• Journal of the Korean Dietetic Association
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• v.20 no.3
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• pp.157-173
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• 2014

The main purpose of this study was to investigate factors that affect bone mineral density (BMD) in Korean adult women ($20{\sim}80{\leq}yr$). Data on BMD, anthropometric (height, weight, body mass index, waist circumference, and body fat), and biochemical (total cholesterol, vitamin D, and alkaline phosphatase) measurements were obtained from the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (KNHANES, 2008~2011). Overall, the BMD of subjects had decreased from year to year: the T-scores decreased from 0.657 (2008~2009) to 0.295 (2010~2011) in 40~49 yr group and from 0.076 to -0.081 in 50~59 yr group. Age was negatively associated with BMD (T-scores of 0.388 in 20~29 yr group and -1.952 in ${\geq}80yr$ group for total femoral). BMD continuously increased with increased weight and body mass index (BMI). High values of total cholesterol (T-scores of -0.005 in 201~229 mg/dL group and -0.094 in ${\geq}230mg/dL$ group for total femoral) and alkaline phosphatase (T-scores of 0.481 in ${\geq}102IU/L$ group and -0.674 in ${\geq}336IU/L$ group for total femoral) were associated with lower BMD. Overall height, weight, and BMI were positively associated with BMD, whereas total cholesterol and alkaline phosphatase (ALP) were negatively associated with BMD. Findings of the present study show that bone loss may be associated with various factors such as age, weight, BMI, total cholesterol, and ALP et al., and that much attention should be paid to bone health of adult women. Therefore, practical and systematic programs are required to improve the BMD of adult women as well as to maintain healthy bone levels.

• Journal of Nutrition and Health
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• v.46 no.6
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• pp.540-551
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• 2013

Vitamin D deficiency (VDD) is becoming an epidemic and thereby a global health problem. Further, VDD adversely affects calcium metabolism and skeletal health, and is associated with increased risk of several diseases, e.g., autoimmune diseases, several types of cancers, type 2 diabetes mellitus, cardiovascular diseases, infectious diseases, asthma, psoriatic arthritis, and etc. To evaluate the prevalence of VDD in Korea, and then to evaluate the association of several factors with serum 25(OH)D level, the author analyzed the data of 14,456 individuals who were 10 years of age and over from the Fifth Korea National Health and Nutrition Examination Survey 1 & 2 (KNHANES V-1 & 2) conducted by the Korean Centers for Disease Control & Prevention. As a result, among Koreans (age $${\geq_-}$$ 10years), 65.9% of males and 77.7% of females were below optimum blood serum 25(OH)D (20 ng/mL). VDD is more severe in female than in male at all age groups. In addition, the younger generations had less 25(OH)D level than older generations in Korea. The analysis by complex sample general linear model (CSGLM) suggested that blood 25(OH)D concentration was related with gender (p < .001), residence (p = .030), occupation (p < .001), anemia (p < .001) and physical activity (p < .001). In conclusion, VDD is pandemic and it is more severe in younger generations in Korea. Further, from the results by CSGLM, serum 25(OH)D status is closely related with the life style of Koreans.

• Journal of the Korean Dietetic Association
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• v.20 no.2
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• pp.110-122
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• 2014

This study investigated factors affecting the bone mineral density (BMD) of Korean young adult women (20~30 yrs) living in Seoul, according to the state of employment. Data on BMD and anthropometric and biochemical measurements were obtained from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V) (2010~2011). BMD of the working group (WG) was generally higher than that of the non-working group (NWG). The prevalence of osteopenia, and osteoporosis between the groups was 29.0/31.5%, and 12.9/18.5% from 20~29 yrs as well as 25.5/24.1%, and 20.2/20.5% from 30~39 yrs, respectively. From 20~29 yrs, prevalence of osteopenia and osteoporosis in the WG was lower than that of the NWG. Alkaline phosphatase activity of the WG was lower than that of the NWG. In the WG, from 20~29 yrs, total femur BMD showed significant positive correlations with waist circumstance and BMI. In the NWG, from 20~29 yrs, total femur, femoral neck, and lumbar spine BMDs showed significant positive correlations with weight and fat mass, whereas they showed significant negative correlations with vitamin D. In the WG, from 30~39 yrs, total femur and femoral neck BMDs showed significant positive correlations with weight and free fat mass. The results of this study show that BMD of young adult women is insufficient regardless of their employment status. Therefore, practical and systematic programs are required to improve the BMD of young adult women as well as to maintain healthy bone levels.

