Korean Journal of Community Nutrition

Research Articles

[Korean]
Nutritional status of North Koreans and related perceptions among South Korean adults: Youngmin Nam, Jihyun Yoon; Korean J Community Nutr 2024;29(4):288-303. Published online August 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00006

Abstract PDF PubReader ePub: Objectives
North Koreans have been facing chronic food shortages and malnutrition. This study examined the nutritional status of North Koreans and the perceptions of South Korean adults regarding their nutritional status.
Methods
The nutritional status was examined using nutritional indicators for the general population, children, and reproductive-aged women in North Korea. An online survey was conducted among 1,000 South Korean adults aged 19–69 years to investigate their perceptions regarding the nutritional status of North Koreans.
Results
Although the nutritional status of children in North Korea has consistently improved, significant progress in the general population and reproductive-aged women in the country remains elusive. The prevalence of malnutrition among North Korean children has decreased to a level that is not considered severe based on international standards, although it shows a substantial difference from that among South Korean children. The prevalence of undernourishment and food insecurity in North Korea remains over 40%. South Korean adults perceive the nutritional status of North Koreans as being more severe than it is in reality. Notably, a significant inconsistency exists between the perceived and actual nutritional status of North Korean children, with over 95% of South Korean adults perceiving North Korean children’s malnutrition as being more severe than it actually is. Moreover, South Korean adults in their 20s to 40s tended to perceive the nutritional status of North Koreans as being more severe than those in their 50s to 60s did.
Conclusions
The nutritional status of North Koreans is a matter of concern. The disparity between South Koreans’ perceptions of the nutritional status of North Koreans and the actual status highlights the need for accurate information dissemination to effectively address malnutrition in North Korea. These efforts could be instrumental in enhancing public awareness and fostering social consensus on food aid and nutritional support programs for North Korea.

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[English]
Effects of a nutrition education program on metabolic syndrome risk factors in middle-aged Korean adults: an intervention study: Minji Kang, Young-Hee Park, Subeen Kim, Eunyoung Tak, Hyun Wook Baik, Hee Young Paik, Hyojee Joung; Korean J Community Nutr 2024;29(4):265-277. Published online August 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00005

Abstract PDF PubReader ePub: Objectives
This study was conducted to evaluate the effects of a nutrition education program on metabolic syndrome in middle-aged Korean adults.
Methods
A total of 411 Korean adults 30–59 years of age were allocated randomly into three groups: the nutrition education group for promoting Han-sik consumption (HG), the nutrition education group for eating balanced diet (EG), and the control group (CG). The HG and EG received four face-to-face nutrition education sessions over 16 weeks to improve nutritional problems based on the individual’ usual diet. Effectiveness of the program was evaluated with the differences of self-reported dietary behaviors, dietary intakes, anthropometric measurements and biochemical indices between the baseline and the end of the nutrition education program. The changes within groups were analyzed using paired t-test and McNemar test and effectiveness among three groups was analyzed by repeated analysis of variance.
Results
After the nutrition education, the percentages of participants who achieved the recommended food group consumption in the Korean Food Guidance Systems significantly increased in HG (P = 0.022). Body weight (P = 0.007), body mass index (P = 0.002), and triglycerides (P = 0.002) significantly decreased in HG. Waist circumference and diastolic blood pressure decreased in all three groups (P < 0.05).
Conclusions
This study found that tailored nutrition education program for middle aged Korean adults showed beneficial effects on improving dietary behaviors and metabolic syndrome risk factors. Further studies are needed to assess the long-term effects of the nutrition education programs on metabolic syndrome risks.

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[English]
Sex differences in health-related quality of life among older Korean adults with type 2 diabetes mellitus: a cross-sectional study: Hyeonji Jeong, Kyong Park; Korean J Community Nutr 2024;29(4):336-347. Published online August 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00003

