Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
권호 표지
DOI QR코드

DOI QR Code

Nutritional and health consequences are associated with food insecurity among Korean elderly: Based on the fifth (2010) Korea National Health and Nutrition Examination Survey (KNHANES V-1)

한국 노인에서 식품불안정 (food insecurity)이 건강상태 및 식이섭취상태에 미치는 영향 연구: 국민건강영양조사 제 5기 1차년도 (2010) 자료를 이용하여

  • Lee, Seungjae (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Lee, Kyung Won (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Oh, Ji Eun (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Cho, Mi Sook (Department of Nutritional Science and Food Management, Ewha Womans University)
  • 이승재 (이화여자대학교 식품영양학과) ;
  • 이경원 (이화여자대학교 식품영양학과) ;
  • 오지은 (이화여자대학교 식품영양학과) ;
  • 조미숙 (이화여자대학교 식품영양학과)
  • Received : 2014.06.09
  • Accepted : 2015.11.23
  • Published : 2015.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to examine the prevalence of food insecurity in Korean elderly and to analyze the health status as well as food and nutrient intakes according to food insecurity status. Methods: A total of 939 elderly subjects (over 65 years old) were used in our analysis from the fifth 2010 Korean National Health and Nutrition Examination Survey (KNHANES V-1). The variables consisted of general characteristics, physical and mental health, nutrient intake, rate of deficient intake of energy and nutrients compared with Dietary Reference Intakes for Koreans (KDRIs) and food quality and diversity according to the status of food insecurity. Food insecurity status was measured using a self-reported food security questionnaire on the dietary situation in the previous year, and participants were classified according to three groups: food secure group, mildly food insecure group, and moderately/severely food insecure group. Results: The proportion of the food insecure group was approximately 67% and the food insecure group had lower income and educational status than the food secure group. Food insecurity was associated with worse physical and mental health status after adjusting potentially confounding variables. The results showed that food insecurity in Korean elderly significantly affected mental health (including stress cognition, depression experience, and suicide thoughts) which exceeded stages of physical health. In addition, food insecurity showed significant association with low nutrient intake and high rate of deficient intakes of energy and nutrients compared with KDRIs, and a reduction of dietary quality and diversity was indicated in the food insecure group. Conclusion: This study concludes that the prevalence of food insecurity may affect the physical and mental health as well as dietary intake of the elderly Korean population. Therefore, food insecurity should be considered as an important public health issue in Korea.

본 연구는 식품불안정이 일반적 특성, 신체적 및 정신적 건강상태, 영양소 섭취량, 한국인영양섭취기준 (KDRIs) 대비 영양소 부족 섭취자의 비율, 식사의 질과 다양성 등에 미치는 영향을 밝히고자 하였다. 이에 제 5기 1차년도 (2010년) 국민건강영양조사 (KNHANES) 자료를 이용하여 65세 이상 노인 939명을 대상으로 하였고, 연구 결과를 요약하면 다음과 같다. 1) 식품불안정은 측정항목의 답변에 따라 총 3개의 그룹인 food secure 군 (FS)과 mildely food insecure 군 (FI 1), moderately/severly food insecure 군 (FI 2)으로 분류하여 분석에 이용하였다. FS군은 33.1%를. 식품불안정군 (FI 1, FI 2)은 67%를 차지하여, 전체대상자의 약 2/3가 식품불안정한 상태에 있는 것을 알 수 있었다. 2) 식품불안정에 따른 일반적 특성에서는 연령, 배우자의 유무, 교육수준, 소득수준에서 유의적인 관련성을 보였다. 식품 공급이 불안정 할수록 평균 연령이 높아졌으며, 교육수준과 소득수준은 낮아졌다. 식품불안정군에서 이혼과 사별을 포함하는 배우자가 없는 경우가 배우자가 있는 경우보다 더 많은 비율을 차지하고 있었는데, 이는 사별을 많이 경험하게 되는 노인에게서 유의미한 결과를 나타내었다. 3) 건강상태를 파악하기 위해 신체적 건강과 정신적 건강을 분석하였는데, 식품불안정 정도가 심각해질수록 건강상태가 좋지 못한 것으로 나타났다. 한국 노인에서는 식품불안정이 신체적 건강보다는 정신적 건강에 더 큰 영향을 미치는 것을 알 수 있었다. 스트레스 인지, 우울 증상 경험, 자살 생각여부를 포함하는 정신적 건강에서 식품불안정 정도가 심각해질수록 그 위험성이 커지는 것을 알 수 있었으며, 특히 식품불안정은 우울 증상을 야기할 뿐만 아니라 우울증의 유지요인으로 작용 하는 것으로 조사되었다. 4) 식품불안정과 영양섭취상태와의 관련성을 파악하기 위해 에너지 비율과 영양소 섭취량, 한국인영양섭취기준 대비 영양소 부족 섭취자의 비율을 조사하였는데, 대부분의 영양소에서 식품불안정군의 절대적인 섭취량이 적었고, 영양섭취기준보다 부족하게 섭취하는 자의 비율이 높았다. 5) 식품불안정군의 식사의 질과 식사의 다양성이 떨어지는 것으로 나타났고, 특히 식사의 다양성을 조사한 총 식품 점수 (DVS)와 식품군 점수 (DDS)에서 식품안정군과 식품불안정군 간의 점수 차이가 큰 것으로 나타났다. 결론적으로 한국 노인에게 식품불안정이 신체적 및 정신적 건강상태를 악화시키고 식이섭취상태에 부정적인 영향을 미치는 요인으로 작용하는 것으로 나타났다.

