DOI QR코드

DOI QR Code

The association between nutrition label utilization and disease management education among hypertension or diabetes diagnosed in Korea using 2018 Community Health Survey: a cross-sectional study

고혈압·당뇨병 진단자의 영양표시 활용과 질환관리교육의 연관성: 2018년 지역사회건강조사 자료를 활용한 횡단연구

  • Miran Jin (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Jayeun Kim (Korea Institute of Child Care and Education) ;
  • Kyuhyun Yoon (Institute of Health and Environment, Seoul National University)
  • Received : 2022.12.12
  • Accepted : 2023.02.10
  • Published : 2023.02.28

Abstract

Objectives: This study examined the association between the experience of disease management education and the use of nutrition labels according to the sociodemographic characteristics and health behaviors of people diagnosed with hypertension and diabetes living in the community. Methods: Among the participants from the Community Health Survey (2018), 74,283 individuals diagnosed with hypertension or diabetes were included in the study population. According to gender, this study evaluated nutrition label use by the experience of disease management education, individual sociodemographic characteristics, and health behavior. Finally, using multiple logistic regression analysis, the association between disease management education and nutrition labels was calculated using the odds ratio (OR) and 95% confidence interval (CI). Results: Males (24.5%) experienced more disease management education than females (22.6%). In addition, younger age, higher education level, and higher equalized personal income experienced more disease management education (P < 0.001). The educational experience rate was higher in the male subjects who did not smoke or were involved in high-risk alcohol consumption (P < 0.001). In addition, the rate of disease management education experience was significantly higher for both men and women who exercised by walking (P < 0.001). The use of nutrition labels was higher in females (9.9%) than males (5.8%), and both males and females were significantly higher in young age, high education, high income, and professional and office positions (P < 0.001). The utilization rate of nutrition labels was high in non-smoking male subjects and high-risk-drinking female subjects. In addition, the utilization rate of nutrition labels was significantly higher in males and females who exercised by walking and those who experienced disease management education (P < 0.001). After adjusting for individual sociodemographic characteristics, health behavior, and disease management education, the use of nutrition labels was high among females (OR 3.19, 95% CI 2.85-3.58), high income (Q4; OR 1.62, 95% CI 1.41-1.87, Q5; OR 1.58, 95% CI 1.37-1.84) and highly educated (high school; OR 2.87, 95% CI 2.62-3.14, above college; OR 5.60, 95% CI 5.02-6.23) while it was low in the elderly (OR 0.43, 95% CI 0.40-0.47), and economically inactive (OR 0.86, 95% CI 0.76-0.96). The use of nutrition labels was high in non-smokers (OR 1.29, 95% CI 1.13-1.48), nonhigh-risk drinkers (OR 1.22, 95% CI 1.08-1.38), and subjects who exercised walking (OR 1.44, 95% CI 1.34-1.54). There was no difference in the utilization rate of nutrition labels according to obesity, and the utilization rate of nutrition labels was significantly higher in subjects who had experienced disease education (OR 1.34, 95% CI 1.24-1.44). Conclusions: Education on the use of nutrition labels, which contributes to food selection for healthy eating, might be a tool for dietary management. Moreover, the utilization rate can be a good indicator for predicting the proportion of the population practicing the guide for disease management. Improving the utilization rate of nutrition labels through disease management education can be a useful intervention for people with chronic diseases who need healthy eating habits for disease management and preventing complications, particularly those diagnosed with hypertension and diabetes.

