• Journal of the Korean Data and Information Science Society
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• v.26 no.3
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• pp.773-779
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• 2015

We study a statistical analysis about the fifth wave data of the Korea National Health and Nutrition Examination Survey based on linear regression models with measurement errors. The data is obtained from a national population-based complex survey. To demonstrate the availability of measurement error models, two results between the general linear regression model and measurement error model are compared based on the model selection criteria which are Akaike information criterion and Bayesian information criterion. For our study, we use the simulation extrapolation algorithm for measurement error model and the jackknife method for the estimation of standard errors.

• Journal of the Korea Convergence Society
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• v.13 no.3
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• pp.113-124
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• 2022

This study was conducted to analyze the relationship between the levels of lead (Pb) exposure and cardiovascular disease (CVD) in Korean adult women. We used cross-sectional data on blood lead and self-reported diagnoses of ischemic heart disease (IHD), stroke and hypertension in a subsample of 1.821 adults 19 years and older who participated in the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). CVD and blood Pb concentrations were analyzed through logistic regression analysis, and correlations between factors were confirmed using the pearson correlation coefficient. An increase of blood Pb was associated with an increased risk of IHD (OR 5.68, 95% CI 1.01-17.51) and hypertension (OR 3.37, 95% CI 2.24-5.07) only in women. Additionally, there was a correlation between blood Pb and nutrient intake. This suggest that blood Pb levels may be used as a key predictor of CVD development, and that women are more susceptable to IHD and hypertension associated with Pb exposure.

• Journal of Nutrition and Health
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• v.50 no.6
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• pp.585-594
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• 2017

Purpose: Food intake of COPD patients decreases because of appetite loss, depression, and breathing problems while eating, which increase the likelihood of patients becoming malnourished. This study investigated the nutrient intake and dietary quality of people with and without COPD in Korea. Methods: There were 2,160 adults aged 50 and over who participated in the $5{\sim}6^{th}$ Korea National Health and Nutrition Examination Survey. The subjects were divided into the COPD group and non-COPD group according to the rate of forced expiratory volume at 1 second (FEV1) against forced vital capacity (FVC). Consumption of food and nutrients were calculated based on the nutrition examination survey. Statistical analyses were conducted using SPSS 19.0. Results: Among individuals in their 50s, intake of vitamin $B_1$ in the COPD group was significantly less than the NCOPD group, while intake of sodium in the COPD group was significantly greater than the NCOPD group. Among individuals in their 60s, the energy intake of the COPD group was significantly less than that of the NCOPD group. The COPD group showed significantly less intake of vitamin $B_1$ and vitamin C, but greater intake of sodium than the NCOPD group. In the group aged 70 and over, The COPD group had significantly less intake of vitamin $B_1$ than the NCOPD group and showed lower nutrient adequacy ratio values in protein, vitamin $B_1$, vitamin $B_2$, and iron than the NCOPD group. Conclusion: The COPD group consumed less energy and certain nutrients, and their dietary quality was poor compared to the NCOPD group. Thus, more detailed research is required to understand the concrete relationship between COPD and malnutrition.

• Nutrition Research and Practice
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• v.14 no.6
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• pp.667-678
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• 2020

BACKGROUND/OBJECTIVES: This study aimed to improve portion size estimation aids (PSEAs) used in the nutrition survey of the Korea National Health and Nutrition Examination Survey (KNHANES) and validate the accuracy and precision of the newly developed aids. SUBJECTS/METHODS: We conducted intensive interviews with survey experts in KNHANES and consulted with experts to collect opinions about improvement of PSEAs. Based on the results of the interviews, 5 types of PSEAs (rice bowl, earthen pots, mounds, measuring spoons, and thickness sticks) were newly developed using 3-dimensional (3D) modeling or modification of color or shape. Validation tests were conducted with 96 adults 20 years old or older. For the rice bowl and earthen pots, the participants were asked to select the more similar PSEA in size after being shown the real dishes. For the mounds, measuring spoons, and thickness sticks, the participants were presented with actual plates of food and asked to estimate the given portion sizes using the given PSEAs. RESULTS: The improved 2-dimensional (2D) picture aid for the rice bowl reflecting the size distortion by angle of view using 3D modeling was perceived more closely to the actual size than the current 2D picture (P < 0.001). The change of the color of 2D pictures and 3D models, the change of shape of the measuring spoons, and the 3-dimensionalization of the 2D mounds had no significant improvement in the subjects' perception. CONCLUSIONS: The currently used 2D PSEAs need to be fully redesigned using 3D modeling to improve subjects' perception. However, change of color or shape will not be necessary. For amorphous foods, it is suggested that more evaluation be performed before reaching a final conclusion in the use of PSEAs, or alternative ways to improve accuracy of estimation need to be explored.

