• Journal of Nutrition and Health
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• v.57 no.1
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• pp.88-104
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• 2024

Purpose: High-sensitivity C-reactive protein (hs-CRP) is primarily synthesized in the liver upon stimulation of infectious disease cytokines, such as interleukin-6 (IL-6), and is used as a biological marker of systemic inflammation. Previous studies reported that hs-CRP is closely related to diet and abdominal obesity. Furthermore, a dietary score favoring the consumption of vegetables, fruits, and whole grains over meat and saturated fat reduced inflammation and decreased the prevalence of obesity and abdominal obesity. Nevertheless, no studies have examined whether hs-CRP mediates the relationship between dietary scores and abdominal obesity, and research on the Korean Healthy Eating Index (KHEI) is lacking. Therefore, the present study examined the association between the KHEI and abdominal obesity and the mediating effect of hs-CRP. Methods: In total, 17,770 adults aged ≥19 years were included in the study using the Korea National Health and Nutrition Examination Survey 2015-2018. KHEI was developed to assess the overall diet quality of Korean adults. Multivariable linear and logistic regression analyses assessed the relationship between KHEI, hs-CRP, and abdominal obesity. The mediation analysis with the bootstrapping method was performed using SAS MACRO. Results: Among women, the odds ratio (OR) of abdominal obesity prevalence was lower in the highest KHEI compared to the lowest KHEI after adjusting for age, body mass index, educational level, income level, occupational status, marital status, household type, region type, alcohol consumption, smoking status, physical activity, total energy intake, and hsCRP (OR 0.744, 95% confidence interval 0.598-0.926). The association between KHEI and abdominal obesity was partially mediated via hs-CRP, and the mediated proportion was 68.7% in men and 38.1% in women. Conclusion: A substantial relationship was observed between the KHEI and abdominal obesity among females. Moreover, according to the KHEI, abdominal obesity may be mediated partially by hs-CRP.

• Journal of dental hygiene science
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• v.17 no.1
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• pp.38-45
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• 2017

We evaluated the association between sleep duration, dental caries, and periodontitis by using representative nationwide data. We examined 8,356 subjects aged ${\geq}19$ years who participated in the sixth Korea National Health and Nutrition Examination Survey (2013~2014). Sleep duration were grouped into ${\leq}5$, 6, 7, 8, and ${\geq}9$ hours. Presence of dental caries was defined as caries in ${\geq}1$ permanent tooth on dental examination. Periodontal status was assessed by using the community periodontal index (CPI), and a CPI code of ${\geq}3$ was defined as periodontitis. A chi-square test and multiple logistic regression analysis were used to determine statistical significance. Model 1 was adjusted for age and sex, model 2 for household income, educational level, and marital status plus model 1, and model 3 for smoking status, alcohol consumption, blood pressure level, fasting blood glucose level, total cholesterol level, and body mass index plus model 2. The prevalence of dental caries according to sleep duration showed a U-shaped curve of 33.4%, 29.4%, 28.4%, 29.4%, and 31.8% with ${\leq}5$, 6, 7, 8, and ${\geq}9$ hours of sleep, respectively. In the fully adjusted model 3, the risk of developing dental caries was significantly higher with ${\leq}5$ than with 7 hours of sleep (odds ratio, 1.23; 95% confidence interval, 1.06~1.43). The prevalence of periodontitis according to sleep duration showed a U-shaped curve of 34.4%, 28.6%, 28.1%, 31.3%, and 32.5%, respectively. The risk of periodontitis was significantly higher with ${\geq}9$ than with 7 hours of sleep in models 1 and 2, whereas the significant association disappeared in model 3. In a nationally representative sample, sleep duration was significantly associated with dental caries formation and weakly associated with periodontitis. Adequate sleep is required to prevent oral diseases such as dental caries and periodontitis.

• Journal of Korean Public Health Nursing
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• v.3 no.2
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• pp.47-76
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• 1989

The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

• Journal of Nutrition and Health
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• v.49 no.5
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• pp.323-334
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• 2016

Purpose: The purpose of this study was to estimate intakes of macronutrients and antioxidant vitamins according to the Hansik consumption rate among Korean adults. Methods: Using data from the 2007~2012 Korea National Health and Nutrition Examination Survey, a total of 33,069 subjects aged over 19 years old were included in this study. We estimated individual daily Hansik consumption rates and intakes of macronutrients and antioxidant vitamins, including vitamin A and its subgroup such as retinol, ${\alpha}$-carotene, ${\beta}$-carotene, and ${\beta}$-cryptoxanthin, vitamin C, and vitamin E, by linking food consumption data with the nutrient and antioxidant vitamin database of commonly consumed foods. Results: Around 75% of subjects consumed Hansik in over 75% of their daily total consumed food. The most frequently consumed Hansik was cabbage kimchi (1.57 times/day), followed by multigrain rice (0.86 times/day) and white rice (0.80 times/day). The household income level and education level was inversely associated with the Hansik consumption rate. There was a positive relationship between Hansik consumption rate and vitamin A, ${\beta}$-carotene, ${\beta}$-cryptoxanthin, and vitamin C intakes. On the other hand, Hansik consumption rate was inversely associated with energy and fat intake. Conclusion: The results of this study suggest that Hansik consumption could provide more antioxidant vitamins and less energy and fat. Thus, further research will be needed to analyze the association between Hansik and health effects.

