• Journal of Nutrition and Health
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• v.42 no.5
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• pp.474-485
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• 2009

The purpose of the present study was to evaluate the characteristics of nutrient intakes of adults aged 20-64 years in Daegu and Gyeongbuk areas in comparison with Seoul and the whole nation. Data from the 1st (1998) to 3rd (2005) Korean National Health and Nutrition Examination Survey (KNHANES) were used. Total numbers of subjects were 296-369 from Daegu and 307-447 from Gyeongbuk while 1076-1244 from Seoul and 5436-6852 from the whole nation. Average energy intakes (men; 2,386, 2,581, 2,305 Kcal, women; 1,937, 1,981, 1,804 Kcal in 1998, 2001, 2005, respectively) of the subjects from Daegu were higher than those from Gyeongbuk (men; 2309, 2267, 2487 Kcal, women; 1,851, 1,845, 1,901 Kcal) and those from Seoul in 1998 and 2001 but not different from those in 2005. Energy from carbohydrate was consistently higher in the subjects from Daegu and Gyeongbuk than in those from Seoul from 1998 to 2005, when the subjects whose carbohydrate energy was over 70% comprised 34 to 58% of the total in the two regions. In 2005, the average intakes of calcium of women and men from Daegu were 512 and 573 mg, iron, 12.8 and 16.6 mg, sodium, 4,650 and 5,951 mg, potassium, 2,585 and 3,152 mg, vitamin A, 823 and 1,038 ${\mu}$gRE, thiamin, 1.10 and 1.43 mg, riboflavin, 1.08 and 1.33 mg, and niacin. 15.4 and 19.3 mg, and vitamin C, 94 and 105 mg and these intakes were not very different from those from Gyeongbuk except higher sodium intake of the Gyeongbuk subjects. Nutrients of which the intakes were over 50% lower than EAR were calcium and riboflavin and those about 30% lower than EAR were iron in women, vitamins A and C in men and women from Daegu and Gyeongbuk. From the present results, it is concluded that high dependence on carbohydrate as energy source and low calcium intake in adults of Daegu and Gyeongbuk are serious and that low intakes of riboflavin, iron and vitamins A and C need to be improved. But changes in the intakes of total energy and other micronutrients from 1998 to 2005 were not reliable enough to judge the regional nutrition due to large variations during this period. The present study also provides the adults' nutrient intakes separated by sex and age groups in the three regions which could be readily used for setting up the nutrition policy for the adults in the regions.

• Journal of Nutrition and Health
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• v.50 no.5
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• pp.483-493
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• 2017

Purpose: The purpose of this study was to determine trends in dietary vitamin E intakes and contributing food groups among Korean adults. Methods: This study included 66,695 subjects aged ${\geq}19years$ who completed a nutrition survey as part of the Korea National Health and Nutrition Examination Survey (1998, 2001, 2005, 2007~2009, 2010~2012, 2013~2015). We estimated individual daily intakes of ${\alpha}-$, ${\beta}-$, ${\gamma}-$, ${\delta}-tocopherol$, and total vitamin E by linking food consumption data with a vitamin E database of commonly consumed foods. Results: Daily vitamin E intake significantly increased from $6.4mg\;{\alpha}-TE/d$ in 1998 to $7.7mg\;{\alpha}-TE/d$ in 2013~2015 (p for trend < 0.0001) among men as well as from $5.4mg\;{\alpha}-TE/d$ in 1998 to $6.5mg\;{\alpha}-TE/d$ in 2013~2015 among women (p for trend < 0.0001). However, the intake of vitamin E was lower than the adequate intake (AI) of Dietary Reference Intakes for Koreans 2015 (2015 KDRI). In 2013~2015, men consumed 6.5 mg/d of ${\alpha}-tocopherol$, 0.5 mg/d of ${\beta}-tocopherol$, 6.0 mg/d of ${\gamma}-tocopherol$, and 3.9 mg/d of ${\delta}-tocopherol$, whereas women consumed 5.7 mg/d of ${\alpha}-tocopherol$, 0.4 mg/d of ${\beta}-tocopherol$, 4.8 mg/d of ${\gamma}-tocopherol$, and 2.8 mg/d of ${\delta}-tocopherol$. The major food groups contributing to vitamin E intake were vegetables (men: 23.3%, women: 22.7%), grains (men: 14.5%, women: 13.9%), and eggs (men: 13.0%, women: 12.5%). Conclusion: This study provides scientific evidence for vitamin E intake in Korean adults. Since the current intake of vitamin E was lower than the reference intakes set by 2015 KDRI, dietary vitamin E intake should be monitored regularly among Korean adults.

