• Nutrition Research and Practice
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• v.16 no.2
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• pp.194-204
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• 2022

BACKGROUND/OBJECTIVES: Sugar-sweetened beverages (SSBs) are regarded as modifiable risk factors for mental health in several populations. Although the consumption of SSBs is steadily increasing in Korea, there is scant evidence regarding the impact of SSB consumption on depression and suicidal ideation. The aim of this study was to investigate the association of SSB consumption with depression and suicidal ideation among adults in Korea. SUBJECTS/METHODS: We used the data for 5,465 participants (2,170 men and 3,295 women) aged ≥ 20 years from the 2014 and 2016 Korea National Health and Nutrition Examination Survey. The subjects were divided into four groups according to SSB consumption using a food frequency questionnaire. Logistic regression analyses were conducted to examine the association of SSB consumption with depression and suicidal ideation, adjusting for sociodemographic, health behavior, and dietary variables. RESULTS: Participants consuming ≥ 1 SSB/day had a significantly higher risk of depression (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.08-2.18; P < 0.001) and suicidal ideation (OR, 2.20; 95% CI, 1.13-4.28; P < 0.001) compared with those in the non-SSB group after adjusting for potential confounding factors. CONCLUSIONS: Our results suggest that SSB consumption is positively associated with depression and suicidal ideation in Korean adults.

• Nutrition Research and Practice
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• v.16 no.1
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• pp.94-105
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• 2022

BACKGROUND/OBJECTIVES: The purpose of this study was to investigate the association between socioeconomic status and chewing discomfort and identify the role of food insecurity in the association's causal pathway in a representative sample of Korean elders. MATERIALS/METHODS: We conducted cross-sectional analyses of the Korea National Health and Nutrition Examination Survey (2013-2015) data for elders aged ≥ 65 years. Socioeconomic status indicators used included household income and education level. Chewing discomfort was assessed according to the self-reported presence of chewing problems. Food security was surveyed using a questionnaire based on the US Household Food Security Survey Module. RESULTS: The odds ratios of chewing discomfort in the 1st and 2nd income quartiles were 1.55 (95% confidence interval [CI], 1.15-2.10) and 1.40 (95% CI, 1.03-1.90), respectively, compared to participants in the highest income quartile. Participants with the lowest education level were 1.89 (95% CI, 1.30-2.75) times more likely to have chewing discomfort than those without chewing discomfort. After including food security in the final model, the logistic coefficients were attenuated in the income and education quartiles. CONCLUSIONS: Low socioeconomic status was associated with chewing discomfort. In addition, the results confirm that food insecurity can mediate the association between socioeconomic inequalities and chewing discomfort among the elderly.

• Nutrition Research and Practice
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• v.14 no.4
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• pp.352-364
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• 2020

BACKGROUND/OBJECTIVES: Given the increasing proportion of the Korean population that is aged 65 years and older, the present study analyzed the relationship between diet quality and sarcopenia in elderly persons by using data from the 2008-2011 Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: Data for 3,373 persons aged 65 years and over (men: 1,455, 43.1%) were selected from the 2008-2011 KNHANES. Sarcopenia assessments are based on a formula that divides a subject's appendicular skeletal muscle mass (ASM) by their weight (wt) and multiplies that result by 100 ([ASM/wt] × 100). Sarcopenia is present if the subject's result was less than one standard deviation (SD) below the sex-specific mean for a young reference group. For evaluation of diet quality, data obtained via the 24-hour recall method were used to calculate the Diet Quality Index for Koreans (DQI-K). A general linear model was applied in order to analyze general information and nutritional intake according to sarcopenia status. For analysis of the relationship between diet quality and sarcopenia, a binominal logistic regression analysis was undertaken. RESULTS: The sarcopenia prevalence rate among the study subjects aged 65 years and over was 37.6%. The DQI-K of those without sarcopenia was 3.33 ± 0.04 points, while that of those with sarcopenia was 3.45 ± 0.04 points (P < 0.05). The relationship between diet quality and sarcopenia revealed that subjects aged 75 and older had a poor diet quality, and their odds ratio (OR) of sarcopenia presence was significantly higher (OR: 1.807, 95% confidence interval: 1.003-3.254, P < 0.05). CONCLUSIONS: This study revealed that poor diet quality was related to sarcopenia presence in Koreans aged 75 and older. In order to improve the diet quality of the elderly (aged 75 and older), it is necessary to develop dietary improvement guidelines.