• The Journal of Korean Society for School & Community Health Education
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• v.23 no.2
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• pp.51-64
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• 2022

Objectives: This study aims to examine diabetic patients' quality of life by using the data of the 8th Korea National Health and Nutrition Examination Survey (1st year, 2019), identify the factors related to this, and utilize the results as basic data for intervention that can improve diabetic patients' quality of life. Methods: For the research subjects, this study extracted 624 patients who were diagnosed with Diabetes by a doctor from the total sample of 8,110 participants of the 8th Korea National Health and Nutrition Examination Survey. The SPSS(version25.0) program was used for the analysis of the collected data. Then, this study used a backward elimination multiple regression analysis method that applied complex sample, to examine the factors related with the finally estimated quality of life. Results: The results of this study revealed that diabetic patients' quality of life was related with gender, age, occupation, restriction of activity, subjected health status. The final model explained 35.7% of the variance (Wald F=28.210, p<.001). Conclusions: In order to improve the quality of life of diabetic patients, it would be desirable to provide differentiated management by developing a customized intervention strategy that takes into account gender, age, and occupation. When managing diabetic patients, the state, local governments, and hospitals should include content that prevents and copes with restrictions on activities that may occur due to disease. In addition, it is required to prepare a strategy to induce positive perception of the subject's own health status.

• Journal of Korean society of Dental Hygiene
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• v.21 no.5
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• pp.601-610
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• 2021

Objectives: The purpose of this study was to analyze the effect of chewing difficulty on depression in Korean adults to provide basic data on improving the quality of life related to oral health of Korean adults. Methods: The raw data of the analysis were obtained from the dataset of the seven Korea National Health and Nutrition Examination Survey conducted between 2016 and 2018. The subjects included 9,535 people who underwent oral examination and answered questions. The collected data were analyzed using the SPSS (ver 21.0) program using composite samples, and the mean crossover analysis and logistic return analysis were performed. Results: An analysis of the effects of chewing difficulty on depression in Korean adults showed that those with chewing difficulty had a 2.24 fold higher risk of depression (95% CI: 1.73-2.90) and a statistically significant difference (p<0.05). Conclusions: The association between the chewing difficulty on depression could be confirmed, and measures improve of the oral health and preventing depression should be prepared.

• Journal of Preventive Medicine and Public Health
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• v.46 no.2
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• pp.96-104
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• 2013

Objectives: The inherent nature of the Korean National Health and Nutrition Examination Survey (KNHANES) design requires special analysis by incorporating sample weights, stratification, and clustering not used in ordinary statistical procedures. Methods: This study investigated the proportion of research papers that have used an appropriate statistical methodology out of the research papers analyzing the KNHANES cited in the PubMed online system from 2007 to 2012. We also compared differences in mean and regression estimates between the ordinary statistical data analyses without sampling weight and design-based data analyses using the KNHANES 2008 to 2010. Results: Of the 247 research articles cited in PubMed, only 19.8% of all articles used survey design analysis, compared with 80.2% of articles that used ordinary statistical analysis, treating KNHANES data as if it were collected using a simple random sampling method. Means and standard errors differed between the ordinary statistical data analyses and design-based analyses, and the standard errors in the design-based analyses tended to be larger than those in the ordinary statistical data analyses. Conclusions: Ignoring complex survey design can result in biased estimates and overstated significance levels. Sample weights, stratification, and clustering of the design must be incorporated into analyses to ensure the development of appropriate estimates and standard errors of these estimates.