Abstract PDF PubReader ePub: Objectives
This cross-sectional study examined sex differences in Health-Related Quality of Life (HRQoL) among seniors with Type 2 Diabetes Mellitus (T2DM).
Methods
Data from the Korea National Health and Nutrition Examination Survey (2008–2020) were analyzed. The EuroQol-5 Dimensions (EQ-5D), a measure of HRQoL, was used. It comprises five dimensions: mobility, self-care, usual activity, pain/discomfort, and anxiety/depression, each with three levels.
Results
Analysis of 3,826 older adults with T2DM showed a significant increasing trend in the EQ-5D Index from the 4th survey phase onwards (P for trend < 0.001 for both men and women). Men consistently reported higher EQ-5D levels than women across all survey years. Women’s EQ-5D levels remained lower than men’s, maintaining a decade-old disparity (P < 0.05). Men scored significantly higher (P < 0.05) in most EQ-5D domains, except for self-care and anxiety/depression, resulting in a higher total EQ-5D Index (P = 0.001). Increased comorbidities were strongly associated with lower EQ-5D levels in both sexes. Additionally, there was a negative correlation between the EQ-5D Index and refined grain intake for both sexes (P for trend < 0.001), with high-EQ-5D groups consuming fewer refined grains. Women in the high-EQ-5D group consumed more nuts, vegetables, and meat compared to men (P for trend < 0.05).
Conclusions
Our study highlights the sex disparities in HRQoL among older adults with T2DM. The findings suggest the need for tailored treatment guidelines aimed at improving the HRQoL of elderly T2DM patients, with a focus on their sex-specific characteristics. Implementing these tailored guidelines could enhance the HRQoL of older women with T2DM and promote more equitable healthcare outcomes. This underscores the importance of considering sex differences to comprehensively improve the well-being of this population.

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[English]
Total sugar intake and its contributed foods by age groups in Koreans using the 8th (2019–2021) Korea National Health and Nutrition Examination Survey: a cross-sectional study: Hyejin Yu, Sang-Jin Chung; Korean J Community Nutr 2024;29(3):222-233. Published online June 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.3.222

Abstract PDF PubReader ePub: Objectives
This study was conducted to investigate the status of total sugar intake and contributing foods in Korea according to age groups.
Methods
This study used 24-hour dietary recall data from the 8th Korea National Health and Nutrition Examination Survey (2019–2021) to investigate the nutritional and total sugar intake status among Koreans. A total of 18,338 research participants (≥3 years old) were included in this study. To analyze the types of foods contributing to total sugar intake, these foods were categorized into 15 types. Moreover, we examined the total sugar intake and ranked the most consumed foods by age groups (3–11 years, 12–18 years, 19–34 years, 35–49 years, 50–64 years, over 65 years). A survey procedure was employed for statistical analysis.
Results
The energy intake ratio from total sugars was approximately 12%–15%, which was within the recommended range. However, the proportion of individuals consuming total sugar exceeding 20% of their total caloric intake is nearly 20%, raising concerns about excessive sugar consumption. Furthermore, the percentage of participants whose intake of sugar from processed foods exceeded 10% of their total calories was highest in the 12–18 age group at 37.1%, followed by the 3–11 age group at 35.2%, and the 19–34 age group at 34.0%. Carbonated drinks, cola, and cider were the primary foods consumed by children and adolescents (3–18 years old) and young adults (19–34 years old). For middle-aged and older adults, mixed coffee with sugar and cream was a prominent contributor to sugar intake.
Conclusions
This study investigated sugar consumption patterns among Koreans, finding the principal foods contributing to this intake. Identifying these contributors is pivotal, given their potential impact on public health.

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[Korean]
Effects of watching Mukbang and Cookbang videos on adolescents’ dietary habits and mental health: cross-sectional study using the 18th Korea Youth Risk Behavior Survey: Seung-Hee Hong; Korean J Community Nutr 2024;29(2):156-170. Published online April 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.2.156

Abstract PDF: Objectives
This study aimed to investigate the association between how often Korean adolescents watch Mukbang and Cookbang videos and their dietary habits.
Methods
Data from the 18th Korea Youth Risk Behavior Survey conducted in 2022 was analyzed for this study. The study included 51,850 middle and high school students and assessed various aspects, including demographics, frequency of watching Mukbang and Cookbang videos per week, dietary habits, health behaviors, and mental health factors.
Results
Nearly a third (29.3%) of Korean adolescents watched Mukbang and Cookbang videos one to four times a week, while 13.5% watched them more than five times weekly. Females, those with lower academic achievement, and those from lower socioeconomic backgrounds were significantly more likely to be frequent viewers (P < 0.001). Increased viewing frequency was associated with poorer dietary habits. Adolescents who watched more frequently were less likely to eat breakfast and consume fruits and milk, while their consumption of fast food, high-caffeine drinks, sugary drinks, and late-night snacks increased (P < 0.001). Higher viewing frequency correlated with increased feelings of stress, depression, and loneliness (P < 0.001). Logistic regression analysis confirmed these associations. More frequent viewers were significantly less likely to eat breakfast (odds ratio (OR), 0.63; 95% confidence interval (CI), 0.58–0.68), and more likely to consume fast food (OR, 1.85; 95% CI, 1.69–2.02), high-caffeine drinks (OR, 1.43; 95% CI, 1.30–1.56), sugary drinks (OR, 1.54; 95% CI, 1.41–1.67), and late-night snacks (OR, 1.37; 95% CI, 1.25–1.51).
Conclusions
Our findings suggest that frequent exposure to Mukbang and Cookbang content is linked to unhealthy dietary habits in adolescents. Educational programs may be necessary to mitigate the potential for these videos to negatively influence dietary choices.