Keywords

References

  1. Lee MS. Health inequalities among Korean adults: socioeconomic status and residential area differences. Korean J Sociol 2005; 39(6): 183-209.
  2. Shim JS, Oh K, Nam CM. Association of household food security with dietary intake - based on the third(2005) Korea National Health and Nutrition Examination Survey(KNHANES III). Korean J Nutr 2008; 41(2): 174-183.
  3. Maxine J, Kate PC, Chris R. Toward reconstructing poverty knowledge: addressing food insecurity through grassroots research design and implementation. J Poverty 2009; 13(1): 1-19. https://doi.org/10.1080/10875540802623260
  4. Godfray HC, Beddington JR, Crute IR, Haddad L, Lawrence D, Muir JF, Pretty J, Robinson S, Thomas SM, Toulmin C. Food security: the challenge of feeding 9 billion people. Science 2010; 327(5967): 812-818. https://doi.org/10.1126/science.1185383
  5. Anderson SA. Core indicators of nutritional state for difficult-tosample populations. J Nutr 1990; 120(11 Suppl 11): 1559-1600.
  6. Campbell CC. Food insecurity: a nutritional outcome or a predictor variable? J Nutr 1991; 121(3): 408-415. https://doi.org/10.1093/jn/121.3.408
  7. Hamelin AM, Habicht JP, Beaudry M. Food insecurity: consequences for the household and broader social implications. J Nutr 1999; 129(2S Suppl): 525S-528S. https://doi.org/10.1093/jn/129.2.525S
  8. Alaimo K, Olson CM, Frongillo EA. Family food insufficiency, but not low family income, is positively associated with dysthymia and suicide symptoms in adolescents. J Nutr 2002; 132(4): 719-725. https://doi.org/10.1093/jn/132.4.719
  9. Whitaker RC, Phillips SM, Orzol SM. Food insecurity and the risks of depression and anxiety in mothers and behavior problems in their preschool-aged children. Pediatrics 2006; 118(3): e859- e868. https://doi.org/10.1542/peds.2006-0239
  10. Kwon SO, Oh SY. Associations of household food insecurity with socioeconomic measures, health status and nutrient intake in low income elderly. Korean J Nutr 2007; 40(8): 762-768.
  11. United States Department of Agriculture. Guide to measuring household food security, revised 2000, Washington, DC: United States Department of Agriculture; 2000.
  12. Guthrie JF, Nord M. Federal activities to monitor food security. J Am Diet Assoc 2002; 102(7): 904-906. https://doi.org/10.1016/S0002-8223(02)90202-6
  13. Kendall A, Olson CM, Frongillo EA Jr. Relationship of hunger and food insecurity to food availability and consumption. J Am Diet Assoc 1996; 96(10): 1019-1024. https://doi.org/10.1016/S0002-8223(96)00271-4
  14. Attree P. Low-income mothers, nutrition and health: a systematic review of qualitative evidence. Matern Child Nutr 2005; 1(4): 227-240. https://doi.org/10.1111/j.1740-8709.2005.00022.x
  15. Rose D. Economic determinants and dietary consequences of food insecurity in the United States. J Nutr 1999; 129(2S Suppl): 517S-520S. https://doi.org/10.1093/jn/129.2.517S
  16. Bhattacharya J, Currie J, Haider S. Poverty, food insecurity, and nutritional outcomes in children and adults. J Health Econ 2004; 23(4): 839-862. https://doi.org/10.1016/j.jhealeco.2003.12.008
  17. Tarasuk V, Mitchell A, McLaren L, McIntyre L. Chronic physical and mental health conditions among adults may increase vulnerability to household food insecurity. J Nutr 2013; 143(11): 1785-1793. https://doi.org/10.3945/jn.113.178483