• The Korean Journal of Food And Nutrition
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• v.32 no.3
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• pp.251-258
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• 2019

The purpose of this study was to examine the association nutrition education experience in regards to metabolic risk and nutrition intake in Korean adult male using the 2016~2017 Korea National Health and Nutrition Examination Survey as the reference. The study involved a total of 1,978 male subjects aged 40~64 who were classified into the 2 groups based on their nutrition education experience: Educated group (n=88) and non-educated group (n=1,890). The household income and education level of educated group were higher than those of the non-educated group. The two groups showed no significant difference in the level of fasting blood sugar, blood lipid profile including total cholesterol and triglyceride, LDL-cholesterol, and hypertension. Vitamin C intake of the educated group (127.5 mg) was higher compared to the non-educated group (88.2 mg) (p<0.05). The percentage of the subjects utilizing nutritional labels was higher in the educated group. The nutrition education experience was inversely proportional to lower Odds Ratio in hyperLDL-cholesterolemia (OR: 0.47, 95% CI: 0.36, 0.84) and HypoHDL-cholesterolemia (OR: 0.57, 95% CI: 0.37, 0.87). This result indicates that nutritional education can be used as an effective tool to avert chronic diseases and develop healthy eating habits.

• Korean Journal of Community Nutrition
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• v.19 no.5
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• pp.468-478
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• 2014

Objectives: Intake of fruits and vegetables has protective effects against stroke attack. This study intended to examine the status of consuming fruits and vegetables and to find out which factors may influence the frequency of consumption of fruits and vegetables in individuals with a history of stroke. Methods: The data of 208 subjects from 5th (2010, 2011) Korea National Health and Nutrition Examination Survey (KNHNES) who reported a stroke diagnosis was used for analysis. To identify major factors influencing the consumption of fruits and vegetables, a classification-tree analysis was carried out. Results: Among those who reported a stroke diagnosis, the frequencies of consumption of fruits and vegetables were influenced by their age, place of residence (urban or rural), economic status, educational level, occupation, number of family members, frequency of eating out, and having meals (breakfast or lunch) with family members. Two factors from fruits and three factors from vegetables were generated by exploratory factor analyses. Urban residents ate fruits and vegetables more frequently in all factors than rural residents. Eating frequencies of 'seasonal fruits (orange, apple, strawberry, melon, pear and watermelon)', 'easily-accessible fruits (persimmon, tangerine, grape, peach, banana)', and 'Western-style vegetables (cabbage, mushroom, carrot, tomato, spinach)' were influenced by the socioeconomic status. Eating frequencies of 'Korean-style vegetables (bean sprout, radish leaves, pumpkin/squash, sea weed)', 'preserved vegetables (Korean cabbage, radish, laver, cucumber)' were influenced by having breakfast with family members. Conclusions: The results of this study suggested that by eating more fruits and vegetables, more preventive effects against secondary stroke attack are expected in stroke patients who live in the rural areas and who do not eat breakfast with family members. In addition, more outreach and education programs are needed for them.

• Korean Journal of Community Nutrition
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• v.23 no.5
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• pp.444-455
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• 2018

Objectives: The current survey environment is changing and participation rates in national nutrition surveys are decreasing. Therefore, the purpose of this study was to develop strategies for improving the nutrition survey system in the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: To develop an alternative system for conducting the KNHANES nutritional survey, we conducted focus group interviews with stakeholders of the survey, SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis, and expert reviews. In addition, spatial analysis of potential sites for conducting surveys instead of relying on household visits was performed, and the perception of nutritional surveys in the population eligible for KNHANES was evaluated. Results: Based on the results of the focus group interviews, SWOT analysis, and expert reviews, we propose two options for survey sites: vehicles specifically prepared for nutritional surveys and public facilities such as community service centers or public health centers. Among public facilities, community service centers were found to be more appropriate sites than public health centers because they were considered more accessible. About 90% of respondents would participate in the survey in public facilities and about 74% would in vehicles. Conclusions: Conducting national nutrition surveys in specially designed vehicles and public facilities could be a viable alternative to home visits. Next, the validity of these newly proposed nutrition survey methods needs to be compared to the results of the current national nutrition survey.