DOI QR코드

DOI QR Code

The association of the Korean Healthy Eating Index with chronic conditions in middle-aged single-person households

  • EunJung Lee (Food and Nutrition Major, School of Wellness Industry Convergence, Hankyong National University) ;
  • Ji-Myung Kim (Food and Nutrition Major, Division of Food Science & Culinary Arts, Shinhan University)
  • Received : 2022.07.13
  • Accepted : 2022.11.25
  • Published : 2023.04.01

Abstract

BACKGROUND/OBJECTIVES: This study investigated the association between dietary quality based on the Korean Healthy Eating Index (KHEI), and the prevalence of chronic conditions among middle-aged individuals (40-60 yrs of age) living alone. MATERIALS/METHODS: The participants were selected (1,517 men and 2,596 women) from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016-2018 and classified into single-person households (SPH) and multi-person households (MPH). Nutrient intake, KHEI, and the prevalence of chronic conditions were compared according to household size. The odds ratios (ORs) of chronic conditions were analyzed according to the tertile levels of KHEI by gender within each household size category. RESULTS: Men in SPH had a significantly lower total KHEI score (P < 0.0001) and a lower prevalence of obesity (OR, 0.576) than those in MPH. For men, the adjusted ORs for obesity, hypertension, and hypertriglyceridemia in the first tertile (T1) of KHEI scores within SPH compared with the third tertile (T3) were 4.625, 3.790, and 4.333, respectively. Moreover, the adjusted OR for hypertriglyceridemia in the T1 group compared to the T3 group within the MPH was 1.556. For women, the adjusted ORs for obesity and hypertriglyceridemia in T1 compared to T3 within the SPH were 3.223 and 7.134, respectively, and 1.573 and 1.373 for obesity and hypertension, respectively, within MPH. CONCLUSIONS: A healthy eating index was associated with a reduced risk of chronic conditions in middle-aged adults. Greater adherence to a healthy eating index could lower the risk of chronic conditions in middle-aged adults living alone.

Keywords

Acknowledgement

This study used data from the Korea Centers for Disease Control and Prevention, Republic of Korea.

