• Journal of Preventive Medicine and Public Health
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• v.40 no.5
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• pp.404-410
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• 2007

Objectives: Due to the assumptions of homogeneity as well as challenges in the socioeconomic position of the elderly, they have been relatively neglected in studies of health inequalities. Therefore, this study was conducted to investigate the social inequalities in preventive services among elderly men and women. Methods: Data were obtained from a nationally representative sample of 342 men and 525 women aged 65 and over collected during the 2001 National Health and Nutrition Examination Survey. Age adjusted proportions and logistic regression were used to identify the social patterning of preventive services among elderly Koreans using various social position indicators. Results: The findings of this study generally supported the presence of social gradients in preventive services among the Korean elderly. The likelihood of using the service becomes progressively higher with social position. Educational level, income, and self-rated living status were significantly associated with increased medical checkups and cancer checks. In addition, logistic regression detected educational inequalities only among older women receiving BP checks. After being stratified based on health status and chronic disease status, social disparities still existed when educational level and self-rated living status were considered. Among unhealthy individuals, place of residence was observed as a barrier to medical checkups. Conclusions: This study demonstrated strong and consistent associations between socioeconomic position and preventive services among the elderly in Korea. The results indicate that public health strategies should be developed to reduce the barriers to preventive services encountered by the elderly.

• Korean Journal of Community Nutrition
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• v.13 no.5
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• pp.701-712
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• 2008

The purpose of the present study was aimed to identify dish items applicable in developing dish?based food frequency questionnaire (DFFQ) for a hypertension study of Koreans. The 24-hour recall data of 4,401 subjects aged $20{\sim}65$ years from the 2001 Korean National Health and Nutrition Examination Survey were used for the analysis. Logistic regression model was used to identify the nutrient related with hypertension. Energy, fiber, sodium, calcium, carotene, vitamin B1 and vitamin C were associated with hypertension. Selection the top 30 dish items for these seven nutrients was performed based on their degree of contribution in supplying nutrients in terms of the cumulative percent contribution (cPC), as well as on their degree of explanation for between?person variation, in terms of the cumulative regression coefficient (cMRC). Rice supplied 43% of total energy consumption. Korean cabbage and radish kimchi were two major sources of sodium and it also covered the 27% of between person variation of sodium intake. Soybean paste soup and single item of orange?colored fruits supplied 43% of total vitamin C intake for Koreans and it covered the almost 79% of between person variation among the Korean population. Korean cabbage kimchi was the major source of fiber, calcium, sodium, carotene, and vitamin C for Koreans. In summary, the top 30 selected dish items supplying the 78% to 89% of the 7 nutrients. Those items also covered the 79% to 94% of between person variation of the 7 nutrients consumption. Therefore, the selected 30 dish items in each categories of nutrient could be applicable in developing dish based food frequency questionnaire for hypertension study.

• Journal of Nutrition and Health
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• v.42 no.7
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• pp.631-638
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• 2009

This study was performed to examine the health risks according to the obesity types based upon body mass index (BMI) and waist circumference (WC) cutoffs. The subjects were 8,966 adults aged 40-79 years from the 1998, 2001 and 2005 Korean National Health and Nutrition Examination Surveys. The subjects were classified into 4 types of obesity groups based on BMI and WC: BMIWC (BMI${\geq}$ 25 kg/$m^2$ and WC${\geq}$ 90 cm for males and ${\geq}$ 85 cm for females), WC (BMI < 25 kg/$m^2$ and ${\geq}$ 90 cm for males and ${\geq}$ 85 cm for females), BMI (BMI ${\geq}$ 25 kg/$m^2$ and < 90 cm for males and < 85 cm for females), normal (BMI < 25 kg/$m^2$ and < 90 cm for males and < 85 cm for females) groups. More than half (n = 5,103) of the subjects fell into the normal group and BMIWC group accounts for 58%, followed by BMI group of 27% and WC group of 16%. Mean ages of subjects were highest in WC group and lowest in BMI group. Blood levels of total cholesterol, triglyceride, LDL-cholesterol and glucose, and blood pressures were higher and HDL-cholesterol was lower in 3 types of obesity groups (BMIWC, WC, BMI) than in the normal group. Among the 3 obesity groups, energy and fat intake was significantly higher in BMIWC than in normal group in males, however, no differences were found among the 4 groups in females. The three obesity groups had greater odds ratios for hypertension, diabetes mellitus, hypercholesterolemia, hyper-LDL-cholesterolemia, hypo-HDL-cholesterolemia, hypertriglyceridemia, and metabolic syndrome compared to the normal group. Among 3 obesity groups, BMIWC group had the highest odds ratios for hypertension, diabetes mellitus, and metabolic syndrome. Especially BMIWC and WC groups showed the highest odds ratios for diabetes mellitus and metabolic syndrome, suggesting the potential role of abdominal obesity in diabetes mellitus and metabolic syndrome. Our data indicate that different types of obesity may show different degrees of health risks. The appropriate selection and use of obesity indexes may be effective for management of obesity as well as obesityrelated diseases.