• Journal of Preventive Medicine and Public Health
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• v.39 no.2
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• pp.115-122
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• 2006

Objectives : This study was conducted to examine the relationships of the several socioeconomic position indicators with the mortality risk in a representative longitudinal study of South Korea. Methods : The 1998 National Health and Nutrition Examination Survey was conducted on a cross-sectional probability sample of South Korean households, and it contained unique 13-digit personal identification numbers that were linked to the data on mortality from the National Statistical Office of Korea. Of 5,607 males and females, 264 died between 1999 and 2003. Cox's regression was used to estimate the relative risks (RR) and their 95% confidence intervals (CI) of mortality. Results: Socioeconomic differences in mortality were observed after adjustments were made for gender and age. Compared with those people having college or higher education, those people without any formal education had a greater mortality risk (RR=2.21, 95% CI=1.12-4.40). The mortality risk among manual workers was significantly greater than that for the non-manual workers (RR=2.73, 95% CI=1.47-5.06). A non-standard employment status was also associated with an increase in mortality: temporary or daily workers had a greater mortality risk than did the full-time workers (RR=3.01, 95% CI=1.50-6.03). The mortality risk for the low occupational class was 3.06 times greater than that of the high and middle occupational classes (95% CI=1.75-5.36). In addition, graded mortality differences according to equivalized monthly household income were found. A reduction of monthly household income by 500 thousand Korean Won (about 400 US dollars) was related with a 20% excess risk of mortality. Self-reported poor living standards were also associated with an increased risk of mortality. Those without health insurance had a 3.63 times greater risk of mortality than the insured (95% CI=1.61-8.19). Conclusions: This study showed the socioeconomic differentials in mortality in a national longitudinal study of South Korea. The existence of socioeconomic mortality inequalities requires increased social discussion on social policies in Korean society. Furthermore, the mechanisms for the socioeconomic inequalities of mortality need to be explored in future studies.

• Journal of Preventive Medicine and Public Health
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• v.38 no.3
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• pp.337-344
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• 2005

Objectives : Job insecurity, such as non-standard work, is reported to have an adverse impact on health, regardless of health behaviors. The aim of this study was to examine the relationship between non-standard employment and health in Korea. Methods : We analyzed a representative weighted sample, which consisted of 2,112 men and 1,237 women, aged 15-64, from the 1998 Korea National Health and Nutrition Examination Survey. Non-standard employment included part-time permanent, short time temporary and daily workers. Self-reported health was used as a health indicator. Results : This study indicated that women were more likely to report poorer health than men with standard jobs. Of all employees, 20.3% were female manual workers. After adjusting for potential confounders, such as age, education, equivalent income, marital, social and self-reported economic status and health behavior factors, nonstandard employment was found to be significantly associated with poor health among female manual workers (OR, 1.86; 95% CI, 1.24 to 2.79). No significant association was found in other working groups Conclusions : Among female manual workers, nonstandard employees reported significantly poorer health compared with standard workers. This result raises concern as there are increasing numbers of non-standard workers, particularly females.