  18. Parker ED, Widome R, Nettleton JA, Pereira MA. Food security and metabolic syndrome in U.S. adults and adolescents: findings from the National Health and Nutrition Examination Survey, 1999-2006. Ann Epidemiol 2010; 20(5): 364-370. https://doi.org/10.1016/j.annepidem.2010.02.009
  19. Lent MD, Petrovic LE, Swanson JA, Olson CM; Megan D. Maternal mental health and the persistence of food insecurity in poor rural families. J Health Care Poor Underserved 2009; 20(3): 645-661. https://doi.org/10.1353/hpu.0.0182
  20. Oh SY, Kim MY, Hong MJ, Jung HR. Food security and children's nutritional status of the households supported by the national basic livelihood security system. Korean J Nutr 2002; 35(6): 650-657.
  21. Choe JS, Ji SM, Park YH. The associations of household food insecurity with socioeconomic status, food behaviors, health status and nutrient intake in the elderly in rural areas. Korean J Community Living Sci 2009; 20(1): 19-32.
  22. Shim JE, Paik HY, Moon HK. Breakfast consumption pattern, diet quality and health outcomes in adults from 2001 National Health and Nutrition Survey. Korean J Nutr 2007; 40(5): 451-462.
  23. Kant AK. Indexes of overall diet quality: a review. J Am Diet Assoc 1996; 96(8): 785-791. https://doi.org/10.1016/S0002-8223(96)00217-9
  24. Kim SH, Chang MJ, Lee L, Yu CH, Lee SS. A survey of food and nutrient intakes of Korean women by age groups. Korean J Nutr 2003; 36(10): 1042-1051.
  25. Kim JS, Lee HS, Jung IK, Kwak DI. Depressive symptoms of the spousal bereaved elders. J Korean Geriatr Psychiatry 1998; 2(1): 85-93.
  26. Zisook S, Shuchter SR, Sledge PA, Paulus M, Judd LL. The spectrum of depressive phenomena after spousal bereavement. J Clin Psychiatry 1994; 55(4 Suppl): 29-36.
  27. Nuss WS, Zubenko GS. Correlates of persistent depressive symptoms in widows. Am J Psychiatry 1992; 149(3): 346-351. https://doi.org/10.1176/ajp.149.3.346
  28. Gilewski MJ, Farberow NL, Gallagher DE, Thompson LW. Interaction of depression and bereavement on mental health in the elderly. Psychol Aging 1991; 6(1): 67-75. https://doi.org/10.1037/0882-7974.6.1.67
  29. Lee S, Kim Y, Seo S, Cho MS. A study on dietary habits and food intakes in adults aged 50 or older according to depression status. J Nutr Health 2014; 47(1): 67-76. https://doi.org/10.4163/jnh.2014.47.1.67
  30. Chang HS, Kim M. A study on dietary status of elderly Koreans with ages. J Korean Soc Food Sci Nutr 1999; 28(1): 265-273.
  31. Kim K, Kim MK, Shin YJ, Lee SS. Factors related to household food insecurity in the Republic of Korea. Public Health Nutr 2011; 14(6): 1080-1087. https://doi.org/10.1017/S1368980010003733
  32. Kendall A, Olson CM, Frongillo EA Jr. Relationship of hunger and food insecurity to food availability and consumption. J Am Diet Assoc 1996; 96(10): 1019-1024. https://doi.org/10.1016/S0002-8223(96)00271-4
  33. Huet C, Rosol R, Egeland GM. The prevalence of food insecurity is high and the diet quality poor in Inuit communities. J Nutr 2012; 142(3): 541-547. https://doi.org/10.3945/jn.111.149278
  34. Willows ND, Veugelers P, Raine K, Kuhle S. Prevalence and sociodemographic risk factors related to household food security in Aboriginal peoples in Canada. Public Health Nutr 2009; 12(8): 1150-1156. https://doi.org/10.1017/S1368980008004345