• Nutrition Research and Practice
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• v.12 no.5
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• pp.406-414
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• 2018

BACKGROUND/OBJECTIVES: The objective of this study was to determine dysphagia risk among community-dwelling elderly people living at home. We also examined the impact of socio-demographic variables on dysphagia risk as well as the relationship between dysphagia risk and dietary characteristics. SUBJECTS/METHODS: The study sample included 568 community-dwelling individuals, aged 65 years and above, who were living independently in their own home in Seoul, Gyeonggi, or Gwangju in South Korea. We used a dysphagia risk assessment scale to screen for dysphagia risk and the Mini nutritional assessment to evaluate the nutritional status. Associations between dysphagia risk and other variables were assessed using logistic regression analysis. RESULTS: Of the 568 subjects, 350 (61.6%) were classified into the dysphagia risk group (DR) and 218 (38.4%) were classified into the normal group (non-DR). Being female (odds ratio (OR) = 1.82, 95% confidence interval (CI) = 1.28-2.59), being 75 years and older (OR = 2.40, 95% CI = 1.69-3.42), having a lower education level (OR = 2.29, 95% CI = 1.33-3.97), and having a lower perceived economic status (OR = 2.18, 95% CI = 1.32-3.60) were more frequently observed with dysphagia risk compared to those who did not have such characteristics. Lowered mastication ability (OR = 14.40, 95% CI = 4.43-46.95), being at risk of malnutrition or malnourished (OR = 2.72, 95% CI = 1.75-4.23), lowered appetite (OR = 3.27, 95% CI = 2.16-4.93), and decreased food intake (OR = 2.95, 95% CI = 1.83-4.78) were observed more frequently in the DR group than in the non-DR group when adjusting for potential confounding factors. CONCLUSIONS: It is necessary to develop and apply integrated programs to improve the dietary habits and nutritional status of elderly individuals at risk for dysphagia, especially for women aged 75 years or older with lower educational and economic levels.

• Korean Journal of Community Nutrition
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• v.27 no.4
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• pp.286-295
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• 2022

Objectives: Sarcopenia is one of the most representative factors of senescence, and nutritional status is known to affect sarcopenia. This study was performed to analyze the relationships between energy and protein intake and sarcopenia. Methods: The study subjects were 3,236 individuals aged ≥65 that participated in the Korea National Health and Nutrition Examination Survey (KNHANES) 2008 ~ 2011. General characteristics and anthropometric and 24-hour dietary recall data were analyzed. Sarcopenia was diagnosed using a formula based on appendicular skeletal muscle mass (ASM) and body weight. Logistic regression was performed to determine relationships between sarcopenia risk and energy and protein intakes. Results: For energy intake, the odds ratio (OR) of sarcopenia in women was significantly higher those with the lowest intake [OR = 1.680, 95% confidence interval (CI) = 1.213-2.326] than those with the highest intake (P for trend = 0.001). Regarding protein intake per kg of body weight, the odds ratio of sarcopenia was significantly higher for those that consumed < 0.8 g/kg of protein daily than those that consumed > 1.2g/kg for men (OR = 2.459, 95% CI = 1.481-4.085) and women (OR = 2.178, 95% CI = 1.423-3.334). Conclusions: This study shows a link between sarcopenia and energy and protein intake levels and suggests that energy and protein consumption be promoted among older adults to prevent sarcopenia.

