• Nutrition Research and Practice
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• 제16권2호
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• pp.233-247
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• 2022

BACKGROUND/OBJECTIVES: The objective of this study was to describe the development process of the Korean Healthy Eating Index (KHEI) based on the Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: The components of KHEI were selected based on Dietary Guidelines for Koreans, domestic and overseas dietary quality indices, and results of the analysis of association with chronic diseases. The standards for scoring of KHEI were selected based on the 2015 Dietary Reference Intakes for Koreans (KDRI). The KHEI scores of Korean adults were calculated using a 1-day 24-h recall data in the 2013-2015 KNHANES. RESULTS: The KHEI included eight adequacy components evaluating the proper intake of recommended foods such as fruit, vegetable, and milk and three moderation components evaluating the consumption of food that limit intake such as sodium and saturated fatty acid. In addition, three balance components assessing the balance of energy intake were included. The KHEI score was defined to range from the minimum of 0 point to the maximum of 100 points. Among Korean adults, the total KHEI score was 63.2 out of 100. Gender and age differences were found in the average of total KHEI scores. Women showed higher score than men (61.7 in men and 64.7 in women, respectively). By age group, 20s and 30s showed the lowest scores with 57.4 and 61.1 respectively, and the scores increased with age by peaking at 67.8 in ages 60-69 and slowed down again in ages 70 or over. CONCLUSIONS: The KHEI can be useful for establishing and assessing national nutritional policies and in epidemiological studies to assess the relationship between overall dietary quality and chronic diseases. KHEI will need to be continuously updated to reflect changes in dietary guidelines and the KDRI.

• 대한영양사협회학술지
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• 제22권2호
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• pp.88-105
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• 2016

This study investigated anthropometric and biochemical characteristics, food and nutrient intakes, and changes in body mass index (BMI) of Korean middle age men (40~49 yrs). Data on BMI, anthropometric (height, weight, waist circumference, body mass index, blood pressure), and biochemical (total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, hemoglobin, GOT, GPT) characteristics, food and nutrients intakes, nutrient density, and index of nutrient quality were obtained from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES, 2001, 2005, 2011). Subjects were divided into three groups by year. Weight, BMI, and hemoglobin increased significantly by year. All anthropometric factors except height showed a positive relation with BMI by year. Consumption of barley, chinese noodle, confections, soybean milk, egg, ice cream, pizza, fried foods, banana, coffee, and raw rice wine increased significantly by year. Intake ratios of nutrients except water and fiber were over 100% of KDRI generally. INQ according to intakes of protein, calcium, phosphorus, iron, vitamin A, thiamine, riboflavin, and niacin per 1,000 kcal increased significantly by year. Distribution of BMI status of subjects showed a significant difference by exercise. The findings of the present study show that BMI of subjects increased by year, and intakes of all nutrients except calcium and riboflavin showed aspects of overnutrition by year. Intakes of fruits decreased while intakes of raw rice wine and coffee increased by year. Therefore, practical and systematic nutrition programs are required to maintain optimum BMI and appropriate intakes of nutrients to maintain a desirable lifestyle and improve dietary life.

• 보건교육건강증진학회지
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• 제33권3호
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• pp.37-48
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• 2016

Objectives: The purpose of the study was to find determinants for participation in the National health screening program participation according to sex in Korean. Methods: Data for 5,355 from the Korea National Health and Nutrition Examination Survey VI was included. Impact factors were analyzed by sex using logistic regression. Results: The participation in men rates(65.6%) higher than women(60.6%). In the case of men, those who have higher age (OR=0.33, 95% CI 0.21-0.52), higher income(OR=0.72, 95% CI 0.54-0.97), higher education (OR=0.54, 95% CI 0.36-0.81), occupation(OR=1.80, 95% CI 1.38-2.36), spouse(OR=1.95, 95% CI 1.45-2.62) were shown to have health examination more frequently. In the case of women, those who live in more developed city(OR=1.42, 95% CI 1.1-1.76), have higher age(OR=0.17, 95% CI 0.11-0.26), higher income(OR=0.17, 95% CI 0.11-0.26), higher education(OR=0.68, CI 0.46-0.99), occupation(OR=1.54, CI 1.32-1.80) and health insurance(OR=2.68, 95% CI 1.17-6-15) were shown to have health examination more frequently insurance were shown to have health examination more frequently. Conclusions: As a result, for both, age, income, education and occupation influenced health examination rate. Additionally, for men, marital status and for women, residence and the type of their health insurance was influenced. Individualized intervention is needed to increase participation rate.