• Women's Health Nursing
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• v.7 no.4
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• pp.486-498
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• 2001

The purpose of this study was to identify transition conditions, health behavior and indicators of healthy transitions among middle-aged women based on Schumacher & Meleis(1994) transition model for developing intervention program for their health promotion. A convenience sample of 221 women aged 40-60 was obtained in Jung-Gu, Seoul and they were asked to complete the questionnaires, which consisted of modified health-promoting lifestyle profile(HPLP), knowledge of menopause, physical well-being, emotional well-being, modified women's role integration protocol (WRIP), Beck's Depression Inventory(BDI), and indicators of healthy transition with subcategories such as subjective well-being, role mastery and well-being of interrelationship. The results were as follows: 1. Women had a mean age of 47.53 years. More than half(53.39%) of the women had jobs and 88.69 % had their spouses, Of 221 women, 51.13 % were premenopausal, 19.91% were perimenopausal, and 28.96% were postmenopausal. 2. Women scored lower on health responsibility and exercise than on self actualization, nutrition and interpersonal support among subcategories of health behavior measured the modified HPLP. Only 11.98% of respondents had breast-self examination and 42.66% had pap smear for screening cancer. 3. In transition conditions, women had poor knowledge about menopause and median level of physical well-being, emotional well-being and stress. 15.45% of the women had clinical depression. 4. As for the outcome index of the transition model, the mean of indicators of healthy transition was 3.69(possible range 1-5). 5. The levels of education and economic and the menstrual status were significantly related to physical well-being, depression and stress in the categories of transition conditions. The total score of health behavior correlated negatively with depression. The total score of indicators of healthy transition correlated with physical well-being, emotional well-being, stress, and depression in the categories of transition conditions. In conclusion, these findings suggested a profile of fragile middle-aged women and contributed to developing the community-based intervention program for health promotion.

• Nutrition Research and Practice
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• v.1 no.4
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• pp.313-320
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• 2007

This study sought to compare intake levels of major dish items and food groups between normal and obese Korean children in order to understand obesity-related eating behaviors. The study was also conducted to apply the information on the differences in major dish items and food groups found in this study to development of a brief food frequency questionnaire (FFQ) for children's obesity-related eating behaviors. Finally, the developed FFQ was evaluated for reliability. A total of 290, 24-hour dietary recall data from 9-11 year-old normal or obese participants in the 2001 Korean National Health and Nutrition Examination Survey (KNHANES) were reviewed to identity dish items and food groups showing outstanding differences between the normal and obese groups. Based on the level of intake amount between the two groups, a total of 7 items, including ddeokbokggi, spaghetti, ham roast, pork cutlet, dairy products & ices, kimchi, and fruits, were selected to be included in the FFQ. The former 5 items were seen to be consumed more in the obese group, while the latter 2 items were so in the normal group. The questionnaire was formatted into a frequency response section of a seven-category option and reference period of the last 7 days. Test-retest reliability of the developed FFQ was examined by administering it to 153, 9-11 year-old children at a public elementary school in Seoul twice at a month interval. The level of reliability was found to be reasonably high. In conclusion, this study suggests that high consumption of several high-calorie dish items and low consumption of kimchi and fruits may be important eating behaviors in relation to obesity risk among 9-11 year-old children who need nutrition educators' attention. The current study also implies that a simple FFQ can be utilized to reliably assess 9-11 year-old children's diets.

• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.505-511
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• 2007

Objectives : While cervical cancer is one of the leading cancers among women worldwide, there are a number of effective early detection tests available. However, the participation rates in cervical cancer screening among Korean women remain low. After the nationwide efforts in 1988 and thereafter to encourage participation in cervical cancer screening, few studies have investigated the effects of socioeconomic inequality on participation in cervical cancer screening. The purpose of this study was to investigate 1) the level of socioeconomic disparities in receiving cervical cancer screening by age group and 2) if there was an improvement in reducing these disparities between 1995 and 2001. Methods : Using data from the Korean National Health Status, Health Behavior and Belief Survey in 1995, the Korean National Health and Nutrition Examination Surveys from 1998 and 2001 (sample sizes of 2,297, 3,738, and 3,283), age-standardized participation rates were calculated according to education level, equivalized household income, and job status. Odds ratios and the relative inequality index (RII) were also calculated after controlling for age. Results : Women with lower education levels were less likely to attend the screening test, and the disparities by education level were most pronounced among women aged 60 years and older. The RIIs among women 60 years and older were 3.64, 4.46, and 8.64 in 1995, 1998, and 2001, respectively. Higher rates of participation were reported among those in the highest income category, which was more notable among the middle aged women (40s and 50s). An inconsistent trend in the rate of participation in cervical cancer screening by occupational level was found. Conclusions : Indicators of socioeconomic position seem to have varying impacts on the inequalities in the rates of participation in cervical cancer screening according to age group. These results demonstrate the need for more aggressive and age-based interventions and policy programs to eliminate the remaining inequalities.

• Food Engineering Progress
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• v.14 no.4
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• pp.307-315
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• 2010

The safety and security of food supply should be one of the primary responsibilities of any government. Estimation of nation's food commodity intakes is important to control the potential risks in food systems since food hazards are often associated with quality and safety of food commodities. The food intake databases provided by Korea National Health and Nutrition Examination Survey (KNHANES) are good resources to estimate the demographic data of intakes of various food commodities. A limitation of the KNHANES databases, however, is that the food intakes surveyed are not based on commodities but ingredients and their mixtures. In this study, reasonable calculation strategies were applied to convert the food intakes of the ingredients mixtures from the KNHANES into food commodity intakes. For example, Perilla leaf consumed with meat, raw fish, and etc. in Korean diets was used to estimate its Korean intakes and develop algorithms for demographic analysis. Koreans have consumed raw, blanched, steamed, and canned perilla leaf products. The average daily intakes of the perilla leaf were analyzed demographically, for examples, the intakes by gender, age, and etc. The average daily intakes of total perilla leaf were 2.03${\pm}$0.27 g in 1998, 2.11${\pm}$0.26 g in 2001, 2.29${\pm}$0.27 g in 2005, 2.75${\pm}$0.35 g in 2007, and 2.27${\pm}$0.20 g in 2008. Generally, people equal to or over 20 years of age have shown higher perilla leaf intakes than people below 20. This study would be contributed to the estimation of intakes of possible chemical contaminants such as residual pesticides and subsequent analysis for their potential risk.

