• Journal of Nutrition and Health
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• v.54 no.2
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• pp.179-198
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• 2021

Purpose: This study examined general characteristics, health status, accessibility to medical services, health-related quality of life, dietary behavior, and energy and nutrient intakes of the elderly at different levels of food security utilizing data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). Methods: The elderly subjects (1,721 males and 2,271 females) were divided into 3 groups (secure, mildly insecure, moderately/severely insecure) according to their food security levels. Health and nutrient status was determined using energy intake, nutrient density, the prevalence of insufficient nutrient intake, dietary behavior, and health status. Results: The elderly with food insecurities had a lower self-evaluated health status and a higher prevalence of physician-diagnosed chronic diseases such as arthritis, osteoarthritis, rheumatoid arthritis, osteoporosis for males, and hypertension, stroke, arthritis, and osteoarthritis for females. The associated financial burden was the major reason for not accessing medical services in the food insecure group. Furthermore, the food insecure group had a higher risk of impaired health-related quality of life compared to the secure group. The proportion of subjects with an energy intake below the estimated energy requirement was higher in the food insecure group and a significantly higher prevalence of insufficient intake was observed for all the nutrients (proteins, vitamin A, vitamin B₁, vitamin B₂, niacin, vitamin C, calcium, and iron) assessed in this study compared to the food secure group. Conclusion: This study suggests that food insecurity poses a challenge to the health and nutritional status of the elderly population in Korea and needs proper management. It would be helpful to develop food and nutrition assistance programs to ensure the food stability of the elderly population and assure quality to address gaps in their nutrient intake.

• Journal of Nutrition and Health
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• v.51 no.5
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• pp.400-413
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• 2018

Purpose: This study examined the association between the antioxidant vitamin intake and obesity in Korean women. Methods: Adult women aged ${\geq}19years$ who completed a health examination and nutrition survey from the Korea National Health and Nutrition Examination Survey between 2007 ~ 2016 were selected for the study (n = 30,425). A BMI ${\geq}25kg/m^2$ and waist circumference ${\geq}85cm$ were defined as obesity and abdominal obesity, respectively. The individual antioxidant vitamin intake was estimated by linking the antioxidant vitamin composition database of commonly consumed foods and the subjects' 24-hour recall food consumption data. Carotenoids, retinol, vitamin A (retinol activity equivalent), vitamin C, tocopherols, and vitamin E (${\alpha}$-tocopherol equivalent) were included in the analysis. Each vitamin intake was converted to the nutrient density per 1,000 kcal. Odds ratio (ORs) and 95% confidence interval (CI) for obesity according to each tertile of the nutrient density was obtained from multiple logistic regression adjusted for age, household income, education level, smoking, alcohol consumption, and physical activity. Results: The mean intake of ${\alpha}$-carotene, retinol, vitamin E, ${\alpha}$-tocopherol, and ${\gamma}$-tocopherol per 1,000 kcal was significantly lower in the obese group than in the normal group. A higher intake of lycopene was inversely associated with obesity (highest vs. lowest; OR = 0.89, 95% CI: 0.83-0.96) and abdominal obesity (highest vs. lowest; OR = 0.88, 95% CI: 0.81-0.95). Higher intakes of ${\alpha}$-carotene, total carotenoids, vitamin A, and ${\gamma}$-tocopherol also had a negative relationship with abdominal obesity. The antioxidant vitamin intakes from eggs, milk and dairy products, seasoning, and grains were significantly lower in the obese group than in the normal group. Conclusion: This study showed that the dietary intake of antioxidant vitamins was inversely associated with obesity and abdominal obesity among Korean women. Further study will be needed to examine the causal relationship between the antioxidant vitamin and obesity.