• 대한지역사회영양학회지
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• 제26권4호
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• pp.296-306
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• 2021

Objectives: The objective of this study was to estimate the distribution of the usual dietary intake of foods with respect to the probability of consumption derived from the Food Frequency Questionnaire (FFQ) of the 2009 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: The intake quantity and frequency of 63 food items were assessed from the 2009 KNHANES which was completed by 7,708 participants. The participants completed one or two 24-h dietary recalls and one FFQ. The usual intake distribution was estimated using the multiple source method (MSM), and the proportion of non-consumers was calculated through the usual intake distribution. This was then compared with the proportion of non-consumers from the 24-hour recall method. Results: The difference in the proportion of non-consumers ranged from 2% to 82.9%, indicating that there is a very large difference based on food groups. The food groups in which the proportion of non-consumers did not differ was composed of foods consumed daily, such as 'rice', 'cereal and barley', and 'Chinese cabbage and kimchi', or foods with distinct palatability such as 'coffee' and 'alcohol'. On the other hand, in the case of the food groups with a high difference in the proportion of non-consumers, most comprised fruits that emphasized seasonality. Conclusions: In the case of foods or food groups that are occasionally consumed, it is desirable to use 2 recalls with additional FFQ data by combining the consumption frequency and the quantity consumed.

• 대한영양사협회학술지
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• 제22권3호
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• pp.151-162
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• 2016

The purpose of this study was to investigate the relationship between Kimchi intake and the prevalence of metabolic syndrome in Korean adults (over 19 years old), using data from the Korean National Health & Nutrition Examination Survey (KNHANES), 2007~2012. A total of 30,630 participants were analyzed in this study. Metabolic syndrome was diagnosed using the NCEP ATP III criteria standards. Out of the 30,630 participants, 8,230 (23.45%) had meatabolic syndrome. When the subjects were grouped by their Kimchi intake, those who consumed a sufficient amount (36.0~82.125 g) showed a lower prevalence of metabolic syndrome (P<0.001). However, multiple logistic regression analysis results after adjusting for sex and age, exercise status, smoking status, drinking status, energy intake, income level, occupation, area, frequency of eating-out, showed that the Kimchi intake did not significantly affect the odds ratio of metabolic syndrome. High sodium contents of Kimchi was the major cause of various cardiovascular diseases, and was associated with the hypertension risk factors of the metabolic syndrome. However, in this study, the Kimchi intake, even after adjusting sodium intake, did not have negative influence on the development of metabolic syndrome.

• 대한지역사회영양학회지
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• 제27권3호
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• pp.245-253
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• 2022

Objectives: This study was conducted to find out if the dietary iron intake of Koreans estimated by 2 different methods (iron content sources) using the food intake data from the Korea National Health and Nutrition Examination Survey (KNHANES) are comparable. One method was based on the KNHANES's Food & Nutrient Database (FND) derived mainly from the Korean Food Composition Table and the other used the iron content (IC) of food samples processed in the Korean Total Diet Study (KTDS). Methods: Dietary intake data from the 2013-2016 KNHANES was used to select representative foods (RFs) in KTDS for iron analysis. Selection of the RFs and cooking methods for each RF (RF × cooking method pair) was performed according to the 'Guidebook for Korean Total Diet Studies' and resulted in a total of 132 RFs and 224 'RF × cooking method' pairs. RFs were collected in 9 metropolitan cities nationwide once or twice (for those with seasonality) in 2018 and made into 6 composites each, based on the origin and season prior to cooking. Then, the RF composites prepared to a 'table ready' state for KTDS were analyzed by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Dietary iron intake of the Korean population was estimated using only RFs' intake data based on the 2 sources of iron content, namely FND-KNHANES and IC-KTDS. Results: RFs in KTDS covered 92.0% of total food intake of Koreans in the 2016-2018 KNHANES. Mean iron intake of Koreans was 7.77 mg/person/day by IC-KTDS vs 9.73 mg/person/day by FND-KNHANES. The major food groups contributing to iron intake were meats (21.7%), vegetables (20.5%), and grains & cereals (13.4%) as per IC-KTDS. On the other hand, the latter source (FND-KNHANES) resulted in a very different profile: grains & cereals (31.1%), vegetables (16.8%), and meats (15.3%). While the top iron source was beef, accounting for 8.6% in the former, it was polished rice (19.2%) in the latter. There was a 10-fold difference in the iron content of polished rice between 2 sources that iron intakes excluding the contribution by polished rice resulted in very similar values: 7.58 mg/person/day by IC-KTDS and 7.86 mg/person/day by FND-KNHANES. Conclusions: This study revealed that the dietary iron intake estimated by 2 different methods were quite comparable, excluding one RF, namely polished rice. KTDS was thus proven to be a useful tool in estimating a 'closer-to-real' dietary intake of nutrients for Koreans and further research on various nutrients is warranted.