• Korean Journal of Community Nutrition
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• v.21 no.4
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• pp.344-353
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• 2016

Objectives: New retinol activity equivalent (RAE) was introduced as vitamin A unit in Dietary Reference Intake (DRI) for Koreans 2015. The purpose of this study was to evaluate the adequacy of 2015 reference intake (RI) of vitamin A in RAE unit by the comparison with RI and dietary intake of vitamin A. Methods: Analyses on RI of vitamin A were based on the Recommended Dietary Allowances (RDA) for Koreans (1962~2000) and DRIs for Koreans (2005~2015). Analyses on Koreans dietary intake of vitamin A were based on the Korea National Health and Nutrition Examination Survey (KNHNES) reports (1969-2014). For recalculation of RI and dietary intake of vitamin A in RE to RAE, 2013 Koreans intake of retinol: carotenoids ratio of 13: 87 was applied. Results: RI of vitamin A was 600~750 RE for Korean adult, and 339~425 RAE when calculated by applying the retinol and carotenoids intake ratio. Vitamin A intakes of Koreans were <100% RI, 267~668 RE from 1969 to 2001. From 2005, vitamin A intake had increased to >700 RE, >100% RI. When vitamin A intake was converted from RE to RAE (2005~2014), 718~864 RE became 405.8~488.1 RAE, decreased to 56.5% level. The recent 2015 RI of vitamin A is 850 RAE, two times of 2005 & 2010 RI of 425 RAE for adult male. Conclusions: When nutritional status of vitamin A was assessed for Koreans using the estimated average requirement (EAR) of 2015 (570, 460 RAE for male, female adults, respectively), ratio of deficient people increased significantly when judged based on the previous intake of Koreans, <490 RAE. We needs to examine the 2015 RI (EAR) of vitamin A, find a way to measure the accurate intake of dietary vitamin A, and to increase the dietary intake of this vitamin.

• Journal of Preventive Medicine and Public Health
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• v.47 no.1
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• pp.18-26
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• 2014

The purpose of this study was to establish food ingestion factors needed to assess exposure to contaminants through food ingestion. The study reclassified the raw data of the Korean National Health and Nutrition Examination Survey in 2001 into 12 subcategories including grain products, meat products, fish and shellfish, and vegetables for international comparability of exposure evaluation. The criteria for food intake calculation were unified according to the characteristics of food groups, and recommended values for food ingestion factors were calculated through moisture correction and recategorization of cooked, processed, and mixed foods for each group. The average intake rate for grain and grain products was 6.25 g/kg-d per capita and the men's intake rate was approximately 8% higher than that of the women. The average intake rate of meat and meat products was 1.62 g/kg-d per capita and the men's intake rate was 30% higher than that of the women, on average. The average intake rate of fish and shellfish was 1.53 g/kg-d per capita, and the age groups of 1 to 2 and 3 to 6 recorded higher capita intake rates than other age groups, 2.62 g/kg-d and 2.25 g/kg-d, respectively. The average intake rate of vegetables was 6.47 g/kg-d per capita, with the age group of 1 to 2 recording the highest per capita intake rate of 9.79 g/kg-d and that of 13 to 19 recording the lowest mean. The study also offers recommended values for food ingestion factors of other food groups by gender, age, and region. The food ingestion exposure factors will need future updates in consideration of ongoing changes in food consumption behavior.

• Journal of Preventive Medicine and Public Health
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• v.48 no.6
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• pp.310-318
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• 2015

Objectives: Previous studies have shown that overweight (including obesity) has increased significantly in Korea in recent decades. However, it remains unclear whether this change has been uniform among all Koreans and to what extent socioeconomic and behavioral factors have contributed to this increase. Methods: Changes in overweight were estimated using data from the 1998, 2001, 2005, 2007-2009, and 2010-2012 Korea National Health and Nutrition Examination Survey (n=55 761). Results: Overweight increased significantly among men but not among women between 1998 and 2012. Changes in socioeconomic and behavioral factors over the time period were not associated with overall trends for both men and women. However, we found significant differences in the prevalence of overweight relative to key risk factors. For men, overweight increased at a significantly greater rate among the non-exercising (predicted probability [PP] from 0.23 to 0.32] and high-calorie (PP from 0.18 to 0.37) groups compared to their active and lower-calorie counterparts, respectively. For women, overweight increased only among the non-exercising (PP from 0.27 to 0.28) and low-income (PP from 0.31 to 0.36) groups during this period. Conclusions: These findings suggest that programs aimed at reducing overweight should target Korean men and women in specific socioeconomic and behavioral risk groups differentially.