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Relationships between obesity, blood and urinary compositions, and dietary habits and depressed mood in Koreans at the age of 40, a life transition period

만 40세 생애전환기 건강진단 수검자의 우울기분과 영양 생활습관 및 건강특성과의 관련성

  • Chu, Ji Eun (Department of Clinical Health Sciences, Graduate School of Clinical Health Sciences, Ewha Womans University) ;
  • Lee, Ji Min (Department of Food and Nutrition, College of Health Science, Ewha Womans University) ;
  • Cho, Han-Ik (Korea Association of Health Promotion) ;
  • Park, Yoon Jung (Department of Clinical Health Sciences, Graduate School of Clinical Health Sciences, Ewha Womans University)
  • 추지은 (이화여자대학교 임상보건과학대학원 임상보건학과) ;
  • 이지민 (이화여자대학교 건강과학대학 식품영양학과) ;
  • 조한익 (한국건강관리협회) ;
  • 박윤정 (이화여자대학교 임상보건과학대학원 임상보건학과)
  • Received : 2013.03.26
  • Accepted : 2013.04.30
  • Published : 2013.06.30

Abstract

This study was designed to investigate the relationships of depressed mood with obesity, blood and urinary compositions, and dietary habits in Koreans at the age of 40, a critical transition to the middle adulthood stage. A total of 27,684 people who have taken the Life Transition Period Health Examination at the Korea Association of Health Promotion in 2011 were divided into two groups; the depressed mood group (DG) and the non-depressed group (NG) according to results of the primary questionnaire for mental health. The results were analyzed using the health examination criteria of the National Health Insurance Corporation. Women and medicaid recipients showed higher incidence of depressed mood than men and health insurance subscribers. People with underweight in BMI or abdominal obesity showed correlation with depressed mood, while there was no significant relationship with metabolic syndrome. Regarding blood and urinary compositions, DG was related to a higher level of hemoglobin and lower levels of HDL-cholesterol and triglyceride, although the relationships diminished after adjustment for other confounder effects. According to dietary habits, more people in DG were categorized as a group for "Needs Much Improvement", and the odds ratio of the depressed mood showed a significant increase. Significant difference regarding the frequency of food items such as milk products, animal proteins, Kimchi, and fruits was observed between DG and NG. In addition, a higher portion of subjects in DG did not consume regular meals and various kinds of food. In conclusion, the depressed mood of 40 year-old adults was significantly related to underweight, higher waist measurement, and undesirable dietary habits. Results of our study can be applicable as a basic resource for development of effective nutrition counseling and education programs for improvement of mental health promotion during the critical transition to the middle adulthood stage.

본 연구는 만 40세 중년기의 대규모 성인을 대상으로 우울한 기분상태와 비만, 복부비만, 대사증후군, 혈압 검사, 혈액 검사 및 요검사의 건강특성 그리고 영양 생활습관 특성과의 관련성을 파악하고, 이들을 대상으로 효과적인 건강증진 프로그램을 개발하는데 기초자료로 활용하고자 시도하였다. 연구는 2011년 1월 1일부터 12월 31일까지 전국의 16개 한국건강관리협회 건강증진의원을 방문하여 생애전환기 건강진단을 수검한 총 27,684명의 검진결과에 대해 생애전환기 1차 건강진단의 문진에서의 정신건강 간이검사 결과에 따라 우울기분군과 비우울군을 분류하여 건강상태 및 영양생활습관과의 관련성을 분석하였고 그 결과는 다음과 같다. 전체 연구대상자의 6.4%인 1,781명은 우울기분군으로, 93.6%인 25,903명은 비우울군으로 분류되었다. 성별로는 남성의 4.3%, 여성의 8.0%가 우울기분군으로 우울기분의 분포는 남성보다 여성에서 유의하게 높았으며, 지역에 따라 다소 편차를 보였고, 건강보험가입자보다 경제적으로 취약한 의료급여수급자에서 높은 분포를 보였다. 또한 가족력이 없는 경우보다 있는 경우, 기존질환이 없는 경우보다 있는 경우 우울기분의 높은 분포가 유의하게 높았다. 체질량지수 (BMI)가 18.5 $kg/m^2$ 이하의 저체중에서 우울기분과의 관련성이 유의하게 높았으나 과체중 및 비만군은 정상군과 유의적 차이를 보이지 않았다. 그러나 허리둘레 기준 남성 90 cm 이상/여성 85 cm 이상의 복부비만에서 우울기분의 분포가 유의하게 높았고, 복부비만에서 우울기분의 오즈비가 유의하게 증가함을 보였다. 체질량지수의 저체중과 복부비만은 다른 일반 특성 및 흡연, 음주, 신체활동 등의 보정 후에도 유의적인 관련성을 나타냈다. 혈액 및 요검사 결과에서는 HDL-콜레스테롤과 트리글리세라이드 결과에 대한 질환의심 비율이 비우울군에서 유의하게 높았으며, 혈색소 결과에서는 질환의심의 비율이 우울기분군에서 유의하게 높았으나, 우울기분의 오즈비에 대해서는 다른 일반 특성 및 흡연, 음주, 신체활동 등의 보정 후 모두 유의한 차이를 보이지 않았다. 영양생활습관 평가 결과에서는 총점 28점 미만으로 바람직하지 않은 식습관을 갖고 있는 비율이 우울기분군에서 비우울군보다 유의하게 높았다. 특히 '우유, 두유, 유제품', '육류, 생선, 달걀, 콩, 두부를 통한 단백질 식품', '김치이외의 채소', '과일이나 과일 주스' 등의 섭취빈도가 낮을수록 '매끼 정해진 시간 식사'를 하지 못하는 경우에 우울기분과 더 높은 관련성을 가지는 결과를 보여주었다. 결론적으로 본 연구에서는 중년기 만 40세 성인의 우울기분은 영양 생활습관과 체질량지수 및 허리둘레에 따른 주요 건강특성과 관련성을 가지고 있으며, 부정적인 영양생활습관은 우울기분과 높은 관련성을 가지고 있음을 알 수 있었다. 따라서 이들을 대상으로 효과적인 질병예방과 건강증진 프로그램을 제공하기 위해서는 심리적 정신적인 건강관리를 위한 지원을 함께 병행하는 것이 매우 중요하며, 우울기분의 관리를 위해서는 영양생활습관의 개선을 교육, 지원하는 것이 필요하다 사료된다.

Keywords

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