References

  1. Korean National Statistical Office. Annual Report on Cause of Death Statistics. Daejeon: Korean National Statistical Office; 2020.
  2. Lee JY, Choi SK, Seo JS. Evaluation of the nutrition status and metabolic syndrome prevalence of the members according to the number of household members based on the Korea National Health and Nutrition Examination Survey (2013-2014). Korean J Community Nutr 2019;24:232-44.  https://doi.org/10.5720/kjcn.2019.24.3.232
  3. Hu EA, Steffen LM, Coresh J, Appel LJ, Rebholz CM. Adherence to the Healthy Eating Index-2015 and other dietary patterns may reduce risk of cardiovascular disease, cardiovascular mortality, and all-cause mortality. J Nutr 2020;150:312-21.  https://doi.org/10.1093/jn/nxz218
  4. Lafreniere J, Carbonneau E, Laramee C, Corneau L, Robitaille J, Labonte ME, Lamarche B, Lemieux S. Is the Canadian Healthy Eating Index 2007 an appropriate diet indicator of metabolic health? Insights from dietary pattern analysis in the PREDISE study. Nutrients 2019;11:1597. 
  5. Grech A, Sui Z, Siu HY, Zheng M, Allman-Farinelli M, Rangan A. Socio-demographic determinants of diet quality in Australian adults using the validated Healthy Eating Index for Australian adults (HEIFA-2013). Healthcare (Basel) 2017;5:7. 
  6. Peltner J, Thiele S. Association between the Healthy Eating Index-2010 and nutrient and energy densities of German households' food purchases. Eur J Public Health 2017;27:547-52.  https://doi.org/10.1093/eurpub/ckw247
  7. Panizza CE, Shvetsov YB, Harmon BE, Wilkens LR, Le Marchand L, Haiman C, Reedy J, Boushey CJ. Testing the predictive validity of the healthy eating Index-2015 in the multiethnic cohort: is the score associated with a reduced risk of all-cause and cause-specific mortality? Nutrients 2018;10:E452. 
  8. Fogli-Cawley JJ, Dwyer JT, Saltzman E, McCullough ML, Troy LM, Meigs JB, Jacques PF. The 2005 Dietary Guidelines for Americans and risk of the metabolic syndrome. Am J Clin Nutr 2007;86:1193-201.  https://doi.org/10.1093/ajcn/86.4.1193
  9. Kesse-Guyot E, Ahluwalia N, Lassale C, Hercberg S, Fezeu L, Lairon D. Adherence to Mediterranean diet reduces the risk of metabolic syndrome: a 6-year prospective study. Nutr Metab Cardiovasc Dis 2013;23:677-83.  https://doi.org/10.1016/j.numecd.2012.02.005
  10. Statistics Korea [Internet]. Daejeon: Statistics Korea; 2022. Available from: www.kostat.go.kr.
  11. Jang YS. The era of single meals, single drinks, and single groups... What is the problem with single-person households? Seoul: 1Conomynews; 2020 Jan 3. Available from: http://www.1conomynews.co.kr/news/articleView.html?idxno=10297.
  12. Jung KH, Nam SH, Jung EJ, Lee JH, Lee YK, Kim JS, Kim HY, Jin MJ. Policy implications of changes in family structure: focused on the increase of single person households in Korea. Sejong: Korea Institute for Health and Social Affairs; 2012.
  13. Byun M. Single person household and urban policy in Seoul. Korean J Cult Soc Issues 2015;21:551-73.  https://doi.org/10.20406/kjcs.2015.08.21.3.551
  14. Kim HY. Floating families in Korea: focusing on one-person households. J Korean Soc Res 2014;15:255-92.
  15. Sellaeg K, Chapman GE. Masculinity and food ideals of men who live alone. Appetite 2008;51:120-8.  https://doi.org/10.1016/j.appet.2008.01.003
  16. Udell JA, Steg PG, Scirica BM, Smith SC Jr, Ohman EM, Eagle KA, Goto S, Cho JI, Bhatt DL; REduction of Atherothrombosis for Continued Health (REACH) Registry Investigators. Living alone and cardiovascular risk in outpatients at risk of or with atherothrombosis. Arch Intern Med 2012;172:1086-95.  https://doi.org/10.1001/archinternmed.2012.2782
  17. Lidfeldt J, Nerbrand C, Samsioe G, Agardh CD. Women living alone have an increased risk to develop diabetes, which is explained mainly by lifestyle factors. Diabetes Care 2005;28:2531-6.  https://doi.org/10.2337/diacare.28.10.2531
  18. Kharicha K, Iliffe S, Harari D, Swift C, Gillmann G, Stuck AE. Health risk appraisal in older people 1: are older people living alone an "at-risk" group? Br J Gen Pract 2007;57:271-6. 
  19. Quandt SA, McDonald J, Arcury TA, Bell RA, Vitolins MZ. Nutritional self-management of elderly widows in rural communities. Gerontologist 2000;40:86-96.  https://doi.org/10.1093/geront/40.1.86
