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Effect of Geographic Area on Dietary Quality across Different Age Groups in Korea
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Research Article
Effect of Geographic Area on Dietary Quality across Different Age Groups in Korea
Hyun Ja Kimorcid, Kirang Kimorcid
Korean Journal of Community Nutrition 2019;24(6):453-464.
DOI: https://doi.org/10.5720/kjcn.2019.24.6.453
Published online: December 31, 2019

1Department of Food and Nutrition, Gangneung-Wonju National University, Gangneung, Korea, Professor.

2Department of Food Science and Nutrition, Dankook University, Cheonan, Korea, Professor.

Corresponding author: Kirang Kim. Department of Food Science and Nutrition, Dankook University, 119, Dandae-ro, Dongnam-gu, Cheonan 31116, Korea. Tel: (041)550-3472, Fax: (041)559-7955, kirangkim@dankook.ac.kr
• Received: September 18, 2019   • Revised: November 4, 2019   • Accepted: November 4, 2019

Copyright © 2019 The Korean Society of Community Nutrition

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    The objective of this study was to examine whether dietary quality varies among different age groups and geographic areas, and whether the difference between geographic areas varies across several age groups in Korea.
  • Methods
    The subjects were 14,170 subjects who participated in the 2013–2015 Korea National Health and Nutrition Examination Survey. The dietary quality was assessed using the Korean Health Eating Index (KHEI). Age groups were categorized into six groupings, and areas were categorized into urban and rural according to their administrative districts. The effect of area on the KHEI score was analyzed by multiple linear regression analysis.
  • Results
    The KHEI was the lowest in the 20-30s group (57.7 ± 0.4 score for 20s and 61.2 ± 0.3 score for 30s) and increased with age (p<0.001), showing the highest score in the 60s (67.9 ± 0.3 score), and then decreased again in the 70s and older (64.6 ± 0.3 score). As a result of comparing the KHEI score by area, the urban areas had higher KHEI scores than did the rural areas (63.5 ± 0.2 score for urban area and 62.2 ± 0.4 score for rural area, p=0.002). The difference between areas was dependent on the age group, showing a significant difference for subjects who were aged from 50s and older (p=0.002 for 50s, p<0.001 for 60s and p<0.001 for 70s and older). After adjusting for confounding factors, the effect of area on the KHEI score was only shown for those subjects in the over 60 years old group (p=0.035 for 60s and p<0.001 for 70s and older).
  • Conclusions
    The dietary quality differed according to the age group and geographic area. The dietary quality was lower for younger people than that for older people, and in rural areas compared to that in urban areas, and especially for older adults. The area factor was a very important factor for the dietary quality.
This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention and the National Research Foundation of Korea (NRF-2019R1H1A2080093).
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Table 1

General characteristics of adults aged 19 years and older, 2013–2015 KNHANES

kjcn-24-453-i001.jpg

KNHANES, Korea National Health and Nutrition Examination Survey.

1) All % (SE) were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

2) P-values for % differences between urban and rural area were calculated using the chi-square test

3) Including housewives or student

Table 2

Mean value of each KHEI item by age group and region

kjcn-24-453-i002.jpg

KHEI, Korean Health Eating Index; SFA, saturated fatty acid; CHO, carbohydrate

All values were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

1) Sex-adjusted means ± SE

2) Age- and sex-adjusted means ± SE

3) P-values for mean differences by age group and region were calculated using multivariate linear regression after adjusting for sex.

4) P-values for mean differences by age group and region were calculated using multivariate linear regression after adjusting for age (continuous) and sex.

Table 3

Difference of mean value of each KHEI item between urban and rural area according to age group

kjcn-24-453-i003.jpg

KHEI, Korean Health Eating Index; SFA, saturated fatty acid; CHO, carbohydrate

All values were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

1) Sex-adjusted means ± SE

2) P-values for mean differences between urban and rural area were calculated using multivariate linear regression after adjusting for sex.

Table 4

Mean value of KHEI total score by factors related to KHEI

kjcn-24-453-i004.jpg

KHEI, Korean Health Eating Index

All values were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

1) Age- and sex-adjusted means ± SE

2) P-values for mean differences of KHEI total score by factors related to KHEI using multivariate linear regression after adjusting for age (continuous) and sex. Different alphabets indicate significant differences by Tukey's test.

3) P-values for mean differences of KHEI total score by area and factors related to KHEI using multivariate linear regression after adjusting for age (continuous) and sex. Different alphabets indicate significant differences by Tukey's test.