• Journal of Nutrition and Health
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• v.54 no.2
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• pp.165-178
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• 2021

Purpose: This study examined the eating-out patterns of Korean infants and school-aged children and compared diet quality. Methods: Data were obtained from the 2016-2018 Korea National Health and Nutrition Examination Survey. The subjects were 306 children aged 3 to 11 years old that ate dinner at restaurants. Percentage energy intakes of 24 food groups were calculated, and cluster analysis was used to identify eating-out patterns. Diet quality was assessed by calculating percentage energy and nutrient intakes using one-third of the 2015 Dietary Reference Intakes for Korean (KDRIs), nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ). Results: Cluster analysis identified 2 eating-out patterns, that is, a 'rice-centered' (53%) and a 'mixed diet' (47%) pattern. For those with the mixed diet pattern, ratios of carbohydrates, protein, and fat to total calories were 48:20:31, whereas for the rice-centered pattern, ratios were 62:15:21 (p < 0.001). Intakes of energy and most nutrients in the mixed diet pattern were excessive, but the intakes of the most nutrients in the rice-centered pattern were much lower than their KDRIs. MARs were higher for the mixed diet pattern than the rice-centered pattern (0.74 vs. 0.66) (p < 0.001), and INQs for vitamin C (p = 0.007) and calcium (p = 0.018) were lower for the rice-centered pattern, whereas INQ for iron (p = 0.003) was lower for the mixed diet pattern. Conclusion: The quality of meals for infants and school-aged children depended on eating-out patterns, but the rice-centered and mixed diet patterns both failed to provide an appropriately balanced meal pattern. The results of this study suggest that healthy menus need to be developed for children in restaurants.

• Journal of Nutrition and Health
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• v.51 no.6
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• pp.538-555
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• 2018

Purpose: This study examined the association of the type and frequency of coffee consumption with the health-related quality of life and metabolic bio-markers in adult men and women from the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: A total of 11,201 subjects (4,483 men and 6,718 women) were classified according to the type of coffee consumption (non-coffee, black coffee, 3-in-1 coffee) and type and frequency of coffee consumption (non-coffee, ${\leq}2$ times/day of black coffee, > 2 times/day of black coffee, ${\leq}2$ times/day of 3-in-1 coffee, > 2 times/day of 3-in-1 coffee) using food frequency questionnaires. Dietary nutrient intake data were assessed using food frequency questionnaires. The health-related quality of life was measured using the EuroQol-5 dimension (EQ-5D) and EQ-5D index score. Data on metabolic bio-markers were obtained from a health examination. Results: Among men and women, the proportion of subjects with an energy intake below the estimated energy requirement (EER) was lower among the 3-in-1 coffee consumption group, and the proportion of subjects with iron intakes below the estimated average requirements (EAR) was lower among the 3-in-1 coffee consumption group. Women (OR: 0.810, 95% CI: 0.657 ~ 0.998) with the ${\leq}2$ times/day of 3-in-1 coffee had a lower risk of impaired health-related quality of life (lowest 20% level in the EQ-5D score) compared to the non-coffee consumers after a multivariable adjustment. In both men and women, the type and frequency of coffee consumption was not associated with metabolic bio-markers risk after multivariable adjustment. Conclusion: These results suggest that 3-in-1 coffee consumption may be associated with a lower risk of impaired health-related quality of life and may not be associated with the metabolic bio-markers risk in adult men and women.

• Journal of Nutrition and Health
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• v.56 no.3
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• pp.300-314
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• 2023

Purpose: This study sought to predict the reasons for skipping breakfast by adolescents aged 13-18 years using the 7^th Korea National Health and Nutrition Examination Survey (KNHANES). Methods: The participants included 1,024 adolescents. The data were analyzed using a complex-sample t-test, the Rao Scott χ²-test, and the classification and regression tree (CART) algorithm for decision tree analysis with SPSS v. 27.0. The participants were divided into two groups, one regularly eating breakfast and the other skipping it. Results: A total of 579 and 445 study participants were found to be breakfast consumers and breakfast skippers respectively. Breakfast consumers were significantly younger than those who skipped breakfast. In addition, breakfast consumers had a significantly higher frequency of eating dinner, had been taught about nutrition, and had a lower frequency of eating out. The breakfast skippers did so to lose weight. Children who skipped breakfast consumed less energy, carbohydrates, proteins, fats, fiber, cholesterol, vitamin C, vitamin A, calcium, vitamin B1, vitamin B2, phosphorus, sodium, iron, potassium, and niacin than those who consumed breakfast. The best predictor of skipping breakfast was identifying adolescents who sought to control their weight by not eating meals. Other participants who had low and middle-low household incomes, ate dinner 3-4 times a week, were more than 14.5 years old, and ate out once a day showed a higher frequency of skipping breakfast. Conclusion: Based on these results, nutrition education targeted at losing weight correctly and emphasizing the importance of breakfast, especially for adolescents, is required. Moreover, nutrition educators should consider designing and implementing specific action plans to encourage adolescents to improve their breakfast-eating practices by also eating dinner regularly and reducing eating out.