Keywords

References

  1. Ministry of Food and Drug Safety. Labeling standards for food, etc. Notice No. 2022-66.
  2. Lee KY, Kim DY. Nutrition labeling in Korea and Canada: Policy implications. Health Welf Policy Forum 2016; 231:137-148.
  3. Park SG, Kim HJ, Kwon YM, Kong MH. Nutrition label use and its relation to dietary intake among chronic disease patients in Korea: Results from the 2008-2009 fourth Korean National Health and Nutrition Examination Survey (KNHANES-IV). Korean J Health Promot 2014; 14(4): 131-140. https://doi.org/10.15384/kjhp.2014.14.4.131
  4. Kim M, Kim J, Yu J. Factors relating to use of food labels among adults with metabolic syndrome. Korean J Health Educ Promot 2012; 29(5): 1-12.
  5. Korea Disease Control and Prevention Agency. Dietary status of Korean people. 2021 Dec. Report No.01.
  6. WHO; Joint Consultation, FAO Expert. Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser 2003; 916(i-viii): 1-149.
  7. Bae JH, Han KD, Ko SH, Yang YS, Choi JH, Choi KM et al. Diabetes fact sheet in Korea 2021. Diabetes Metab J 2022; 46(3): 417-426. https://doi.org/10.4093/dmj.2022.0106
  8. Kim HC. Prevalence and management of hypertension in Korean adults. J Korean Med Assoc/Taehan Uisa Hyophoe Chi 2022; 65(10): 633-639. https://doi.org/10.5124/jkma.2022.65.10.633
  9. Kim HR. Nutrition transition and shiting diet linked noncommunicable diseases and policy issues. Health Welf Policy Forum 2013; 198(4): 27-37.
  10. Statistics Korea. Annual report on the causes of death statistics [Internet]. Statistics Korea; 2020 [cited 2019 Nov 25]. Available from:.
  11. Zarkin GA, Dean N, Mauskopf JA, Williams R. Potential health benefits of nutrition label changes. Am J Public Health 1993; 83(5): 717- 724. https://doi.org/10.2105/AJPH.83.5.717
  12. Chung JY, Kim MJ. Using and understanding of nutrition labels and related factors among female adults in the Seoul area. Korean J Community Nutr 2007; 12(4): 417-425.
  13. Song EJ, Kim YE, Ji SM. Impact of a primary health care chronic diseases management pilot program. Korean J Med 2021; 96(1): 7-12. https://doi.org/10.3904/kjm.2021.96.1.7
  14. Uijeongbu Community Health Center. Hypertension diabetes standardization classroom operation [Internet]. Uijeongbu Community Health Center; 2016 [cited 2022 Dec 8]. Available from: https://www.ui4u.go.kr/health/contents.do?mId=0501020000.
  15. Kim NH. Introduction of chronic disease management business to strengthen community-centered primary care and future development plan. Health Insur Rev Assess Serv. 2018; 12(5): 18-27.
  16. Bae TJ, Jeon NE, Choi SK, Seo JS. Effect of nutrition counseling by nutrition care process on diet therapy practice and glycemic control in type 2 diabetic patients. Korean J Community Nutr 2020; 25(3): 214-225. https://doi.org/10.5720/kjcn.2020.25.3.214
  17. Choi ES, Ha Y. Work-related stress and risk factors among Korean employees. J Korean Acad Nurs 2009; 39(4): 549-561. https://doi.org/10.4040/jkan.2009.39.4.549
  18. Yoon BJ. Differential effects on self-rated health by socioeconomic class. J Health Inform Stat 2016; 41(1): 35-42. https://doi.org/10.21032/jhis.2016.41.1.35
  19. Kang JH. Current status and treatment of obesity in Korea. J Korean Med Assoc 65(12): 783-788.
  20. Kristal AR, Levy L, Patterson RE, Li SS, White E. Trends in food label use associated with new nutrition labeling regulations. Am J Public Health 1998; 88(8): 1212-1215. https://doi.org/10.2105/AJPH.88.8.1212
  21. Macon JF, Oakland MJ, Jensen HH, Kissack PA. Food label use by older Americans: Data from the Continuing Survey of Food Intakes by Individuals and the Diet and Health Knowledge Survey 1994-96. J Nutr Elder 2004; 24(1): 35-52. https://doi.org/10.1300/J052v24n01_03
  22. Stran KA, Knol LL. Determinants of food label use differ by sex. J Acad Nutr Dietetics 2013; 113(5): 673-679. https://doi.org/10.1016/j.jand.2012.12.014