• The Journal of the Korean dental association
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• v.51 no.5
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• pp.265-273
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• 2013

The insurance payment plan for dental implants in Korea has been criticized because the payment priority has not been properly established, and the benefits are concentrated among middle-class citizens. In the current study, the relationship between the oral health condition and socioeconomic status of the elderly was analyzed using data from the Korea National Health and Nutrition Examination Survey (KNHANES). This study aims to determine the reason underlying the criticism of the insurance payment plan. The subjects were >65-year-old individuals in the 2010 and 2011 database of KNHANES. Data from 2,812 subjects were analyzed. The socioeconomic status was determined based on edentulousness, molar tooth loss, and presence of 28 teeth. According to the analysis, the average income was 1,560,000 won for edentulous elderly, 1,811,000 won for elderly who had lost molar teeth, and 1,896,000 won for elderly with 28 teeth (p<0.05). In addition, elderly with a low education level demonstrated a poor oral health condition (p<0.001). In conclusion, the insurance plan currently under examination is not properly designed for economically impoverished elderly because the plan only covers 50% of the costs and is limited to implantation of molar teeth only. This plan will not provide practical benefits to elderly with a poor socioeconomic status; therefore, the insurance payment plan needs to be improved so that the appropriate beneficiaries can be targeted.

• Journal of the East Asian Society of Dietary Life
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• v.24 no.6
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• pp.710-722
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• 2014

This study investigated factors affecting the bone mineral density (BMD) of Korean adult men. Data on BMD and anthropometric (height, weight, body mass index, BMI, waist circumference, body fat) and biochemical(total cholesterol, vitamin D, alkaline phosphatase, ALP) measurements were obtained from the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (KNHANES, 2008~2011). Overall, BMD of the subjects was decreased from year to year (T-score of 30~39 yr decreased to 0.447 (2010~2011) from 0.106(2008~2009) and in 50~59 yr decreased to 0.234 from 0.033. Age was negatively associated with BMD (T-score 0.361 of 20~29 yr group and -0.894 of ${\geq}80yr$ group in total femoral). According to increase of weight, BMI and waist circumference continuously increased BMD. High value of total cholesterol (T-score 0.157 of 201~<230 mg/dL group and 0.064 of ${\geq}230mg/dL$ group in total femoral) and alkaline phosphatase (T-score 0.337 of ${\leq}102IU/L$ group and -0.270 of ${\geq}336IU/L$ group in total femoral) were associated with lower BMD. Overall height, weight and BMI were positively associated with BMD, and ALP were negatively associated with BMD. Finding of the present study showed that bone loss may be associated with various factors such as age, weight, BMI, total cholesterol, vitamin D and ALP density and that much attention should be paid to bone health of adult men. Therefore, practical and systematic programs are required to improve the BMD of adult men as well as to maintain bone health.