• Journal of Nutrition and Health
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• v.50 no.6
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• pp.603-614
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• 2017

Purpose: This study was performed to identify the health and nutritional status of Korean adults according to food security by age group. Methods: The subjects were 20~79 year old adults (n = 16,595) who participated in the fifth Korea National Health and Nutrition Examination Survey (2010~2012). Subjects were divided into three groups based on food security such as secure, mildly insecure, and moderately/severely insecure groups. Dietary intake was estimated by 24-hour dietary recall. As for mental health status, the data on mental stress, sleep hours, depression symptoms, and suicide ideation were used. Results: Korean adults who were exposed to high food insecurity typically had low income levels, lived alone, and were recipients of basic welfare. In the 20~39y group, people with higher food insecurity had lower concentrations of hemoglobin and higher iron-binding capacity. In the 40~59y group, people with higher food insecurity had lower HDL-cholesterol. In the 60~79y group, people with higher food insecurity had higher total cholesterol levels, more stress, more experiences of depression symptoms, and were more suicidal. Mean intakes of energy, protein, calcium, phosphorus, potassium, vitamin A, carotene, vitamin $B_1$, vitamin $B_2$, niacin, and vitamin C were lower in the food insecure groups. Amounts of vegetables, fruits, and seasoning intakes tended to be lower in people with higher food insecurity. The effects of food security on nutrition intake were greater in the 40~59y and 60~79y groups than the 20-39y group. Conclusion: Food insecurity was related to certain health indicators such as anemia and cholesterol levels and affected mental health. The effects of food insecurity on health and nutritional status were different by age group.

• Journal of Nutrition and Health
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• v.42 no.8
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• pp.691-701
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• 2009

This study was conducted to evaluate the dietary quality of school-aged children from low-income families in comparison with those from higher income families. The socio-demographic and anthropometric data and one day 24-hour recall dietary intake data of 1,782 school-aged children were used for analysis from the data of 2001 National Health and Nutrition Survey. The children whose family had monthly household income 120% or lower than the 2001 Minimum Cost of Living were classified into Low Income Group (LIG), and the others were classified into Higher Income Group (HIG). The consumption levels of the food groups of the Korean Food Guide as well as the general nutritional status based on their weight and height, energy and nutrient intake were compared between LIG and HIG in elementary (n = 989), middle (n = 432), and high (n = 361) school-aged children, respectively. LIG tended to have lower weight, height, and BMI than HIG, but the difference was significant only in the weight and the BMI of the middle school-aged children. The energy intake of LIG didn't differ from that of HIG, but LIG consumed a higher percentage of energy from carbohydrate and a lower percentage of energy from fat than HIG. Some micronutrient intake was lower in LIG than HIG in case of the elementary and the middle school-aged children. The average numbers of servings of milk dairy products and fruits consumed by LIG were significantly lower than those consumed by HIG in the elementary and the middle school-aged children, and they were less than the respective recommended serving. The average number of servings of meat fish egg beans consumed by LIG was lower than that consumed by HIG in the middle and the high school-aged children, and it was also less than the recommended serving. The results suggested that the diet of children from low-income families should be intervened by strategies different from the other children in order to improve the consumption level of milk dairy products, fruits, and meat fish egg beans.

• Journal of Korean Society of Transportation
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• v.22 no.1 s.72
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• pp.43-62
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• 2004

Conventionally the estimation method of the origin-destination Matrix has been developed by implementing the expansion of sampled data obtained from roadside interview and household travel survey. In the survey process, the bigger the sample size is, the higher the level of limitation, due to taking time for an error test for a cost and a time. Estimating the O-D matrix from observed traffic count data has been applied as methods of over-coming this limitation, and a gradient model is known as one of the most popular techniques. However, in case of the gradient model, although it may be capable of minimizing the error between the observed and estimated traffic volumes, a prior O-D matrix structure cannot maintained exactly. That is to say, unwanted changes may be occurred. For this reason, this study adopts a conjugate gradient algorithm to take into account two factors: estimation of the O-D matrix from the conjugate gradient algorithm while reflecting the prior O-D matrix structure maintained. This development of the O-D matrix estimation model is to minimize the error between observed and estimated traffic volumes. This study validates the model using the simple network, and then applies it to a large scale network. There are several findings through the tests. First, as the consequence of consistency, it is apparent that the upper level of this model plays a key role by the internal relationship with lower level. Secondly, as the respect of estimation precision, the estimation error is lied within the tolerance interval. Furthermore, the structure of the estimated O-D matrix has not changed too much, and even still has conserved some attributes.

