. https://doi.org/10.3390/healthcare9091116
  21. Lee HY, Noh SC, Choi EY. Growth pattern and spatial distribution of one-person households by socio-economic demographic characteristics. J Korean Geogr Soc 2011; 46(4): 480-500.
  22. Lee KW, Shin D. Relationships of dietary factors with obesity, hypertension, and diabetes by regional type among single-person households in Korea. Nutrients 2021; 13(4): 1218. https://doi.org/10.3390/nu13041218
  23. Korea Disease Control and Prevention Agency. User Guide for the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII). Chungcheongbuk-do: Korea Disease Control and Prevention Agency; 2020.
  24. Oh SE, Park YJ. Associations of fiber intake and acid-base load in diet with risk of sarcopenia in Korean postmenopausal women: Based on the Korea National Health and Nutrition Examination Survey (2008~2011). J Korean Soc Food Sci Nutr 2019; 48(3): 352-361. https://doi.org/10.3746/jkfn.2019.48.3.352
  25. Lee KW, Song WO, Cho MS. Dietary quality differs by consumption of meals prepared at home vs. outside in Korean adults. Nutr Res Pract 2016; 10(3): 294-304. https://doi.org/10.4162/nrp.2016.10.3.294
  26. Romans S, Cohen M, Forte T. Rates of depression and anxiety in urban and rural Canada. Soc Psychiatry Psychiatr Epidemiol 2011; 46(7): 567-575. https://doi.org/10.1007/s00127-010-0222-2
  27. McKenzie K, Murray A, Booth T. Do urban environments increase the risk of anxiety, depression and psychosis? An epidemiological study. J Affect Disord 2013; 150(3): 1019-1024. https://doi.org/10.1016/j.jad.2013.05.032
  28. Cho SJ, Oh DH, Lee JA, Choi BY, Park YC, Nam JH. Prevalence of main psychiatric disorders in relation to urbanization in Gyeonggi province by using the Korean Version of the Mini-International Neuropsychiatric Interview. J Korean Neuropsychiatr Assoc 2011; 50(4): 288-296.
  29. Kim YW. Trends in markets for home meal replacamnets. Food Sci Ind 2017; 50(1): 57-66. https://doi.org/10.23093/FSI.2017.50.1.57
  30. Ha AW, Kim WK. The food and nutrient intakes from daily processed food in Korean adults: Based on the 6th Korea National Health and Nutrition Examination Survey data (2013~2015). J Nutr Health 2019; 52(5): 422-434. https://doi.org/10.4163/jnh.2019.52.5.422
  31. Tani Y, Kondo N, Takagi D, Saito M, Hikichi H, Ojima T et al. Combined effects of eating alone and living alone on unhealthy dietary behaviors, obesity and underweight in older Japanese adults: Results of the JAGES. Appetite 2015; 95: 1-8. https://doi.org/10.1016/j.appet.2015.06.005
  32. Kim HK, Chung J. Associations of the eating alone behavior with nutrient intake, obesity and metabolic syndrome in middle-aged adults based on the 2013~2017 Korean National Health and Nutrition Examination Survey. J Nutr Health 2019; 52(5): 435-448. https://doi.org/10.4163/jnh.2019.52.5.435
  33. Yeon JY, Bae YJ. Evaluation of the meal variety with eating breakfast together as a family in Korean children: Based on 2013~2015 Korean National Health and Nutrition Examination Survey. J Nutr Health 2018; 51(1): 50-59. https://doi.org/10.4163/jnh.2018.51.1.50
  34. Ma Y, Bertone ER, Stanek III EJ, Reed GW, Hebert JR, Cohen NL et al. Association between eating patterns and obesity in a free-living US adult population. Am J Epidemiol 2003; 158(1): 85-92. https://doi.org/10.1093/aje/kwg117
  35. Jenkins DJ, Wolever TM, Vuksan V, Brighenti F, Cunnane SC, Rao AV et al. Nibbling versus gorging: Metabolic advantages of increased meal frequency. N Engl J Med 1989; 321(14): 929-934. https://doi.org/10.1056/NEJM198910053211403