  20. Sidenvall B, Nydahl M, Fjellstrom C. Managing food shopping and cooking: the experiences of older Swedish women. Ageing Soc 2001;21:151-68.  https://doi.org/10.1017/S0144686X01008121
  21. Sidenvall B, Nydahl M, Fjellstrom C. The meal as a gift - the meaning of cooking among retired women. J Appl Gerontol 2000;19:405-23.  https://doi.org/10.1177/073346480001900403
  22. Wham CA, Bowden JA. Eating for health: perspectives of older men who live alone. Nutr Diet 2011;68:221-6.  https://doi.org/10.1111/j.1747-0080.2011.01535.x
  23. Kweon S, Kim Y, Jang MJ, Kim Y, Kim K, Choi S, Chun C, Khang YH, Oh K. Data resource profile: the Korea National Health and Nutrition Examination Survey (KNHANES). Int J Epidemiol 2014;43:69-77.  https://doi.org/10.1093/ije/dyt228
  24. Willett W. Nutritional Epidemiology. 3rd ed. New York (NY): Oxford University Press; 2013.
  25. World Health Organization. The Asia-Pacific Perspective: Redefining Obesity and Its Treatment. Brussels: International Obesity Task Force, World Health Organization; 2000.
  26. Korea Centers for Disease Control and Prevention. Guide to the Utilization of the Data from the Seventh Korean National Health and Nutrition Examination Survey (KNHANES VII). Cheongju: Korea Centers for Disease Control and Prevention; 2020.
  27. National Rural Resources Development Institute. Korean Food Composition Table. 8th ed. Suwon: Rural Development Administration; 2011.
  28. Yook SM, Park S, Moon HK, Kim K, Shim JE, Hwang JY. Development of Korean Healthy Eating Index for adults using the Korea National Health and Nutrition Examination Survey data. J Nutr Health 2015;48:419-28.  https://doi.org/10.4163/jnh.2015.48.5.419
  29. Burns C, Bentley R, Thornton L, Kavanagh A. Reduced food access due to a lack of money, inability to lift and lack of access to a car for food shopping: a multilevel study in Melbourne, Victoria. Public Health Nutr 2011;14:1017-23.  https://doi.org/10.1017/S136898001000385X
  30. Coleman-Jensen AJ. Working for peanuts: nonstandard work and food insecurity across household structure. J Fam Econ Issues 2011;32:84-97.  https://doi.org/10.1007/s10834-010-9190-7
  31. Duerr L. Food security status of older adult home-delivered meals program participants and components of its measurement. J Nutr Elder 2006;26:1-26.  https://doi.org/10.1300/J052v26n01_01
  32. Lee JS, Frongillo EA Jr. Factors associated with food insecurity among U.S. elderly persons: importance of functional impairments. J Gerontol B Psychol Sci Soc Sci 2001;56:S94-9. https://doi.org/10.1093/geronb/56.2.S94
  33. Quine S, Morrell S. Food insecurity in community-dwelling older Australians. Public Health Nutr 2006;9:219-24.  https://doi.org/10.1079/PHN2005834
  34. GBD 2017 Diet Collaborators. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2019;393:1958-72.  https://doi.org/10.1016/S0140-6736(19)30041-8
  35. Neelakantan N, Koh WP, Yuan JM, van Dam RM. Diet-quality indexes are associated with a lower risk of cardiovascular, respiratory, and all-cause mortality among Chinese adults. J Nutr 2018;148:1323-32.  https://doi.org/10.1093/jn/nxy094
  36. Lee E. Relationship between household types, health-related lifestyle, health service usage, and health outcomes across age groups. Korean J Health Educ Promot 2021;38:1-12.  https://doi.org/10.14367/kjhep.2021.38.3.1
  37. Lee H, Cho YT. Comparison of health behaviors, disease prevalence between middle aged one-person households and multi-member households in South Korea. Health Soc Welf Rev 2019;39:380-407.  https://doi.org/10.15709/hswr.2019.39.3.380
  38. Shin SR, Lee SM. Relation between the total diet quality based on Korean Healthy Eating Index and the incidence of metabolic syndrome constituents and metabolic syndrome among a prospective cohort of Korean adults. Korean J Community Nutr 2020;25:61-70.  https://doi.org/10.5720/kjcn.2020.25.1.61
  39. Rashidipour-Fard N, Karimi M, Saraf-Bank S, Baghaei MH, Haghighatdoost F, Azadbakht L. Healthy eating index and cardiovascular risk factors among Iranian elderly individuals. ARYA Atheroscler 2017;13:56-65. 
  40. Nicklas TA, O'Neil CE, Fulgoni VL 3rd. Diet quality is inversely related to cardiovascular risk factors in adults. J Nutr 2012;142:2112-8.  https://doi.org/10.3945/jn.112.164889
  41. Park S, Kim K, Lee BK, Ahn J. Association of the Healthy Eating Index with estimated cardiovascular age in adults from the KNHANES 2013-2017. Nutrients 2020;12:2912.