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[English]
Dietary intake and food sources of essential fatty acids among Korean adolescents: a cross-sectional study based on the 2016–2021 KNHANES data: Enkhgerel Erdenetsetseg, Hye Ran Shin, SuJin Song; Korean J Community Nutr 2024;29(2):144-155. Published online April 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.2.144

Abstract PDF: Objectives
This study evaluated dietary intake and food sources of essential fatty acids in Korean adolescents.
Methods
This study was comprised of 3,932 adolescents (9–18 years) who participated in the 2016–2021 Korea National Health and Nutrition Examination Surveys. Dietary intake and food sources of essential fatty acids, including alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and linoleic acid (LA) were evaluated using data obtained from one-day 24-hour dietary recall. The proportions of adolescents consuming ALA, EPA + DHA, and LA above or below the adequate intake (AI) of the 2020 Dietary Reference Intakes for Koreans were calculated. All statistical analyses accounted for the complex sampling design effect and appropriate sample weights.
Results
The mean intakes of ALA, EPA, DHA, and LA among Korean adolescents were 1.29 g/day, 69.6 mg/day, 166.0 mg/day, and 11.1 g/day, respectively. Boys had higher intakes of all essential fatty acids compared to girls. By age group, adolescents aged 15–18 years showed lower intakes of EPA and DHA compared to adolescents in younger age groups. The 9–11-yearold adolescents had lower intakes of ALA and LA than older adolescents. The proportions of adolescents who consumed more than AI were 35.7% for ALA, 30.4% for EPA + DHA, and 41.5% for LA. Adherence to the AI for ALA did not differ by sex or age group, although boys showed a lower adherence to the AI for EPA + DHA than girls. Major food sources for ALA and LA were plant-based oils, mayonnaise, pork, and eggs. Mackerel was the most significant contributor to EPA and DHA intake (EPA, 22.6%; DHA, 22.2%), followed by laver, squid, and anchovy.
Conclusions
The proportion of Korean adolescents who consumed EPA + DHA more than AI was low. Our findings highlight that nutrition education emphasizing an intake of essential fatty acids from healthy food sources is needed among Korean adolescents.

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[Korean]
Comparative study on the health and dietary habits of Korean male and female adults before and after the coronavirus disease 2019 pandemic: utilizing data from the 8 th Korea National Health and Nutrition Examination Survey (2019–2021): Chaemin Kim, Eunjung Kim; Korean J Community Nutr 2024;29(1):65-80. Published online February 29, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.1.65

Abstract PDF

Objectives
This study aims to compare changes in physical factors, health behaviors, eating habits, and nutritional intake among Korean male and female adults over a period of three years (2019–2021) before and after the outbreak of coronavirus disease 2019 (COVID-19).
Methods
This study utilized raw data from the 8^th Korea National Health and Nutrition Examination Survey (2019–2021). The participants in this study included 6,235 individuals in 2019, 5,865 individuals in 2020, and 5,635 individuals in 2021. Individuals whose daily energy intake was less than 500 kcal or exceeded 5,000 kcal were excluded from the study.
Results
In comparison to 2019, overweight/obesity rates, weight, waist circumference, weekend sleep hours, and resistance exercise days/week increased in both male and female during the COVID-19 pandemic. Regarding eating habits, the proportions of people skipping breakfast, not eating out, consuming health supplements, and recognizing nutritional labels increased in 2020 and 2021, whereas the rate of skipping dinner decreased. Total energy intake has continued to decrease for the two years since 2019. A comparison of nutrient intake per 1,000 kcal before and after the outbreak of COVID-19 revealed that intake of nutrients, including protein, phosphorus, iron, vitamin A, riboflavin, and niacin increased, while folic acid intake decreased. In male, calcium, phosphorus, riboflavin, and niacin intakes increased, whereas iron, vitamin C, and folic acid intakes decreased. In female, phosphorus, iron, vitamin A, and riboflavin intake increased significantly, while protein and niacin intake decreased significantly.
Conclusions
After COVID-19, the obesity rate, breakfast skipping rate, health supplement intake, and nutritional label use increased, while the frequency of eating out, dinner skipping rate, and total energy intake decreased. These environmental changes and social factors highlight the need for nutritional education and management to ensure proper nutritional intake and reduce obesity rates in the post-COVID-19 era.