Table 5

Region effect on KHEI total score after adjusting for confounding factors by age group

kjcn-24-453-i005.jpg

KHEI, Korean Health Eating Index

All values were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

1) Beta for rural area vs. urban

Model was adjusted for sex, household type, marital status, household income, education level, job status, weight status, smoking, alcohol drinking, walking exercise, nutritional education, eating with others, food assistance program participation, and food security.

Figure & Data

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    Effect of Geographic Area on Dietary Quality across Different Age Groups in Korea
    Effect of Geographic Area on Dietary Quality across Different Age Groups in Korea

    General characteristics of adults aged 19 years and older, 2013–2015 KNHANES

    KNHANES, Korea National Health and Nutrition Examination Survey.

    1) All % (SE) were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

    2) P-values for % differences between urban and rural area were calculated using the chi-square test

    3) Including housewives or student

    Mean value of each KHEI item by age group and region

    KHEI, Korean Health Eating Index; SFA, saturated fatty acid; CHO, carbohydrate

    All values were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

    1) Sex-adjusted means ± SE

    2) Age- and sex-adjusted means ± SE

    3) P-values for mean differences by age group and region were calculated using multivariate linear regression after adjusting for sex.

    4) P-values for mean differences by age group and region were calculated using multivariate linear regression after adjusting for age (continuous) and sex.

    Difference of mean value of each KHEI item between urban and rural area according to age group

    KHEI, Korean Health Eating Index; SFA, saturated fatty acid; CHO, carbohydrate

    All values were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

    1) Sex-adjusted means ± SE

    2) P-values for mean differences between urban and rural area were calculated using multivariate linear regression after adjusting for sex.

    Mean value of KHEI total score by factors related to KHEI

    KHEI, Korean Health Eating Index

    All values were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

    1) Age- and sex-adjusted means ± SE

    2) P-values for mean differences of KHEI total score by factors related to KHEI using multivariate linear regression after adjusting for age (continuous) and sex. Different alphabets indicate significant differences by Tukey's test.

    3) P-values for mean differences of KHEI total score by area and factors related to KHEI using multivariate linear regression after adjusting for age (continuous) and sex. Different alphabets indicate significant differences by Tukey's test.

    Region effect on KHEI total score after adjusting for confounding factors by age group

    KHEI, Korean Health Eating Index

    All values were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

    1) Beta for rural area vs. urban

    Model was adjusted for sex, household type, marital status, household income, education level, job status, weight status, smoking, alcohol drinking, walking exercise, nutritional education, eating with others, food assistance program participation, and food security.

    Table 1 General characteristics of adults aged 19 years and older, 2013–2015 KNHANES

    KNHANES, Korea National Health and Nutrition Examination Survey.

    1) All % (SE) were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

    2) P-values for % differences between urban and rural area were calculated using the chi-square test

    3) Including housewives or student

    Table 2 Mean value of each KHEI item by age group and region

    KHEI, Korean Health Eating Index; SFA, saturated fatty acid; CHO, carbohydrate

    All values were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

    1) Sex-adjusted means ± SE

    2) Age- and sex-adjusted means ± SE

    3) P-values for mean differences by age group and region were calculated using multivariate linear regression after adjusting for sex.

    4) P-values for mean differences by age group and region were calculated using multivariate linear regression after adjusting for age (continuous) and sex.

    Table 3 Difference of mean value of each KHEI item between urban and rural area according to age group

    KHEI, Korean Health Eating Index; SFA, saturated fatty acid; CHO, carbohydrate

    All values were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

    1) Sex-adjusted means ± SE

    2) P-values for mean differences between urban and rural area were calculated using multivariate linear regression after adjusting for sex.

    Table 4 Mean value of KHEI total score by factors related to KHEI

    KHEI, Korean Health Eating Index

    All values were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

    1) Age- and sex-adjusted means ± SE

    2) P-values for mean differences of KHEI total score by factors related to KHEI using multivariate linear regression after adjusting for age (continuous) and sex. Different alphabets indicate significant differences by Tukey's test.

    3) P-values for mean differences of KHEI total score by area and factors related to KHEI using multivariate linear regression after adjusting for age (continuous) and sex. Different alphabets indicate significant differences by Tukey's test.

    Table 5 Region effect on KHEI total score after adjusting for confounding factors by age group

    KHEI, Korean Health Eating Index

    All values were calculated by applying sampling weights assigned to individual participants in the nutrition survey.

    1) Beta for rural area vs. urban

    Model was adjusted for sex, household type, marital status, household income, education level, job status, weight status, smoking, alcohol drinking, walking exercise, nutritional education, eating with others, food assistance program participation, and food security.


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