• Nutrition Research and Practice
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• v.14 no.4
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• pp.384-400
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• 2020

BACKGROUND/OBJECTIVES: Dietary factors are important contributors to cardiometabolic and cancer mortality. We examined the secular trends of nine dietary factors (fruits, vegetables, whole grains, nuts and seeds, milk, red meat, processed meat, sugar-sweetened beverages, and calcium) and the associated burdens of cardiometabolic and cancer mortality in Korea using representative cross-sectional survey data from 1998 to 2016. SUBJECTS/METHODS: Using dietary data from Korean adults aged ≥ 25 years in the Korea National Health and Nutrition Examination Survey (KNHANES), we characterized secular trends in intake levels. We performed comparative risk assessment to estimate the population attributable fraction and the number of cardiometabolic and cancer deaths attributable to each dietary factor. RESULTS: A total of 231,148 cardiometabolic and cancer deaths were attributable to nine dietary risk factors in Korea from 1998 to 2016. Suboptimal intakes of fruits and whole grains were the leading contributors. Although the intakes of fruits, vegetables, and whole grains moderately improved over time, the intake levels in 2016 (192.1 g/d, 225.6 g/d, and 10.9 g/d, respectively) remained far below the optimal levels. Deaths attributable to the low intakes of nuts and seeds (4.5 g/d), calcium (440.5 mg/d), and milk (37.1 g/d) and the high intakes of red meat (54.7 g/d), processed meat (4.7 g/d), and sugar-sweetened beverages (33.0 g/d) increased since 1998. Compared with older age groups (≥ 45 years), more unfavorable changes in dietary patterns were observed in the younger population aged 25-44 years, including more sharply increased intakes of processed meat. CONCLUSIONS: We observed improvement in the intakes of fruits, vegetables, and whole grains and unfavorable changes in the intakes of processed meat and sugar-sweetened beverages over the past few decades. Our data suggest that to reduce the chronic disease burden in Korea, more effective nutritional policies and interventions are needed to target these dietary risk factors.

• Korean Journal of Health Education and Promotion
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• v.28 no.1
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• pp.93-101
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• 2011

Objectives: The aim of this study was to investigate the prevalence of metabolically obese, normal-weight (MONW) phenotype and the association between lifestyle factors and the risk of MONW in Korean adolescents. Methods: Normal-weight (BMI, 5th to 85th percentile) subjects with ${\geq}1$ metabolic abnormalities were categorized as MONW phenotype. Data from adolescents aged 12 to 18 years who have participated in the Korean National Health and Nutrition Examination Survey in 1998 (n=751) and 2008 (n=455) were analyzed. Physical activity and dietary intakes were assessed. Results: The prevalence of hypertension and hyperglycemia in 2008 decreased compared with that in 1998 (P<0.001) but the prevalence of abdominal obesity, hypertriglyceridemia and low HDL did not changed. The overall prevalence of MONW in Korean adolescents declined over 10 years (P<0.001). Adolescent boys and girls engaging regular exercise significantly increased over 10 years (P<0.01). Physically active adolescents had a lower risk of being MONW in 1998. Dietary intake patterns were not associated with a risk of MONW. Conclusions: The prevalence of MONW among Korean adolescents declined over 10 years which may be due to the decreased prevalence of hypertension and hyperglycemia. The risk of MONW would be lower in individuals who are physically active.

• Korean Journal of Health Education and Promotion
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• v.18 no.3
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• pp.11-36
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• 2001