• Journal of Korea Entertainment Industry Association
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• v.14 no.8
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• pp.455-465
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• 2020

The purpose of this study was to investigate the relationship between physical activity and health-related quality of life of adults using the 7th National Health and Nutrition Survey. The study was conducted with 11,211 adults, and the health-related quality of life was defined using the EuroQol group's EQ-5D and physical activity using GPAQ. Data analysis was performed using the SAS 9.4 program, the general characteristics and degree of physical activity of the subject, Chi-square for KEQ-5D index, and Logistic Regression Analysis for the relationship between physical activity and quality of life. As a result of the study, the general characteristics of the subjects were marital status, educational status, occupation, smoking, alcohol consumption, economic status, stress, chronic disease, chronic disease treatment, physical activity due to leisure and physical activity due to occupation, depending on gender. There was a difference (p<0.05). As for the quality of life related to physical activity and health, the quality of life was significantly lower by 37% in the 'minimum physical activity group' of occupational physical activity (p<0.05). The results of this study are expected to be provided as basic data for physical activity-related health policy establishment and physical activity programs.

• Journal of Korean society of Dental Hygiene
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• v.20 no.3
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• pp.313-324
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• 2020

Objectives: The aim of this study was to confirm the association among the health status, health behaviors, and periodontitis according to total, age and sex in cases of adult metabolic syndrome(MetS). Methods: This cross-sectional study used collected data from the 7^th Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2016 to 2018 with 3,394 adults with MetS aged 19-79 years. The complex samples logistic regression analysis confirmed the relevant factors for periodontitis. Results:Periodontitis was diagnosed in 43.6% of all MetS cases. Diabetes (Odds Ratio [OR]=1.554), abdominal obesity (OR=1.336), current smoking (OR=2.465), past smoking (OR=1.379), and not-using oral care products (OR=1.414) were associated with periodontitis in MetS. In the age of 19-39 years with MetS group, diabetes (OR=5.379), elevated blood pressure (OR=3.975), current smoking (OR=7.430), and not using oral care products (OR=3.356) were associated with periodontitis. In the 40-79 age group, diabetes (OR=1.398), abdominal obesity (OR=1.360), current smoking (OR=2.022), and not using oral care products (OR=1.416) were associated with periodontitis. In the male MetS group, current smoking (OR=3.119), past smoking (OR=1.625), and brushing teeth more than three times (OR=0.743) were associated with periodontitis. In the female MetS group, diabetes (OR=1.733), impaired fasting glucose (OR=1.434), abdominal obesity (OR=1.479), and not using oral care products (OR=1.992) were associated with periodontitis. Conclusions: Improvement in blood sugar control, obesity, smoking cessation, and oral health education, including how to use oral care products in all individuals with MetS may result in improved oral health. In addition, improvement in elevated blood pressure in the MetS group aged under 40 years, and brushing teeth more than three times a day in the male MetS group can reduce the risk of periodontitis. Therefore, public and oral health professionals should emphasize on the relationship between age and sex during the metabolic syndrome management program and share relevant information with patients.

• 한국체육학회지인문사회과학편
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• v.57 no.4
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• pp.375-386
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• 2018

Due to the rapid increase of the elderly population in Korea, there is a growing interest in 'Healthy Aging.' In this trend, it is important to identify the relationship between their lifestyle factors and quality of life. The purpose of this study was to identify the association of physical activity level, sedentary behavior and health-related quality of life (HRQoL) among Korean older adults. A total of 4,589 older adults at the Sixth and Seventh National Health and Nutrition Examination Survey was analyzed. The results showed that better HRQoL was observed among physically active older female, which was more evident among physically active female with central obesity while no such relationship was observed among older male. On the other hand, higher sedentary time was associated with lower HRQoL in both male and female subjects. Our analyses indicated that central obesity was closely related with HRQoL regardless of their physical activity levels in female subjects. Further analyses investigating association between sub-dimension of HRQoL and sub-domain of physical activity showed that higher transport physical activity was associated with better anxiety/depression score and higher sedentary time was associated with poorer score on mobility, usual activities among male and mobility, self-care, usual activity and anxiety/depression among female. Our finding suggests that physical activity level, sedentary behavior and central obesity associated with HRQoL.

