• Nutrition Research and Practice
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• 제16권6호
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• pp.755-764
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• 2022

BACKGROUND/OBJECTIVES: Cardiovascular diseases (CVDs) are the leading cause of death in Koreans, and eating habits, including diet quality, are among the etiologies of these diseases. Recently, various studies on regional health disparities have been conducted. However, there are limited studies on their relationship with nutritional factors. This study aimed to identify the magnitude of regional disparities in diet quality and prevalence of CVD in Korean adults. SUBJECTS/METHODS: This study included 17,646 participants aged ≥ 20 years from the 7^th (2013-2016) Korean National Health and Nutrition Examination Survey. Participants were classified into four groups based on their residential areas: City 1, City 2, City 3, and non-city. Demographic characteristics, health-related factors, body mass index (BMI), metabolic syndrome index, diet quality, and CVD prevalence were evaluated. RESULTS: In terms of demographic characteristics, age (P < 0.001), marital status (P < 0.001), educational level (P < 0.001), and income (P < 0.001) were lower in the non-city category. Health-related factors such as monthly drinking rate (P < 0.01) and mental stress (P < 0.05) were the highest in City 1 and lowest in the non-city group. Conversely, the current smoking rate (P < 0.05), BMI (P < 0.05), and prevalence of metabolic syndrome (P < 0.001) were the highest in the non-city group (P < 0.05). The non-city group also had the highest prevalence of CVDs (35.6%). This group had the lowest diet quality index (68.36 ± 0.22, P < 0.01), caused by low intake of fruit and calcium, a lack of sodium moderation, and an overall imbalance in the macronutrient and fatty acid ratio. When the diet quality index was increased by 1, the odds ratio for the prevalence of CVDs was reduced by 0.991 (P < 0.001), but this was not the case in all regions. CONCLUSIONS: This study provides useful information and data in identifying and resolving the regional health disparities related to CVD prevalence and implementation of public health nutrition systems.

• Journal of Preventive Medicine and Public Health
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• 제44권2호
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• pp.93-100
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• 2011

Objectives: This study was performed to identify the socioeconomic factors, health behavior factors and dietary patterns that have an influence on the fasting blood glucose in adults. Methods: This study used data collected from the 2007, 2008, 2009 Korea National Health and Nutrition Examination Survey. The final sample included 4163 subjects who were 30-59 years old and who had completed the necessary health examinations, the health behaviors survey and nutrition survey. Results: Eleven dietary patterns emerged from the factor analysis with different factor loading. After controlling for potential confounders, multiple regression analysis of the dietary patterns showed that 'fruits', 'alcohols', and 'starchy foods' affected the fasting blood. Lower consumption of 'fruits' and higher consumption of 'alcohols' and 'starch foods' were significantly associated only with an increased risk of high blood glucose. Conclusions: In the light of the results of this study, it appears pretty likely that the risk of developing high blood glucose can be reduced by changing a person's dietary patterns.

• Journal of Nutrition and Health
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• 제50권6호
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• pp.585-594
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• 2017

Purpose: Food intake of COPD patients decreases because of appetite loss, depression, and breathing problems while eating, which increase the likelihood of patients becoming malnourished. This study investigated the nutrient intake and dietary quality of people with and without COPD in Korea. Methods: There were 2,160 adults aged 50 and over who participated in the $5{\sim}6^{th}$ Korea National Health and Nutrition Examination Survey. The subjects were divided into the COPD group and non-COPD group according to the rate of forced expiratory volume at 1 second (FEV1) against forced vital capacity (FVC). Consumption of food and nutrients were calculated based on the nutrition examination survey. Statistical analyses were conducted using SPSS 19.0. Results: Among individuals in their 50s, intake of vitamin $B_1$ in the COPD group was significantly less than the NCOPD group, while intake of sodium in the COPD group was significantly greater than the NCOPD group. Among individuals in their 60s, the energy intake of the COPD group was significantly less than that of the NCOPD group. The COPD group showed significantly less intake of vitamin $B_1$ and vitamin C, but greater intake of sodium than the NCOPD group. In the group aged 70 and over, The COPD group had significantly less intake of vitamin $B_1$ than the NCOPD group and showed lower nutrient adequacy ratio values in protein, vitamin $B_1$, vitamin $B_2$, and iron than the NCOPD group. Conclusion: The COPD group consumed less energy and certain nutrients, and their dietary quality was poor compared to the NCOPD group. Thus, more detailed research is required to understand the concrete relationship between COPD and malnutrition.