  36. Jackson LW. The most important meal of the day: Why children skip breakfast and what can be done about it. Pediatr Ann 2013; 42(9): e194-e197. https://doi.org/10.3928/00904481-20130823-10
  37. Mekary RA, Giovannucci E, Cahill L, Willett WC, van Dam RM, Hu FB. Eating patterns and type 2 diabetes risk in older women: Breakfast consumption and eating frequency. Am J Clin Nutr 2013; 98(2): 436-443. https://doi.org/10.3945/ajcn.112.057521
  38. Yi YH, Kim YJ, Lee SY, Lee JG, Jeong DW, Cho YH et al. The correlation of meal frequency and nutrition with mental health status in women aged 20-39 years: The 5th Korea National Health and Nutrition Examination Survey, 2010-2012. Korean J Obes 2015; 24(2): 101-107. https://doi.org/10.7570/kjo.2015.24.2.101
  39. Kim A. Effect of health behaviors, dietary habits, and psychological health on metabolic syndrome in one-person households among Korean young adults. J Digit Converg 2018; 16(7): 493-509. https://doi.org/10.14400/JDC.2018.16.7.493
  40. Park K, Park YR, Son D. The relationship between social connectedness and depressive symptom: A comparison between the rural and urban elderly. J Korea Contents Assoc 2020; 20(2): 667-677. https://doi.org/10.5392/JKCA.2020.20.02.667
  41. Williams KL, Galliher RV. Predicting depression and self-esteem from social connectedness, support, and competence. J Soc Clin Psychol 2006; 25(8): 855-874. https://doi.org/10.1521/jscp.2006.25.8.855
  42. Maas J, Van Dillen SM, Verheij RA, Groenewegen PP. Social contacts as a possible mechanism behind the relation between green space and health. Health Place 2009; 15(2): 586-595. https://doi.org/10.1016/j.healthplace.2008.09.006
  43. Mundel E, Chapman GE. A decolonizing approach to health promotion in Canada: The case of the Urban Aboriginal Community Kitchen Garden Project. Health Promot Int 2010; 25(2): 166-173. https://doi.org/10.1093/heapro/daq016
  44. Macromill Embrain Trend Monitor. 2015 A survey of employees' perception related to lunch time [internet]. Macromill Embrain; 2015 [cited 2021 Sep 10]. Available from: https://trendmonitor.co.kr/tmweb/trend/allTrend/detail.do?bIdx=1279&code=0402&trendType=CKOREA.
  45. Kwon H, Ju YA. A qualitative study on the process of maintaining the 'eating alone' (honbob) lifestyle. Korean J Cult Soc Issues 2018; 24(4): 657-689. https://doi.org/10.20406/kjcs.2018.11.24.4.657
  46. Long CR, Averill JR. Solitude: An exploration of benefits of being alone. J Theory Soc Behav 2003; 33(1): 21-44. https://doi.org/10.1111/1468-5914.00204
  47. Kim SY, Chae GM. The effects of university student's life stress on suicidal ideation: The moderating effects of perceived social support and the meaning of life. J Human Underst Couns 2013; 34(1): 1-3.
  48. Lee SA, Park EC, Ju YJ, Nam JY, Kim TH. Is one's usual dinner companion associated with greater odds of depression? Using data from the 2014 Korean National Health and Nutrition Examination Survey. Int J Soc Psychiatry 2016; 62(6): 560-568. https://doi.org/10.1177/0020764016654505
  49. Song EG, Yoon YS, Yang YJ, Lee ES, Lee JH, Lee JY et al. Factors associated with eating alone in Korean adults: Findings from the sixth Korea National Health and Nutrition Examination Survey, 2014. Korean J Fam Pract 2017; 7(5): 698-706. https://doi.org/10.21215/kjfp.2017.7.5.698
  50. Kim Y, Lee E, Lee H. Characteristics of eating alone affecting the stress, depression, and suicidal ideation. Community Ment Health J 2020; 56(8): 1603-1609. https://doi.org/10.1007/s10597-020-00621-8