• Journal of Nutrition and Health
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• v.55 no.1
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• pp.120-140
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• 2022

Purpose: The purpose of the study was to investigate whether adherence to the Korea Healthy Eating Index (KHEI) was associated with metabolic syndrome and risk markers. Methods: The participants included 8,345 adults, aged 20-59 years, who took part in the 7th Korea National Health and Nutrition Examination Survey (KNHANES). The data were analyzed using a complex-sample t-test, the Rao Scott χ²-test, and logistic regression analysis on the SPSS v. 26.0 software. The participants were divided into four groups by quartiles of KHEI scores. Results: The average KHEI score was 61.06 points out of 100, and the women's score (62.50 points) was significantly higher than that of men (59.63 points). The KHEI quartiles status showed significant differences by age (p < 0.001), household income (p < 0.001), smoking status (p < 0.001), and food security. Specifically, the KHEI quartiles in the men showed significant differences in education (p < 0.001) and economic activity (p < 0.001) whereas those of women showed significant differences in alcohol-consumption (p < 0.001), depression (p < 0.01) and eating-out (p < 0.001). As the KHEI scores increased, the proportion of subjects with an energy intake below the estimated energy requirement (EER) was lower, and significantly better levels of intake were observed for carbohydrate, protein, vitamin C, calcium, vitamin B₁, vitamin B₂, and niacin. The incidence of the metabolic syndrome risk factors, hypertriglyceridemia and hyperglycemia for men and hypertension, and hyperglycemia for women showed significant differences. The KHEI scores were inversely associated with abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, hyperglycemia, hypertension, and metabolic syndrome. Conclusion: Based on these results, we conclude that higher adherence to the KHEI was associated with lower metabolic syndrome risk factors and incidence of the metabolic syndrome.

• Journal of Food Hygiene and Safety
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• v.33 no.5
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• pp.361-368
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• 2018

N-nitrosamines are probable or possible human carcinogens, which are produced by the reaction between secondary amines and nitrogen oxide in the acidic environment or by heating. Common risk assessment procedure involves the comparison between exposures expressed in the unit, mg/kg body weight/day and the Health-Based Reference dose expressed in the same unit. This procedure is suitable for the policy decision-making and is considered as inappropriate for the consumers to get information about their dietary decision-making. Therefore, the distributions of NDMA (N-nitrosodimethylamine), NDBA (N-nitrosodibutylamine), the six N-nitrosamines (NDMA, NDBA, NDEA (N-nitrosodiethylamine), NPYR (N-nitrosopyrrolidine), NPIP (N-nitrosopiperidine), and NMOR (N-nitrosomorpholine) in the menus grouped based on the presence of main ingredients and cooking methods were analyzed to generate consumer-friendly information regarding food contaminants. Recipes and intakes were taken from 2014 to 2016 KNHANES (The Korean National Health and Nutrition Examination Survey) and only the data from ages of 7 years or older were used. The contamination data were collected from the 2014~2016 Total Diet Study and all the analysis were performed using R software. Rockfish, eel, anchovy broth and pollock were mainly exposed to N-nitrosamines. In terms of cooking methods, soups and stews appeared to contain the highest amount of N-nitrosamines. Cereals, fruits, and dairy products in the ingredient categories, and rice dishes and rice combined with others in recipe categories had the lowest level exposure to N-nitrosamines. In case of N-nitrosamines, unlike other cooking related food contaminants, boiled dishes such as soups and stews and dishes mainly consisting of fishes and shellfishes had highest level of exposure, showing a large discrepancy with the previous thought of processed meat is the main source of N-nitrosamines.