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Intake of energy and macronutrients according to household income among elementary, middle, and high school students before and during the COVID-19 pandemic: a cross-sectional study
Chae-Eun Jeong, Heejin Lee, Jung Eun Lee
Korean Journal of Community Nutrition.2024; 29(3): 234. CrossRef

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[Korean]
Association of ultra-processed food with diabetes and impaired fasting glucose in elderly populations (urban and rural): a cross-sectional study: Seung Jae Lee, Mi Sook Cho; Korean J Community Nutr 2024;29(1):51-64. Published online February 29, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.1.51

Abstract PDF: Objectives
This study examined the association between ultra-processed food (UPF) consumption and chronic diseases in elderly Koreans.
Methods
Data from the 2019–2021 Korea National Health and Nutrition Examination Survey were analyzed. Dietary intake and UPF consumption were assessed using the NOVA food classification based on 24-hour recall data from 3,790 participants (aged 65+ years). Participants were divided into 4 groups based on the quartile of energy intake from UPFs. Regions were classified as urban or rural. Multivariable logistic regression was employed to estimate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) after controlling for potential confounders.
Results
Among the participants, 71.3% resided in urban and 28.7% in rural areas. Compared to the urban elderly, rural participants tended to be older, have lower education and income levels, be more likely to live in single-person households, and have a higher smoking rate (P < 0.05). Urban elderly consumed more UPFs daily (146.1 g) compared to rural residents (126.6 g; P < 0.05). “Sugar-sweetened beverages” were the most consumed category in both regions. “Sweetened milk and its products” and “traditional sauces” were prominent in urban areas, while rural elderly consumed more “traditional sauces” and “distilled alcoholic beverages.” Rural areas also had a higher carbohydrate-to-calorie ratio than urban areas. Compared to the lowest quartile of UPF intake, the highest quartile was significantly associated with impaired fasting glucose only in rural areas (AOR, 1.48; 95% CI, 1.00–2.19; P for trend = 0.0014). No significant associations were observed for diabetes in either urban or rural areas.
Conclusions
This study suggests that high intake of UPFs is associated with increased odds of impaired fasting glucose in rural elderly. Further research is needed to elucidate the specific negative health effects of UPFs in different populations, and targeted efforts should promote healthy diets in both urban and rural areas.

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[Korean]
Sustainable diets: a scoping review and descriptive study of concept, measurement, and suggested methods for the development of Korean version: Sukyoung Jung; Korean J Community Nutr 2024;29(1):34-50. Published online February 29, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.1.34

Abstract PDF: Objectives
Transformation through a sustainable food system to provide healthy diets is essential for enhancing both human and planetary health. This study aimed to explain about sustainable diets and illustrate appropriate measurement of adherence to sustainable diets using a pre-existing index.
Methods
For literature review, we used PubMed and Google Scholar databases by combining the search terms “development,” “validation,” “sustainable diet,” “sustainable diet index,” “planetary healthy diet,” “EAT-Lancet diet,” and “EAT-Lancet reference diet.” For data presentation, we used data from National Health and Nutrition Examination Survey, 2017–2018, among adults aged 20 years and older (n = 3,920). Sustainable Diet Index-US (SDI-US), comprising four sub-indices corresponding to four dimensions of sustainable diets (nutritional quality, environmental impacts, affordability, and sociocultural practices), was calculated using data from 24-hour dietary recall interview, food expenditures, and food choices. A higher SDI-US score indicated greater adherence to sustainable diets (range: 4–20). This study also presented SDI-US scores according to the sociodemographic status. All analyses accounted for a complex survey design.
Results
Of 148 papers, 16 were reviewed. Adherence to sustainable diets fell into 3 categories: EAT-Lancet reference diet-based (n = 8), Food and Agriculture Organization (FAO) definitionbased (n = 4), and no specific guidelines but including the sustainability concept (n = 4). Importantly, FAO definition emphasizes on equal importance of four dimensions of diet (nutrition and health, economic, social and cultural, and environmental). The mean SDI-US score was 13 out of 20 points, and was higher in older, female, and highly educated adults than in their counterparts.
Conclusions
This study highlighted that sustainable diets should be assessed using a multidimensional approach because of their complex nature. Currently, SDI can be a good option for operationalizing multidimensional sustainable diets. It is necessary to develop a Korean version of SDI through additional data collection, including environmental impact of food, food price, food budget, and use of ready-made products.