• Nutrition Research and Practice
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• 제6권2호
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• pp.162-168
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• 2012

Vitamin D deficiency is a risk factor for metabolic syndromes. We examined whether vitamin D deficiency altered the prevalence of cardiovascular disease (CVD) in older Koreans. Cross-sectional analysis of data from the Korean National Health and Nutrition Examination Survey IV 2008-2009 was used to examine the association between serum 25-hydroxyvitamin D (25(OH)D) levels and the prevalence of CVD in a representative population-based sample of 5,559 men and women aged ${\geq}50$ years. CVD was defined as angina pectoris, myocardial infarction, or stroke. The prevalence of CVD (7.0%) in the older Korean population was lower than that in the older US population, although average serum 25(OH)D levels were much lower in the Korean population. Additionally, serum 25(OH)D levels did not differ significantly between the CVD and non-CVD groups. However, subjects in the lowest category (< 25 nmol/l) of serum 25(OH)D level had the greatest prevalence of CVD, about two-fold higher than subjects in the highest category (> 75 nmol/l), after adjusting for age, gender, body mass index, education level, residence location, and region. The prevalence of other risk factors for CVD, including higher waist circumference, fasting glucose, low-density lipoprotein (LDL) cholesterol, and triglyceride levels and lower high-density lipoprotein (HDL) cholesterol levels, was also higher among subjects in the lowest category than among those in the highest category. In conclusion, low serum 25(OH)D may be an independent risk factor for CVD in older Koreans.

• Journal of Preventive Medicine and Public Health
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• 제46권2호
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• pp.96-104
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• 2013

Objectives: The inherent nature of the Korean National Health and Nutrition Examination Survey (KNHANES) design requires special analysis by incorporating sample weights, stratification, and clustering not used in ordinary statistical procedures. Methods: This study investigated the proportion of research papers that have used an appropriate statistical methodology out of the research papers analyzing the KNHANES cited in the PubMed online system from 2007 to 2012. We also compared differences in mean and regression estimates between the ordinary statistical data analyses without sampling weight and design-based data analyses using the KNHANES 2008 to 2010. Results: Of the 247 research articles cited in PubMed, only 19.8% of all articles used survey design analysis, compared with 80.2% of articles that used ordinary statistical analysis, treating KNHANES data as if it were collected using a simple random sampling method. Means and standard errors differed between the ordinary statistical data analyses and design-based analyses, and the standard errors in the design-based analyses tended to be larger than those in the ordinary statistical data analyses. Conclusions: Ignoring complex survey design can result in biased estimates and overstated significance levels. Sample weights, stratification, and clustering of the design must be incorporated into analyses to ensure the development of appropriate estimates and standard errors of these estimates.

• 대한지역사회영양학회지
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• 제25권4호
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• pp.329-339
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• 2020

Objectives: This study was undertaken to evaluate the intake of vitamins and minerals from dietary supplements (DSs) in Korean adults and elderly. Methods: Data for this study was generated from the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). We analyzed 4,204 individuals aged 19 years and older (2,579 users and 1,625 non-users). The survey included 24-h recall questions on food and DS intakes, as well as questions on DS use over the past year. The nutrient DSs evaluated were calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C. Total nutrient intakes were obtained by combining nutrient intakes of foods and DSs consumed by each subject. Results: Most micronutrient intakes from food (except for thiamin) in adult users, and the four micronutrient intakes (iron, vitamin A, vitamin B₂ and vitamin C) in elderly users, were significantly higher than values obtained in non-users. For total intake of nutrients and DSs, both adult and elderly users had a significantly higher intake than non-users. While proportions below Estimated Average Requirements for all micronutrients by adding respective DSs in users were significantly reduced in adults and elderly as compared to non-users, the proportions of above Tolerable Upper Intake Levels for calcium and vitamin A in adults, and vitamin A in elderly, were significantly increased. In the total subjects examined, consumption of DSs was associated with lower odds ratios of undernutrition of micronutrients, and with higher odds ratios of overnutrition of calcium, iron, and vitamin A, as compared to non-users of DSs. Conclusions: Although DSs consumption by adults and the elderly improves the micronutrient status, it also increases the risk of excessive intake of certain vitamins and minerals.