• Journal of Nutrition and Health
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• v.48 no.6
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• pp.507-518
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• 2015

Purpose: The aim of this study was to examine the association of food security with the total and individual flavonoid intakes among Korean adults. Methods: Study subjects were 13,454 men and 19,563 women aged 19 years and older who participated in the 2007~2012 Korea National Health and Nutrition Examination Survey. Subjects were classified into food-secure and food-insecure groups using the answers to a self-reported question on food sufficiency of subjects' household. The total and individual flavonoid intakes were calculated by linking 24-h dietary recall data of subjects with a flavonoid database. Mean differences in dietary outcomes by food security status, and major food sources of total flavonoids were examined. Results: In this cross-sectional study, 5.8% of male adults and 6.6% of female adults were in food insecure households. Mean daily intakes of total flavonoids, flavonols, flavones, flavanones, flavan-3-ols, isoflavones, and proanthocyanidins were significantly lower in food-insecure groups than food-secure groups among both male and female adults. The differences were maintained in total flavonoids, flavones, flavanones, and flavan-3-ols after adjusting for total energy intake. Mean intakes of fruits and vegetables were significantly lower in food-insecure groups and the total flavonoid intake from fruits and vegetables was also significantly lower in food-insecure groups. The major food sources of total flavonoids were apples (20.7%), mandarines (12.0%), and tofu (11.5%) in the food-secure group, and apples (14.9%), tofu (13.3%), and mandarines (12.6%) in the food-insecure group. Conclusion: This study showed that food insecurity was associated with lower intakes of flavonoids and reduced intakes of fruits and vegetables in a representative Korean population.

• Journal of Nutrition and Health
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• v.49 no.4
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• pp.247-257
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• 2016

Purpose: The aim of this study was to investigate the relationship between instant noodle intake and metabolic factors in Korean adults. Methods: Study subjects were 5,894 (male 2,293, female 3,601) aged 19~64 years who participated in the 2013~2014 KNHANES. Information on frequency and consumption of instant noodles was obtained by the food frequency questionnaires method in KNHANES (Korean National Health and Nutrition Examination Survey), and subjects were classified according to age, sex, and instant noodle consumption (INC). Results: The frequency and consumption of instant noodles was 1.2 times/week and 1.2 servings in subjects. High INC group (${\geq}1$ serving/week) was significantly younger in age compared with the low INC group (< 1 serving/week). However, the high INC group had significantly higher waist circumference, metabolic factors (triglyceride, cholesterol, and HDL-cholesterol), and dietary intake (energy intake, fat, and sodium density) compared with the low INC group. Hyperglycemia showed association with higher risk of highest quartile of INC after adjustments for multiple confounding factors, including age, gender, household income, education, smoking, and alcohol compared with the lowest quartile (OR: 1.4, 95% CI: 1.1-1.8). In female, abdominal obesity showed association with higher risk of highest quartile of INC after adjustments for multiple confounding factors compared with the lowest quartile (OR: 1.6, 95% CI: 1.2-2.2). Conclusion: Consumption of instant noodles was associated with increased prevalence of abdominal obesity and hyperglycemia in women. These findings suggest an association of instant noodle consumption status with metabolic risk.

• Korean Journal of Community Nutrition
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• v.25 no.5
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• pp.416-429
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• 2020

Objectives: This study examined the personal, interpersonal and community factors related to food sufficiency and variety among Korean adults using data from the 2017 Community Health Survey. Methods: A total of 228,310 adults aged ≥ 19 years were classified into three groups: food sufficiency with variety, food sufficiency without variety and food insufficiency. Personal factors included sociodemographic characteristics, health behavior and health status. Interpersonal factors included social networking and social activities, and community factors included safety, natural environment, living environment, availability of public transportation and health care services. The association of food sufficiency and variety with interpersonal and community factors was assessed using multivariable logistic regression analyses. Results: Of the total sample, the food-sufficiency-without-variety group and food insufficiency group accounted for 31.5% and 3.2%, respectively. The sociodemographic factors associated with food insufficiency and non-variety were women, ≥ 65 years of age, with low education level, low household income, unemployed, single, and living in areas of small population sizes. There were significant differences in health behavior and health status, interpersonal and community factors among the three groups. Multivariable logistic regression analyses conducted after adjusting for confounding factors showed that lack of social networking and social activities and lower satisfaction derived from community environments were associated with the risk of food insufficiency and non-variety. Conclusions: Our results showed that interpersonal and community factors as well as personal factors were related to food sufficiency and variety. Therefore, public policies to help build social networks and participation in social activities, and improve community environment are needed together with food assistance to overcome the problems of food insufficiency and non-variety.