• Health Policy and Management
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• v.32 no.2
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• pp.228-236
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• 2022

The aim of this study was updating suicide-related indicators, including the number of suicidal deaths, suicide rate, and the prevalence of suicidal ideation and suicide attempts. We observed trends in suicide-related indicators based on up-to-date information. This study used five data sources to evaluate the trends of suicide-related indicators: Statistics Korea (1983-2020), Korean Wealth Panel Study (KOWEPS, 2012-2020), and Korea Health Panel Survey (KHP, 2010-2013, 2016-2018), Korean National Health and Nutrition Examination (KNHANES, 2007-2013, 2015-2020), and Korean Community Health Survey (KCHS, 2008-2009, 2013, 2017). The suicide rate per 100,000 population decrease from 26.9 in 2019 to 25.7 in 2020. Based on recently available data, the rates of suicidal ideation were 1.48% (KOWEPS, 2020), 2.61% (KHP, 2018), 4.62% (KNHANES, 2019), and 6.96% (KCHS, 2017). Those of suicide attempt as were 0.07% (KOWEPS, 2020), 0.44% (KNHANES, 2020), and 0.32% (KCHS, 2017). Annual percentage change (APC) of suicide rate was -1.87% (Statistics Korea, 2011-2020). APC of suicidal ideation was -10.7% (KOWEPS, 2012-2020), -11.5% (KHP, 2010-2013, 2016-2018), -14.7% (KNHANES, 2007-2013, 2015, 2017, 2019), and -2.5% (KCHS, 2008-2009, 2013, 2017). APC of suicide attempt was -11.3% (KOWEPS, 2012-2019), -5.2% (KNHANES, 2007-2013, 2015-2020), and -4.4% (KCHS, 2008-2009, 2013, 2017). Although the suicide rate in Korea has decreased compared to 10 years ago, it is still at a high level. Thus, continuous observation and appropriate suicide prevention policies are needed.

• Korean Journal of Community Nutrition
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• v.22 no.2
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• pp.136-144
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• 2017

Objectives: The purpose of this study was to determine which factors influence the bone mineral density (BMD) of total femur (TF), femoral neck (FN) and lumbar spine (LS) of the adult men by analyzing nationally representative Korean survey data. Methods: This study was conducted based on the data of 1,770 men aged 19-64 years from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2011. The BMD was analyzed by various factors (general characteristics, anthropometric data, health habits, chronic diseases, nutrient intake status). SPSS statistics for complex samples was used to analyze the data. Results: We observed that the BMD decreased significantly with aging. The BMD in each of the second lowest quartile of waist circumference (in TF & FN) and body mass index (in TF & LS) was lower than the respective BMD in the highest quartile group. The BMD in FN was higher in the group who reported the weight training. The BMD in LS was lower in hypercholesterolemia group than in the normal group. The BMD in TF, FN and LS was lower in hypertriglyceridemia group and in diabetes group than in the normal group. The BMD in TF, FN and LS was higher in the group with < Estimated Average Requirement iron intake. But there was no evidence to suggest that the BMD was related with educational level, income level, smoking, alcohol intake, anemia and nutrient intake status (except for iron). Conclusions: This study suggested that aging, waist circumference, body mass index, weight training, hypercholesterolemia, hypertriglycemia, diabetes were site-specifically associated with the BMD in TF, FN and LS in the adult men. These bone site-specific factors need to be considered for the prevention of osteoporosis.

• Journal of the Korean Dietetic Association
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• v.22 no.2
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• pp.106-117
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• 2016

Osteoporosis is a major health problem that can lead to mortality. This study was conducted to estimate the prevalence of osteopenia and osteoporosis separately and to assess the risk factors associated with osteopenia/osteoporosis in Korean men aged 50 years and over. A total of 1,136 subjects were analyzed among the participants of the Korea National Health and Nutrition Examination Survey (KNHANES) 2010~2011 by using SPSS statistics complex samples (windows ver. 23.0). The prevalence rates of osteopenia and osteoporosis were 46.3% and 7.3%, respectively, and the mean ages of both osteopenia and osteoporosis risk groups were significantly higher than that of the normal group. The mean values for lifetime tallest height and bone mineral density in whole body, total femur, femoral neck, and lumbar spine were significantly lower in the risk group(osteopenia/osteoporosis) than in the normal group, whereas the mean values for height, body weight, BMI, waist circumference, alkaline phosphatase, parathyroid hormone, fasting blood glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides of the two groups showed no significant differences. The intakes of energy and carbohydrates were significantly higher in the risk group than in the normal group. The results of multiple logistic regression showed that being underweight and having hypercholesterolemia were significantly related with the prevalence of osteopenia/osteoporosis, whereas health habits such as smoking and exercise, chronic diseases such as obesity and hypertension, and nutrient intakes were not. These findings suggest the need for further studies to examine osteopenia/osteoporosis risk factors and outcomes specificly focused on Korean men.