• 한국보건간호학회지
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• 제34권3호
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• pp.416-428
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• 2020

Purpose: This study identified socioeconomic factors affecting the health status of Korean adults. Methods: Secondary data from 12,921 adults aged 19 to 64 old in the 7th Korean National Health and Nutrition Examination Survey were used. The participants' health status was measured using the indicators that included health behaviors (smoking, high-risk drinking, strength exercise, and aerobic physical activity) and health outcomes (metabolic syndrome, and subjective health status). Results: For all health behaviors and health outcomes, gender, age, educational level, and income were common affecting factors. Regarding health behaviors, the employment status was related to smoking, high-risk drinking, strength exercise, and aerobic physical activity. The marital status was related to high-risk drinking, strength exercise, and aerobic physical activity. The household type was related to smoking. The residential area was related to smoking, high-risk drinking, and aerobic physical activity. For health outcomes, the household type was related to obesity, and subjective health status; residential area was related to obesity. Conclusion: This study presented basic data for assessing the differences in health status. The characteristics of the affecting factors to health status should be considered, depending on the health behaviors and health outcomes.

• 대한지역사회영양학회지
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• 제19권5호
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• pp.468-478
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• 2014

Objectives: Intake of fruits and vegetables has protective effects against stroke attack. This study intended to examine the status of consuming fruits and vegetables and to find out which factors may influence the frequency of consumption of fruits and vegetables in individuals with a history of stroke. Methods: The data of 208 subjects from 5th (2010, 2011) Korea National Health and Nutrition Examination Survey (KNHNES) who reported a stroke diagnosis was used for analysis. To identify major factors influencing the consumption of fruits and vegetables, a classification-tree analysis was carried out. Results: Among those who reported a stroke diagnosis, the frequencies of consumption of fruits and vegetables were influenced by their age, place of residence (urban or rural), economic status, educational level, occupation, number of family members, frequency of eating out, and having meals (breakfast or lunch) with family members. Two factors from fruits and three factors from vegetables were generated by exploratory factor analyses. Urban residents ate fruits and vegetables more frequently in all factors than rural residents. Eating frequencies of 'seasonal fruits (orange, apple, strawberry, melon, pear and watermelon)', 'easily-accessible fruits (persimmon, tangerine, grape, peach, banana)', and 'Western-style vegetables (cabbage, mushroom, carrot, tomato, spinach)' were influenced by the socioeconomic status. Eating frequencies of 'Korean-style vegetables (bean sprout, radish leaves, pumpkin/squash, sea weed)', 'preserved vegetables (Korean cabbage, radish, laver, cucumber)' were influenced by having breakfast with family members. Conclusions: The results of this study suggested that by eating more fruits and vegetables, more preventive effects against secondary stroke attack are expected in stroke patients who live in the rural areas and who do not eat breakfast with family members. In addition, more outreach and education programs are needed for them.

• Communications for Statistical Applications and Methods
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• 제10권2호
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• pp.553-566
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• 2003

In many cases, the measurement error variances may be functions of the unknown true values or related covariates. This paper considers design-based estimators of the parameters of these variance functions based on the within-unit sample variances. This paper devotes to: (1) define an error scale factor $\delta$; (2) develop estimators of the parameters of the linear measurement error variance function of the true values under large-sample and small-error conditions; (3) use propensity methods to adjust survey weights to account for possible selection effects at the replicate level. The proposed methods are applied to medical examination data from the U.S. Third National Health and Nutrition Examination Survey (NHANES III).

• 여성건강간호학회지
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• 제27권2호
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• pp.93-103
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• 2021

Purpose: The purpose of this study was to explore unmet healthcare needs among low-income overweight and obese women and to identify the factors affecting unmet healthcare needs. Methods: The study was a secondary analysis of data from the 2017 Korea National Health and Nutrition Examination Survey. A final sample of 388 out of 8,127 participants was analyzed using complex descriptive statistics, the chi-square test, the independent t-test, and logistic regression. Results: The mean age of the participants was 66.51±1.05 years. Unmet healthcare needs were experienced by 19.4% of low-income overweight and obese women. Women with depression, stress, and poor self-reported health status were significantly more likely than their counterparts to experience unmet healthcare needs. Poor self-reported health status was confirmed to be related to unmet health needs in low-income overweight and obese women (odds ratio, 2.65; p=.011). Conclusion: The study provides the novel insight that the unmet healthcare needs of low-income overweight and obese women were influenced by self-reported health status. Healthcare providers should make efforts to develop strategies to reduce unmet healthcare needs among low-income overweight and obese women, who constitute a vulnerable population.