Although the idea that obese people consume higher calorie diets is widely accepted, many dietary surveys have shown that obese people do NOT consume larger amounts of energy. We had an opportunity to study the relationship between calorie intake and obesity in Korea from the data contained in the '98 National Health and Nutrition Examination Survey of Korea. The survey was executed nationwide for two months - from Nov. 1 to Dec.30 in 1998. The survey included 10,876 (aged >10 years) subjects of whom 9,771 underwent health examinations. Surveyors visited each household and checked health status, measured anthropometry and blood pressures, collected blood and urine samples, and interviewed from the health questionnaires. Well-trained dietitians evaluated the food consumption of 11,525 subjects over the age of 1 year with the 24-hour recall method. The number of subjects from whom a complete health examination and food consumption information was obtained was 8,004. Subjects were classified by BMI (< 20, 20-22, 22-24, 24-26, 26-28, 28 $\leq$) and into newly diagnosed patients with DM (FBS $\geq$ 126 mg/㎗), hypertension (SBP $\geq$ 140 mmHg or DBP $\geq$ 90 mmHg) and hyperlipidemia (Total cholesterol $\geq$ 220 mg/㎗ or TG $\geq$ 200 mg/㎗). Our main results were as following:1) their average energy intake was 2,029.6 $\pm$ 908.5 ㎉ and BMI is 22.6 $\pm$ 3.4 kg/$m^2$;2) a comparison of nutrient intakes by BMI level did not show a significant difference of energy intake even though BMI increased (BMI, < 20: 1,999 ㎉ ∼ 28 $\leq$: 2,028 ㎉);and 3) Even in newly diagnosed patients with diabetes, hypertension or hyperlipidemia, their energy consumption was not significantly increased as BMI increased (from BMI 20). There are several possible explanations for these results:1) Reduced physical activity caused the weight of obese people to increase even with the same energy intake;2) people underreported their energy consumption;or, people intentionally reduced their energy consumption due to self-image regarding their obesity. We might also hypothesize that there is a metabolic problem conceiving obese people, because calorie intake was not higher in obese people than in non-obese people in Korea. Further research is necessary for re-evaluating these current conclusions.
This analysis was performed to investigate the relationship between nutrition and anthropometric indices using the data from a cross-sectional survey of a large national sample, '98 Korean national health and nutrition examination survey. Subjects were selected by stratified multistage probability sampling design and completed dietary questionnares including food intakes for one day by 24-hour recall method. For this analysis, 6566 subjects were selected by age(over 20 years old). For anthropometry, height, weight, and waist- and hip- circumference were measured. They were classified by body mass index(BMI, weight(Kg)/$height^2 $($m^2 $)) and waist-hip ratio(WHR, waist circumference(Cm)/hip circumference(Cm)). The nutrients intake of subjects were compared with the recommended daily allowances(RDA). Mean adequacy ratio(MAR) was calculated. Mean heights, weights, BMIs were higher in the groups with nutrient intake over 125% of RDA than the lower intake groups for most nutrients. However, Mean WHR was the highest in the groups with nutrient intake under 75% of RDA for most nutrients excluding iron intake of women aged 20-64 years. Among women aged 20-64 years, means of MAR were 0.71 for obese individuals(BMI>30), 0.72 for subjects with underweight(BMI<18.5), and 0.76 for subjects with normal weight(18.5$\leq$BMI<25). Normal subjects has statistically significantly higher MAR than those of other groups. However, among elderly people aged over 65 years, obese group had the highest MAR, 0.68. Women with abdominal obesity(WHR>0.9) had lower MAR, 0.71 than those with normal weight(MAR=0.76). From these results, obesity and abdominal obesity seems to be the results of malnutrition including both undernutrition and overnutrition rather than simple problem of excess energy intake. Obesity in elderly people needs to be handled differently from adults.
Younjhin Ahn;Lee, Ji-Eun;Paik, Hee-Young;Lee, Hong-Kyu;Inho Jo;Kim, Kuchan m
Nutritional Sciences
/
v.6
no.3
/
pp.173-184
/
2003
Objective : This study was carried out to develop a semi-quantitative food frequency Questionnaire (SQFFQ) for estimating average dietary intake to determine the risk factor for lifestyle-related diseases in a conjoint cohort study. Design : We developed an SQFFQ for genomic epidemiological studies based on the data in the'98 Korea Health and Nutrition Examination Survey. A subset of data on informative food items was collected using the 24-hr recall method with 2,714 adults aged 40 or older living in middle-sized cities or in rural areas in Korea. The cumulative percent contribution and cumulative multiple regression coefficients of 17 nutrients (energy, fat, carbohydrate, protein, fiber, iron, potassium, sodium, calcium, phosphorus, vitamin A, retinol, $\beta$-carotene, vitamin $B_1$, vitamin $B_2$, niacin and vitamin C) of each food were computed. Results : Two hundred and forty-nine foods, which were selected based on their 0.9 cumulative percent contribution, and 254 foods, which were selected based on their 0.9 cumulative multiple regression coefficients, respectively, were grouped into 97 food groups according to their nutrient contents. Several popular Korean foods, which were missing from the list due to the seasonality of the survey, were included. The portion sizes were derived from the same data set. The SQFFQ covered 84.8 percent of the intake of 17 nutrients in the one day diet record data of our 326 cohort study subjects. Conclusions . The final list included 103 food items. The foods list in the SQFFQ described herein accounted for 84.8 percent of the average intake of 17 nutrients. Therefore, the list could be used for the assessment of the baseline dietary intakes of the conjoint cohort studies.