• 대한영양사협회학술지
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• 제23권1호
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• pp.39-53
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• 2017

Insufficient vitamin D intake is a major health problem around the world. Recently, many studies have suggested that vitamin D intake may influence insulin resistance. However, little is known about the association between vitamin D and diabetes mellitus. The aim of this study was to investigate the association between serum 25-hydroxy vitamin D (25(OH)D) levels and diabetes mellitus in Korean adults. This study was a cross-sectional analysis of 3,686 participants of the Korean National Health and Nutrition Examination Survey (KNHANES) 2013~2014 aged 19 years and higher. The results showed that the mean serum 25-hydroxy vitamin D (25(OH)D) level in Korean adults was 16.77 ng/mL, and 74.2% of them had an insufficient serum 25-hydroxy vitamin D (25(OH)D) level (below 20 ng/mL). In normal and pre-diabetic groups, the serum 25-hydroxy vitamin D (25(OH)D) level significantly increased with age (P<0.001), but there was no significant difference relative to age in the diabetic group. Low vitamin D levels (25-hydroxy vitamin D < 10 ng/mL) were associated with increased fasting blood glucose levels, compared with optimal vitamin D levels (25-hydroxy vitamin D > 30 ng/mL), after adjusting for variables that may affect fasting blood glucose, but this result was not significant. In conclusion, although no significant association was observed between diabetes prevalence and vitamin D levels in this study, further studies are needed because the effect of vitamin D on diabetes remains controversial. This nutrient plays a crucial role in the body, and levels are insufficient in the Korean population.

• 대한영양사협회학술지
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• 제21권3호
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• pp.181-193
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• 2015

This study investigated anthropometric and biochemical characteristics, nutrient intakes, and bone density of Korean elderly men (over 65 yrs). Data on bone density and anthropometric (height, weight, waist circumference, body mass index and blood pressure) and biochemical (total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, triglyceride and hemoglobin) characteristics, nutrient intakes, and nutrient density were obtained from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES, 2008~2011). Subjects were categorized into smoking and non-smoking groups, and smoking groups were divided into three groups by smoking period (under 20 yrs, 21~40 yrs and over 41 yrs). Serum triglyceride concentrations of the smoking group aged 21~40 yrs were higher than those of other groups (P<0.01), whereas other biochemical factors were not different. Intake ratios of energy, protein, phosphorus and sodium in subjects were over 100% of Dietary Reference Intake for Koreans (KDRI). Nutrient densities according to intakes of thiamin, riboflavin, and niacin per 1,000 kcal were significantly different among the groups (P<0.05). Bone density of subjects decreased according to smoking period (T-score of total femur in non-smoking group -0.3108, and -0.2918, -0.4941, -0.6847 in smoking group, respectively). Ratio of osteoporosis was 38.1% in the non-smoking group and 44.4%, 51.1%, and 64.0% in the smoking group, respectively. The findings of the present study show that smoking may be associated with bone health, higher ratio of osteoporosis, and low nutrient density in elderly men. Therefore, practical and systematic non-smoking programs are required to improve the bone density of elderly men as well as maintain healthy bone levels and desirable lifestyle.

• 대한영양사협회학술지
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• 제20권3호
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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.

• 동아시아식생활학회지
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• 제24권6호
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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.