The purpose of this study is to analyze health behavior by comparing the difference between self-perceived health status and health examination results. The study subjects consist of 7,702 people aged over 20, surveyed by Health Interview survey, Health Examination survey, Dietary Life survey, Health Consciousness and Behavior survey. Data used in the study are drawn from raw data from a 1998 National Health and Nutrition survey. General characteristics variables are sex, age, education level, residential area, marital status, occupation, and living standard while dichotomous variables, ‘not healthy’ and ‘healthy’ are used to measure self-perceived health status. Variables for health examination results are high blood pressure, high cholesterol, diabetes, liver diseases, liver inflammation, kidney diseases, normal weight, regular diet, optimum sleeping time(7-8 hours), regular health examination and health behavior practice group. Major findings of the study are as follows: 1) Analysis of self-perceived health status and health behavior by disease: Variables significantly correlated with high self-perceived health status have strong associations with high health behavior practice, which supports the hypothesis that as one has high self-perceived health status, one is more likely to practice health promoting behavior. The results of analysis of health behavior differences by dividing subjects into two categories, ‘cases of illness’ and ‘cases of no illness’ indicate that drinking, sleeping time, health examination are significant variables (p〈0.001, 0.05) whereas smoking, weight control, regular exercise, regular diet are not significant. 2) Analysis of disparity patterns between self-perceived health status and health examination: The hypothesis that health behaviors would be different according to the disparity pattern between self-perceived health status and health examination is supported as a result of χ2 test. Among Type I : Self-perceived health status is high and actual health status is good (no disease) Type II: Self-perceived health status is high and actual health status is poor(have disease) Type III: Self-perceived health status is low and actual health status is good(no disease) Type IN: Self-perceived health status is low and actual health status is poor(have disease) Type I and Type IV show no disparity, Type I shows the highest health promoting behavior whereas Type IV shows the lowest health promoting behavior. Type II, and III, compared to Type I, practise lower health promoting behavior. Multi-logistics regression analysis was conducted to find out the degree of impact on health behavior. Independent variables are general characteristics, self-perceived health status and health examination result and presence of illness, while the dependent variable is health promoting behavior. The analysis of the impact of self-perceived health status on the health promoting behavior shows that smoking, drinking, weight control, regular exercise, health examination practice, and/or regular diet are significantly correlated to self-perceived health status. High self-perceived health status is inversely related to high health promoting behavior. This finding supports the hypothesis that the higher one perceives one's health, the more likely one is to practice health promoting behavior. On the contrary, the presence of illness has little impact on health promoting behavior. 3) Multiple logistics analysis on how disparity patterns between self-perceived health status and health examination affect health behavior: The results of multiple logistics analysis made on health behavior variables compared to the standard variable are as follows: When analyzed on the standard of Type I, smoking is a significant risk factor for the Type IV. In case of drinking, all the patterns show a high probability of relative risk ratio. With regard to weight control, it is a risk factor for Type II while all the patterns show high probability of not practising when analyzed on the standard of type IV. Type III and IV show high probability of not doing regular exercise while Type IV, shows a high probability of not taking appropriate sleeping time. When analyzed on the standard of type IV, all the patterns show a high probability of not taking health examinations. Type III and IV show a high probability of not having regular meals. As for overall health promoting behavior, Type III and IV show a high relative risk ratio. These two groups have low self-perceived health status. It implies that self-perceived health status has significant impact on health promoting behavior. This is also supported by the fact that Type I with high self-perceived health status and no illness shows a high practice rate of health promoting behavior. Types II and III the groups with high disparity between self-perceived health status and health examination results, show a low practice rate of health promoting behavior when compared to Type I. Type IV, that is the group with low self-perceived health status and actual illness, shows the lowest practice of health promoting behavior. It is highly probable that this type proves to be the poorest health group.

• Journal of the East Asian Society of Dietary Life
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• v.22 no.2
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• pp.147-162
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• 2012