  23. Cowburn G, Stockley L. Consumer understanding and use of nutrition labelling: A systematic review. Public Health Nutrition 2005; 8(1): 21-28. https://doi.org/10.1079/PHN2005666
  24. Kwon KI, Yoon SW, Kim SJ, Kang H, Kim HN, Kim JY et al. A survey on customers' perceptions of nutrition labeling for processed food and restaurant meal. Korean J Nutr 2010; 43(2): 181-188. https://doi.org/10.4163/kjn.2010.43.2.181
  25. Driskell JA, Schake MC, Detter HA. Using nutrition labeling as a potential tool for changing eating habits of university dining hall patrons. J Am Diet Assoc 2008; 108(12): 2071-2076. https://doi.org/10.1016/j.jada.2008.09.009
  26. Miller LMS, Cassady DL. Making healthy food choices using nutrition facts panels. The roles of knowledge, motivation, dietary modifications goals, and age. Appetite 2012; 59(1): 129-139. https://doi.org/10.1016/j.appet.2012.04.009
  27. Rothman RL, Housam R, Weiss H, Davis D, Gregory R, Gebretsadik T et al. Patient understanding of food labels: The role of literacy and numeracy. Am J Prev Med 2006; 31(5): 391-398. https://doi.org/10.1016/j.amepre.2006.07.025
  28. Drichoutis AC, Lazaridis P, Nayga Jr RM. Consumers' use of nutritional labels: A review of research studies and issues. Acad Mark Sci Rev 2006; 2006: 1.
  29. Fitzgerald N, Damio G, Segura-Perez S, Perez-Escamilla R. Nutrition knowledge, food label use, and food intake patterns among Latinas with and without type 2 diabetes. J Am Diet Assoc 2008; 108(6): 960-967. https://doi.org/10.1016/j.jada.2008.03.016
  30. Cannoosamy K, Pugo-Gunsam P, Jeewon R. Consumer knowledge and attitudes toward nutritional labels. J Nutr Educ Behav 2014; 46(5): 334-340. https://doi.org/10.1016/j.jneb.2014.03.010
  31. Satia JA, Galanko JA, Neuhouser ML. Food nutrition label use is associated with demographic, behavioral, and psychosocial factors and dietary intake among African Americans in North Carolina. J Am Diet Assoc 2005; 105(3): 392-402. https://doi.org/10.1016/j.jada.2004.12.006
  32. Campos S, Doxey J, Hammond D. Nutrition labels on pre-packaged foods: A systematic review. Public Health Nutr 2011; 14(8): 1496-1506. https://doi.org/10.1017/S1368980010003290
  33. Miller ER, Erlinger TP, Appel LJ. The effects of macronutrients on blood pressure and lipids: An overview of the DASH and OmniHeart trials. Curr Atheroscler Rep 2006; 8(6): 460-465. https://doi.org/10.1007/s11883-006-0020-1
  34. Appel LJ, Sacks FM, Carey VJ, Obarzanek E, Swain JF, Miller ER et al. Effects of protein, monounsaturated fat, and carbohydrate intake on blood pressure and serum lipids: Results of the OmniHeart randomized trial. Jama 2005; 294(19): 2455-2464. https://doi.org/10.1001/jama.294.19.2455
  35. Kreuter MW, Brennan LK, Scharff DP, Lukwago SN. Do nutrition label readers eat healthier diets? Behavioral correlates of adults' use of food labels. Am J Prev Med 1997; 13(4): 277-283. https://doi.org/10.1016/S0749-3797(18)30175-2
  36. Neuhouser ML, Kristal AR, Patterson RE. Use of food nutrition labels is associated with lower fat intake. J Am Diet Assoc 1999; 99(1): 45-53. https://doi.org/10.1016/S0002-8223(99)00013-9
  37. Lewis JE, Arheart KL, LeBlanc WG, Fleming LE, Lee DJ, Davila EP et al. Food label use and awareness of nutritional information and recommendations among persons with chronic disease. Am J Clin Nutr 2009; 90(5): 1351-1357. https://doi.org/10.3945/ajcn.2009.27684
  38. Post RE, Mainous III AG, Diaz VA, Matheson EM, Everett CJ. Use of the nutrition facts label in chronic disease management: Results from the National Health and Nutrition Examination Survey. J Am Diet Assoc 2010; 110(4): 628-632. https://doi.org/10.1016/j.jada.2009.12.015
  39. Kang HJ, Shin EM, Kim KY. Evaluation of nutrition education for diabetes mellitus management of older adults. Korean J Community Nutr 2009; 14(6): 734-745.