• Nutrition Research and Practice
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• v.17 no.1
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• pp.62-72
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• 2023

BACKGROUND/OBJECTIVES: Many studies have revealed an association between fat mass and the obesity-related gene (FTO) and obesity. On the other hand, no meta-analysis was conducted with data from only Koreans. Therefore, this study performed a meta-analysis using Korean data to provide evidence for the association between FTO single nucleotide polymorphisms (SNPs) and the risk of obesity among Korean adults. SUBJECT/METHODS: Meta-analysis was finally conducted with data extracted from seven datasets of four studies performed on Korean adults after the screening passed. Five kinds of FTO SNPs (rs9939609, rs7193144, rs9940128, rs8050136, and rs9926289) were included, and the relationship between FTO SNPs and body mass index (BMI) was investigated using linear regression with an additive model adjusted for covariants, such as age, sex, and area. RESULTS: The minor alleles of FTO SNPs were associated with increased BMI (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.21-1.42). In sub-group analysis, FTO rs9939609 T>A was significantly associated with BMI (OR, 1.23; 95% CI, 1.06-1.42). The other FTO SNPs together were significantly associated with BMI (OR, 1.37; 95% CI, 1.25-1.49). The publication bias was not observed based on Egger's test. CONCLUSIONS: This meta-analysis showed that minor alleles in the FTO SNPs were significantly associated with an increased BMI among Korean adults. This meta-analysis is the first to demonstrate that minor alleles in the FTO SNPs contribute significantly to the increased risk of obesity among Korean adults using data from a Korean population.

• Nutrition Research and Practice
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• v.17 no.2
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• pp.175-191
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• 2023

BACKGROUND/OBJECTIVES: The scientific evidence of a sodium-obesity association is limited by sodium intake assessments. Our specific aim is to synthesize the association between dietary sodium intake and obesity across the sodium intake assessments as evidenced by systematic reviews in adults. SUBJECTS/METHODS: A systematic search identified systematic reviews comparing the association of dietary sodium intakes with obesity-related outcomes such as body mass index (BMI), body weight, waist circumference, and risk of (abdominal) obesity. We searched PubMed on October 24, 2022. To assess the Risk of Bias in Systematic Reviews (ROBIS), we employed the ROBIS tool. RESULTS: This review included 3 systematic reviews, consisting of 39 unique observational studies (35 cross-sectional studies and 4 longitudinal studies) and 15 randomized controlled trials (RCTs). We found consistently positive associations between dietary sodium intake and obesity-related outcomes in cross-sectional studies. Studies that used 24-h urine collection indicated a greater BMI for those with higher sodium intake (mean difference = 2.27 kg/m²; 95% confidence interval [CI], 1.59-2.51; P < 0.001; I² = 77%) compared to studies that used spot urine (mean difference = 1.34 kg/m²; 95% CI, 1.13-1.55; P < 0.001; I² = 95%) and dietary methods (mean difference = 0.85 kg/m²; 95% CI, 0.1-1.51; P < 0.05; I² = 95%). CONCLUSIONS: Quantitative synthesis of the systematic reviews has shown that cross-sectional associations between dietary sodium intake and obesity outcomes were substantially different across the sodium intake assessments. We need more high-quality prospective cohort studies and RCTs using 24-h urine collection to examine the causal effects of sodium intake on obesity.

• Journal of Nutrition and Health
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• v.54 no.5
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• pp.515-533
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• 2021

Purpose: A systematic review and meta-analysis of nutrition educational intervention studies was performed to assess the association between nutrition education intervention and fruit & vegetable (F&V) preferences and nutrition knowledge in preschool children. Methods: The relevant studies of nutrition education intervention and F&V preferences and nutrition knowledge published from January 2000 to June 2020 were located using PubMed, Web of Science, Cochrane Library, Research Information Sharing Service, Korean Studies Information Service System databases, and lists of references. A random-effects meta-analysis was conducted to estimate the standardized mean difference with a 95% confidence interval (CI). Subgroup analyses were performed to identify the association between nutrition education and F&V preferences and nutrition knowledge. Results: The results show that the effect sizes (ES) of F&V preferences and nutrition knowledge of preschool children were 0.31(95% CI, 0.23, 0.39), and 1.69(95% CI, 1.27, 2.12), respectively. The result of subgroup analysis, nutrition education focused on F&V (F&V preferences, ES: 0.32; nutrition knowledge, ES: 2.09) presented a slightly larger effect than general nutrition education (F&V preferences, ES: 0.26; nutrition knowledge, ES: 1.62). As for the type of exposure to F&V, direct exposure education (F&V preferences, ES: 0.40) had a greater effect than indirect exposure (F&V preferences, ES: 0.26). This meta-analysis showed that nutrition education intervention had positive effects on the F&V preferences and nutrition knowledge in preschool children. Conclusion: In conclusion, from the meta-analysis and subsequent subgroup analysis, we found that varied types of nutrition education intervention had varying effects on F&V preferences and nutrition knowledge in preschool children.