• Nutrition Research and Practice
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• v.15 no.4
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• pp.528-540
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• 2021

BACKGROUND/OBJECTIVES: In a healthy person, from 35 years of age, there is an annual loss of muscle mass at the rate of 1-2% and is associated with a decline in the quality of life. This study aimed to identify the particular dietary patterns associated with the risk of lower lean muscle mass in Korean postmenopausal women. SUBJECTS/METHODS: The Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based, continuous cross-sectional annual survey. The participants of the KNHANES IV (2008-2009) and V (2010-2011) were considered for this study. The study sample consisted of 1548 postmenopausal women, aged 45-86 years. Lower lean muscle mass was defined as having appendicular skeletal muscle mass corrected for body weight less than 1 standard deviation of the young reference group aged 20 to 39 years in KNHANES IV and V. To identify the dietary pattern using factor analysis, 24-h recall data was used. RESULTS: The prevalence of lower lean muscle mass was 31.3% in this study population. Four dietary patterns were identified by factor analysis; 'Diverse', 'Western', 'Traditional', and 'Snacks and beverages'. The 'Western' pattern, highest factor loadings for flour and bread, potatoes, red meat, processed meat, eggs, and cheese, was significantly associated with a high (60%) risk of lower lean muscle mass (odds ratio [95% confidence interval] = 1.60 [1.07-2.39], P for trend = 0.01) after adjustments for potential covariates. The other 3 dietary patterns were not associated with lower lean muscle mass. CONCLUSIONS: The study findings suggest that the 'Western' dietary pattern that includes flour and bread, potatoes, red meat, processed meat, eggs, and cheese, may be associated with a higher risk of lower lean muscle mass in Korean postmenopausal women.

• Tuberculosis and Respiratory Diseases
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• v.83 no.4
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• pp.268-275
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• 2020

Background: It is not evident that the attributable risk of smoking on mortality in Korea has decreased. We investigated the impact of smoking on all-cause mortality and estimated the attributable risk of smoking in Korean adults. Methods: Those aged ≥20 years with smoking history in the Korean National Health and Nutrition Examination Surveys (KNHANES) 2007-2015 were enrolled. We categorized the participants into three groups as follows: never smoker, <20 pack-years (PY) smokers, and ≥20 PY smokers. We applied inverse probability weighting using propensity scores to control various confounders between the groups. All-cause mortality risks were compared between the groups using the Kaplan-Meier log-rank test. The effects of smoking-attributable risks (ARs) on mortality were also calculated. Results: A total of 50,458 participants were included. Among them, 19,334 (38.3%) were smokers and 31,124 (61.7%) were never smokers. Those with a smoking history of 20 PY or more (≥20 PY smokers), those with a smoking history of less than 20 PY (<20 PY smokers), and never smokers were 18.1%, 20.2%, and 61.7%, respectively, of the study population. Smokers had a higher risk of all-cause mortality compared to never smokers (log-rank test p<0.01). The ARs of smoking were 21.8% (95% confidence interval [CI], 5.7%-37.9%) and 9.0% (95% CI, 6.1%-12.0%) in males and females, respectively. ARs decreased from 24.2% to 19.5% in males and from 9.5% to 4.1% in females between 2007-2010 and 2011-2015. Conclusion: Our study using KNHANES IV-VI data demonstrated that smoking increased the risk of all-cause mortality in a dose-response manner and the ARs of smoking on mortality were 21.8% in males and 9.0% in females during 2007-2015. This suggests that the ARs of smoking on mortality have decreased since around 2010.