The purpose of this study was to analyze a cohort, age, and time effects on sodium and sodium-calorie intake using the 2007~2017 Korea National Health and Nutrition Examination Survey (KNHANES). For analysis, we have constructed cohort panel data that combine KNHANES data in a time series. The age effect gradually increased from age 45~49 and then decreased afterwards. The time effect showed an increase in average sodium intake until 2010 followed by a subsequent decrease. The cohort effect showed that the sodium intake was the highest for the War of Liberation 1946~1953, and that the younger the latter, the lower the sodium intake. According to a cohort analysis, the younger the generation, the lower the sodium intake compared to the calorie intake, according to the baby boomers. Based on the results of this study, efforts should be made to educate and promote the dieting and providing low-salt meals to reduce sodium intake by generation. An analysis of the health hazards including sodium by generation and age is thought to enable the establishment relevant policies.
Objectives: This study was performed to investigate the associations of food security with socio-demographic characteristics, nutrient intakes and mental health status among older Korean adults. Methods: This study was conducted using data from the 2008-2010 Korea National Health and Nutrition Examination Survey (KNHANES). Subjects were 4,451 adults aged 65~98 years. Food security was measured using a self-reported question on food sufficiency of subjects' household. Based on the answers, study subjects were classified into secure, mildly insecure, moderately insecure, and severely insecure groups. Dietary intake was estimated by 24-hour dietary recall. Nutrient intake was assessed by dietary reference intakes (DRI). As for mental health status, the data on mental stress, depression, and suicide ideation were used. Results: Rate of food insecurity in older adults was 14.3%. Old age, being female, low education, low income level, living alone, and discomfort in daily living were more related to food insecurity. Means of nutrient intakes were significantly different according to food security status. Intakes of calcium, potassium, and vitamin $B_2$ were lower than recommended intakes in all groups. Consumption amounts of soy and soybean products, vegetables, mushrooms, fruits, vegetable oils, meats, eggs, seafood, and dairy products were lower in food insecure groups. Mental stress, depression, and suicide ideation were higher in food insecure groups independent of the gender and income level. Conclusions: These present findings suggested that food security is related to mental health as well as nutrition status in older Korean adults. A national system that include food and psychosocial support programs for the elderly should be considered in order to improve the overall health of older Korean adults.
This study was performed to determine the effects of dietary calcium (Ca) intake, milk and dairy product intake, and serum vitamin D level on bone mineral density. The survey data from the 2008-2009 Korea National Health and Nutrition Examination Survey (KNHANES) for adults (3,819 males, 5,625 females) aged > 20 years were examined; osteoporosis was defined according to the standards for Asian populations (T-score < -2.5). The risk for osteoporosis significantly decreased as Ca intake increased; this effect persisted (quartile 4 vs. quartile 1 of Ca intake: odds ratio [OR] 0.66; 95% confidence interval [CI]: 0.50-0.87) even after adjustment for gender, age, and other factors (body mass index, serum vitamin D, menstruation, female hormone intake, menopausal status, and the number of days per week of muscular strength exercise). Additionally, the risk for osteoporosis significantly decreased as the Ca/P ratio increased (quartile 4 vs. quartile 1: OR 0.76; 95% CI: 0.58-0.98). The degree of risk was 0.96 (0.66-1.38) in those who consumed < 1 portion of milk or dairy products daily, and 0.71 (0.53-0.96) in those who consumed > 1 portion per day, compared with those who had zero intake. The risk for osteoporosis significantly decreased as the serum 25(OH) vitamin D level increased. From these results, we advocate an increase in Ca, milk, and dairy product intake, and that serum 25(OH) vitamin D levels be maintained within the normal range, for the maintenance of bone health and the prevention of osteoporosis in adults.