• Journal of Nutrition and Health
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• v.51 no.5
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• pp.414-422
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• 2018

Objective: Dietary nutrients may play a significant role in depressive disorders. However, sufficient evidences in epidemiological studies are limited. We investigated the cross-sectional association between dietary nutrients and the prevalence of depressive disorder in Korean adults using representative Korean data. Methods: Participants were 2,938 adults aged 19 ~ 64 years from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted in 2014. Dietary intakes were assessed using 24-h recall method. Depressive disorder was assessed using Patients Health Questionnaire-9 (PHQ-9, self-depression test) as applied in 2014 KNHANES only. We defined depressive disorder as having a PHQ-9 score of ${\geq}10$, which was characterized as moderate depression and more. A multivariate logistic regression analysis was performed to estimate the adjusted odd ratios (ORs) and 95% confidence interval (CIs) of depressive disorder. Results: Among the 2,938 subjects, 170 were identified as having depressive disorder. The multivariate-adjusted regression analysis demonstrated that the risk of depression was significantly associated with riboflavin (OR = 0.44, 95% CI: 0.24-0.85, p for trend = 0.018), thiamin (OR = 0.48, 95% CI: 0.23-0.99, p for trend = 0.045), and vitamin C (OR = 0.57, 95% CI: 0.34-0.95, p for trend = 0.025) in the highest versus lowest tertiles of intake. Conclusion: The high consumption of riboflavin, thiamin, and vitamin C was associated with the low prevalence of depressive disorder in Korean adults.

• Nutrition Research and Practice
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• v.14 no.5
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• pp.519-531
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• 2020

BACKGROUND/OBJECTIVES: Regional disparities in dietary factors might be related to regional disparities in cardiometabolic health. Therefore, this study investigated the associations of cardiometabolic risk factors and dietary factors with regional types in Korean adults. SUBJECTS/METHODS: Based on data from the 2007-2017 Korea National Health and Nutrition Examination Survey, the study included 39,781 adults aged ≥ 19 years who completed the dietary survey and a health examination. Healthy and unhealthy dietary factors (fat, sodium, fruit, and vegetable intakes) were evaluated using 1-day 24-h dietary recall method, as well as the use of nutrition labels with a questionnaire. RESULTS: Of the participants, 48.7%, 36.0%, and 15.2% lived in metropolitan, urban, and rural areas, respectively. Adults living in urban and rural had higher odds ratios (ORs) for obesity (OR for urban, 1.07; 95% confidence interval (CI), 1.01-1.14; OR for rural, 1.14; 95% CI, 1.05-1.24) than adults living in metropolitan areas; these associations were significantly observed in middle-aged adults. Compared to metropolitan residents, rural residents had lower ORs for hypertension in middle-aged (OR, 0.86; 95% CI, 0.76-0.96) and metabolic syndrome in older adults (OR, 0.78; 95% CI, 0.67-0.91). Regarding urban residents, a lower OR for diabetes in middle-aged adults (OR, 0.85; 95% CI, 0.74-0.97) and a higher OR for hypertension in older adults (OR, 1.19; 95% CI, 1.02-1.39) were observed. Overall rural residents had higher ORs of excessive carbohydrate, low fruit, and high salted-vegetable intakes than metropolitan residents. Low fruit intake was positively associated with obesity, metabolic syndrome, and hypertension, after adjustment for regional type and other confounders in total participants. CONCLUSIONS: These findings indicate that cardiometabolic risk and unhealthy dietary factors differ among regional types and age groups within Korea. Nutritional policy and interventions should consider regional types for prevention and management of cardiometabolic risk factors.