Abdominal obesity is an important factor of metabolic syndrome and is known as an independent risk factor of cardiovascular disease. The purpose of this study was to examine the fatty acid intake pattern as well as the association between fatty acid intake and abdominal obesity and hyperglycemia in Korean adults. This study was based on data from the Korea National Health and Nutrition Examination Surveys (KNHANES) I, II, III, and IV. After excluding subjects who had missing data for dietary intakes, anthropometric measurments, and laboratory tests, a total of 12,320 subjects aged 20~64y (5,266 men and 7,054 women) were included in the study. Trends in individual consumption of dietary fatty acids by year were analyzed by One-way ANOVA test, and the association between fatty acid intake and abdominal obesity and hyperglycemia was analyzed by logistic regression analysis after adjusting for age, energy intake, marital status, job, education level, alcohol intake, and smoking status. In men, intakes of TFA, SFA, MUFA, FUFA, and n-6 PUFA significantly increased with year. On the other hand, intakes of TFA, SFA and FUFA significantly increased with year in women. Logistic regression analysis showed that the risk of abdominal obesity was significantly associated with intakes of PUFA, LNA and n-3 PUFA in women. However, there was no association with any fatty acid intakes in men. The risk of hyperglycemia was significantly and positively associated with intakes of TFA, SFA, PUFA, and LNA in men, but, there was no significant association with any fatty acid intakes in women. These results show that abdominal obesity and hyperglycemia are significantly associated with individual intake of fatty acids, suggesting that fatty acid type may be associated with risk of abdominal obesity and hyperglycemia. Futher, the macronutrients of measl must be properly balanced.

• Journal of the Korean Society of School Health
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• v.22 no.2
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• pp.25-36
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• 2009

Purpose: The purpose of this study was to estimate income-related health inequalities among adolescent population across regions in Korea. Methods: Data of 8,456 adolescents from 1998, 2001, 2005, 2007 Korean Health and Nutrition Examination Survey were used for the analysis. True health status was proxied by self-rated health and overweight status. Per capita income was computed from household monthly average income adjusted by consumer price with base year 2005. Adolescent health inequalities were estimated by Concentration Index (CI) across income and space. Results: Ill health score was related with age (p<0.0001), gender (p=0.0155) and income (p<0.0001). Negative relationship between income and ill-health indicated that higher income group tended to enjoy better health and less overweight. These evidences suggested ill health were accumulated on the economically disadvantaged adolescents. The size of health inequalities (ill-health score) were estimated as CI=-0.057 and CI=-0.030 across income groups and regions, respectively. Comparable measures of within region health disparities were also observed. Conclusion: Since health disparity among adolescent population was small compared to adult population, lessening adolescent health inequality could be a helpful way of mitigating health disparities in later stage. Considering life stage of adolescents, school system and local communities could play important roles toward adolescent health distribution. Although health disparity between regions existed, health disparity within a region should not be neglected.

• Journal of Nutrition and Health
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• v.52 no.2
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• pp.206-216
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• 2019

Purpose: Management of the metabolic risk factors in diabetes patients is essential for preventing or delaying diabetic complications. This study compared the levels of the metabolic risk factors in diabetes patients according to the income levels, and examined the secular trends in recent decades. Methods: The data from the Korea National Health and Nutrition Examination Survey 1998 ~ 2014 were used. The diabetes patients were divided into three groups based on their household income levels. General information was obtained through self-administered questionnaires, and the blood biomarkers and blood pressure data were obtained from a health examination. Multivariable linear regression models were used to compare the metabolic biomarker levels according to the household income levels, adjusting for potential confounding factors. Results: The fasting blood glucose, hemoglobin A1c, and blood lipid (total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride) levels were similar in the three groups. During the survey period of 16 years, the blood pressure showed a significant decreasing trend with time in all groups (p < 0.001). In contrast, the fasting blood glucose (p = 0.004), total cholesterol (p < 0.001), and LDL-cholesterol levels (p = 0.007) decreased significantly, and the HDL-cholesterol level (p < 0.001) increased significantly in the highest-income groups. In the lowest-income group, the fasting blood glucose (p = 0.02), total cholesterol (p < 0.001), and triglyceride (p = 0.003) levels showed a significant decreasing trend over time. On the other hand, the middle-income group showed no significant change in any of the metabolic risk factors except for blood pressure. Conclusion: The level of management of metabolic risk factors according to the income level of Korean diabetes patients was similar. On the other hand, the highest- and lowest-income groups showed positive trends of management of these factors during 16 years of observation, whereas the middle-income group did not show any improvement.