objectives: This study was conducted to estimate medical expenditure attributable to overweight and obesity in adults with ischemic heart disease and stroke using Korea National Health and Nutrition Examination survey data and Korea National Health Corporation data. methods : The medical expenditure of ischemic heart disease and stroke related to overweight and obesity were composed of inpatient care costs, outpatient care costs and medication costs. The population attributable risk (PAR) of overweight and obesity was calculated from national representative data of Korea such as the National Health Insurance Corporation cohort data and 2005 Korea National Health and Nutrition Examination survey data. results: The medical expenditure attributable to overweight and obesity of ischemic heart disease were 97.4 billion won(74.1-122 billion won). and stroke were 64.6 billion won(33.1-98.1 billion won). Consequently, these costs corresponded to 11.4% of total medical expenditure due to ischemic heart disease and stroke. conclusion: We conclude that overweight and obesity have increased medical expenditure from ischemic heart disease and stroke in Korea. These findings provide important support for implementing overweight and obesity management strategies in Korea.
The relationship between mortality and the Korean Healthy Eating Index ("KHEI") is well established. This study was to investigate the associations between health habits, mental health, and nutritional status and KHEI in older Koreans (aged≥65 years). A total of 4,247 subjects (1,842 men and 2,405 women) that participated in the 2016~2018 Korean National Health and Nutrition Examination Survey were included in the analysis. The lowest scoring KHEI item was milk and milk products. KHEI tertile groups were classified by total KHEI score. Tertile group percentages were related to general characteristics such as gender, residential area, educational level, income level, number of family members, and age. Logistic regression analysis adjusted for general characteristics, showed that ex-smokers (OR: male 1.53 female 2.29), smokers (OR: male 2.90), low hand grip strength (OR: male 1.42 female 1.90), poor self-rated health status (OR: female 1.83), stressful mental status (OR: female 1.51), poor health-related quality of life (OR: female 1.64), poor nutritional status (OR: male 2.88~37.20 female 1.98~16.12), and food insecurity (OR: male 6.87 female 2.03) were significantly related to a lower KHEI. This study suggests that gender-specific associations exist between mental health status and KHEI.
BACKGROUND/OBJECTIVES: Studies on the impact of dietary fiber intake on kidney stones are few, and their results were controversial. This study aimed to explore the association between dietary fiber intake and kidney stones in the nationally representative population of the USA. SUBJECTS/METHODS: This cross-sectional research included 8,588 participants from the National Health and Nutrition Examination Survey, 2011 to 2018. Information regarding dietary fiber intake was obtained from a 24-h recall survey. Participants were categorized into different dietary fiber intake tertiles according to the average of 2 days of dietary recall data. The outcome was self-reported kidney stones. After adjusting for the traditional risk factors, a multivariate logistic regression model was used to examine the association between dietary fiber intake and kidney stones. RESULTS: Eight hundred seventy-two participants had kidney stones. The weighted prevalence (SE) of kidney stones in the lowest tertile, medium tertile, and highest tertile of dietary fiber intake was 11.8% (0.8%), 10.3% (0.8%), and 9.1% (0.8%), respectively. After adjusting for age, sex, race and ethnicity, education level, smoking status, alcohol consumption, physical activity, body mass index, hypertension, diabetes, dyslipidemia, daily water intake, chronic kidney disease stage 3-5, and total energy intake, participants with the highest tertile of fiber intake had a significantly lower risk of kidney stones (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.48-0.95) compared to those in the lowest tertile. Every 5 g/day increment in dietary fiber intake was associated with a significant decrease in risk of kidney stones (OR, 0.90; 95% CI, 0.83-0.98). CONCLUSION: An increase in dietary fiber intake was associated with a lower risk of kidney stones, suggesting adults should be encouraged to maintain an adequate dietary fiber intake to prevent the development of kidney stones. Our results provide evidence to formulate nutrition management strategies for the prevention of kidney stones.
Objectives : The aim of this study was to investigate the prevalence of metabolic syndrome and the association between lifestyle factors and the risk of metabolic syndrome in Korean adolescents. Methods : The metabolic syndrome was defined with ${\geq}$ 3 metabolic abnormalities using the age-modified criteria of the Adult Treatment panel III specified by National Cholesterol Education Program in adolescents aged 12 to 18 years who have participated in the Kroean National Health and Nutrition Examination Survey in 1998(n=936) and 2008(n=620). Physical activity and dietary intakes were assessed. Results : The overall prevalence of metabolic syndrome in Korean adolescents declined over 10 years (P < 0.01). Adolescents engaging regular exercise significantly increased over 10 years (P < 0.001). Physically activity was associated with a lower risk of metabolic syndrome (P < 0.001). Dietary intake patterns were not associated with a risk of metabolic syndrome. Conclusions : The prevalence of metabolic syndrome among Korean adolescents declined over 10 years which may be in part due to the increased regular physical activity. The risk of metabolic syndrome is lower in individuals who are physically active.
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