  35. Tarasuk V, Vogt J. Household food insecurity in Ontario. Can J Public Health 2009; 100(3): 184-188.
  36. Kim K, Hong SA, Kim MK. Nutritional status and food insufficiency of Korean population through the life-course by education level based on 2005 National Health and Nutrition Survey. Korean J Nutr 2008; 41(7): 667-681.
  37. Klesges LM, Pahor M, Shorr RI, Wan JY, Williamson JD, Guralnik JM. Financial difficulty in acquiring food among elderly disabled women: results from the Women's Health and Aging Study. Am J Public Health 2001; 91(1): 68-75. https://doi.org/10.2105/AJPH.91.1.68
  38. Stuff JE, Casey PH, Szeto KL, Gossett JM, Robbins JM, Simpson PM, Connell C, Bogle ML. Household food insecurity is associated with adult health status. J Nutr 2004; 134(9): 2330-2335. https://doi.org/10.1093/jn/134.9.2330
  39. Choi R, Moon HJ, Hwang BD. The influence of chronic disease on the stress cognition, depression experience and suicide thoughts of the elderly. Korean J Health Serv Manag 2010; 4(2):73-84.
  40. Heflin CM, Siefert K, Williams DR. Food insufficiency and women's mental health: findings from a 3-year panel of welfarerecipients. Soc Sci Med 2005; 61(9): 1971-1982. https://doi.org/10.1016/j.socscimed.2005.04.014
  41. Oh SY. The association of dietary life, health behavior and mental health in Korean adolescents [dissertation]. Daejeon: Daejeon University; 2012.
  42. Jeong MS, Kim HK. A study on the nutritional status and health condition of elderly in Ulsan area. Korean J Diet Cult 1998; 13(3): 159-168.
  43. Kim JH, Kang SA, Ahn HS, Jung IK, Lee L. Relationship between cognitive function and dietary patterns in Korean elderly women. Korean J Nutr 1998; 31(9): 1457-1467.
  44. Lim YS, Cho KJ, Nam HJ, Lee KH, Park H. A comparative study of nutrient intakes and factors to influence on nutrient intake between low income elderly living in urban and rural area. J Korean Soc Food Sci Nutr 2000; 29(2): 257-267.
  45. Kim K, Hong SA, Kwon SO, Choi BY, Kim GY, Oh SY. Validation of food security measures for the Korean National Health and Nutrition Examination Survey. Korean J Community Nutr 2011; 16(6): 771-781. https://doi.org/10.5720/kjcn.2011.16.6.771
  46. Pérez-Escamilla R, Ferris AM, Drake L, Haldeman L, Peranick J, Campbell M, Peng YK, Burke G, Bernstein B. Food stamps are associated with food security and dietary intake of inner-city preschoolers from Hartford, Connecticut. J Nutr 2000; 130(11): 2711-2717. https://doi.org/10.1093/jn/130.11.2711
  47. Townsend MS, Peerson J, Love B, Achterberg C, Murphy SP. Food insecurity is positively related to overweight in women. J Nutr 2001; 131(6): 1738-1745. https://doi.org/10.1093/jn/131.6.1738
  48. Swindale A, Bilinsky P. Development of a universally applicable household food insecurity measurement tool: process, current status, and outstanding issues. J Nutr 2006; 136(5): 1449S-1452S. https://doi.org/10.1093/jn/136.5.1449S
  49. Webb P, Coates J, Frongillo EA, Rogers BL, Swindale A, Bilinsky P. Measuring household food insecurity: why it's so important and yet so difficult to do. J Nutr 2006; 136(5): 1404S-1408S. https://doi.org/10.1093/jn/136.5.1404S

Cited by

  1. Diet and Health Status of Elderly Women According to the Family Type vol.21, pp.3, 2016, https://doi.org/10.5720/kjcn.2016.21.3.256
  2. Dietary Assessment and Factors Related to Prevalence of Metabolic Syndrome in Korean Youth: Based on the Korea National Health and Nutrition Examination Survey 2007~2013 vol.27, pp.4, 2016, https://doi.org/10.7856/kjcls.2016.27.4.875
  3. Quality of life and subjective health status according to handgrip strength in the elderly: a cross-sectional study pp.1364-6915, 2017, https://doi.org/10.1080/13607863.2017.1387766
  4. An iodine database establishment and iodine intake in Korean adults: Based on the 1998~2014 Korea National Health and Nutrition Examination Survey vol.50, pp.6, 2017, https://doi.org/10.4163/jnh.2017.50.6.624
  5. Dietary Assessment and Frequency of Home Meals according to the Socio-economic Characteristics of Korean Adults: Data from the Korea National Health and Nutrition Examination Survey 2013~2015 vol.29, pp.2, 2018, https://doi.org/10.7856/kjcls.2018.29.2.169
  6. 한국 성인의 국물 음식류 섭취에 따른 식생활 평가 : 2011~2014 국민건강영양조사 자료를 이용하여 vol.49, pp.5, 2015, https://doi.org/10.4163/jnh.2016.49.5.335
  7. Evaluation of Dietary Habit and Nutritional Intake of Korean Elderly: Data from Korea National Health and Nutrition Examination Survey 2013∼2015 vol.28, pp.4, 2015, https://doi.org/10.17495/easdl.2018.8.28.4.258
  8. Evaluation of Dietary Habit and Nutritional Intake of Korean Elderly: Data from Korea National Health and Nutrition Examination Survey 2013∼2015 vol.28, pp.4, 2015, https://doi.org/10.17495/easdl.2018.8.28.4.258
  9. 전기노인과 후기노인의 식품안정성에 따른 식생활 및 건강 특성 : 제6기 (2013~2015년) 국민건강영양조사 자료 분석 vol.52, pp.1, 2015, https://doi.org/10.4163/jnh.2019.52.1.104
  10. Sex Differences in the Association between Living Environmental Factors and Nutritional Status in Community-Dwelling Elderly Koreans vol.17, pp.17, 2020, https://doi.org/10.3390/ijerph17176034
  11. Trends and Dietary Assessment According to Fruit and Vegetable Intake in Korean Elderly People: Analysis Based on the Korea National Health and Nutrition Examination Survey 1998, 2008, and 2018 vol.9, pp.11, 2020, https://doi.org/10.3390/foods9111712
  12. Dietary Assessment and Factors According to Fruits and Vegetables Intake in Korean Elderly People: Analysis of Data from the Korea National Health and Nutrition Examination Survey, 2013–2018 vol.12, pp.11, 2020, https://doi.org/10.3390/nu12113492
  13. Association of Food Insecurity with Nutrient Intake and Depression among Korean and US Adults: Data from the 2014 Korea and the 2013–2014 US National Health and Nutrition Examination Surveys vol.18, pp.2, 2015, https://doi.org/10.3390/ijerph18020506
  14. Food Security Status is not Associated with Increased Risk of Metabolic Syndrome in Korean Adults vol.19, pp.4, 2015, https://doi.org/10.1089/met.2020.0101
  15. 한국 노인의 연령 세분화에 따른 식사의 질과 주관적 건강 관련 인식 및 만성질환의 연관성 vol.26, pp.5, 2015, https://doi.org/10.5720/kjcn.2021.26.5.363