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[Korean]
Factors related to adolescent obesity and changes: a cross-sectional study based on the Korea Youth Risk Behavior Survey: Bora Lee, Ho Kyung Ryu; Korean J Community Nutr 2023;28(5):363-375. Published online October 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.5.363

Abstract PDF

Objectives
The objective of this study was to identify factors associated with adolescent obesity, as well as any new factors that correlated with a change in the rate of obesity over time.
Methods
The study used 5-yearly data collected by the Korea Youth Risk Behavior Survey starting from the year 2006 up until 2021 (data from 2nd, 7th, 11th, and 17th surveys were analyzed). Factors such as demographics, dietary factors, health behavioral factors, and mental health factors were studied. All data were analyzed using IBM SPSS 27.0, employing chi-square tests and multiple logistic regression analysis.
Results
This study included data from a total of 255,200 participants. Factors contributing to obesity varied with time. Over the survey duration of 15 years, low academic achievement, parents with low levels of education, low frequency of fruit consumption, low frequency of fast food intake, long periods of being seated, and high levels of stress were significantly associated with a high rate of obesity. Factors that showed a new correlation with an increase in obesity rates included living with single parents, low frequency of muscle strengthening exercises, and experiencing intense sadness and despair in the past year. Factors that were correlated with a change in obesity rates over time included household economic status, frequency of carbonated beverage consumption, frequency of intense physical activity, and frequency of alcohol consumption. Breakfast intake and smoking were not significantly associated with obesity rates in the 15-year period.
Conclusions
While several factors associated with obesity remained consistent over time, several new factors have emerged in response to social, economic, and environmental changes contributed to a change in obesity rate over time. Therefore, to prevent and manage adolescent obesity, continuous research into the new emergent factors contributing to obesity is needed.

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Effects of watching Mukbang and Cookbang videos on adolescents’ dietary habits and mental health: cross-sectional study using the 18th Korea Youth Risk Behavior Survey
Seung-Hee Hong
Korean Journal of Community Nutrition.2024; 29(2): 156. CrossRef

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[Korean]
Dietary sodium and potassium intake of Koreans estimated using 2 different sources of their contents in foods, Food & Nutrient Database and the Korean Total Diet Study : a comparative study: Jee Yeon Lee, Sung Ok Kwon, Soo Hyun Lee, Min Jeong Seo, Gae Ho Lee, Cho-il Kim; Korean J Community Nutr 2023;28(3):235-244. Published online June 30, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.3.235

Abstract PDF: Objectives
Based on the results from the Korean Total Diet Study (KTDS), the sodium (Na) and potassium (K) intake of Koreans were estimated and compared with intake estimates from the Food & Nutrient Database (FNDB), as in the Korea National Health and Nutrition Examination Survey (KNHANES) to verify the validity of these estimates.
Methods
One hundred and thirty-four representative foods (RFs) covering 92.5% of the total food intake of Koreans were selected, and 228 pairs of corresponding ‘RF x representative cooking method’ were derived by reflecting the methods used mainly in terms of frequency and quantity in their cooking. RF samples were collected from three cities with a larger population size in three regions (nine cities) nationwide, and six composite samples were made for each RF, considering its regional and/or seasonal characteristics. One thousand three hundred and sixty-eight ‘RF x representative cooking method’ pair samples were prepared, and the Na and K contents were assessed using inductively coupled plasma atomic emission spectrometry (ICP-MS). The Na and K intake of the Korean population was estimated by linking the content with the food intake data from the 7th KNHANES.
Results
The mean Na and K intake of Koreans were 2,807.4 mg and 2,335.0 mg per person per day, respectively. A comparison with the Na and K intake from KNHANES, including only RFs of KTDS, showed comparable results with less than 5% variation. While the contribution and ranking of food items to Na intake were similar between KNHANES and KTDS, there were differences in K intake. This was attributed to the large discrepancies in the K content of rice and coffee between KTDS results and the values in the 9th Revision of the National Food Composition Table used in KNHANES.
Conclusions
The Na and K intake of Koreans estimated based on the KTDS, which performed nutrient analysis on samples prepared to a ‘table-ready’ state using foods of the representative collection, was similar and comparable with that of KNHANES. This supports the validity and usefulness of FNDB-based nutrient intake estimation at the population level. The list of nutrients studied in KTDS is expected to be expanded, allowing for intake estimation of nutrients with currently insufficient or absent information in the FNDBs in use.

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[English]
Nutritional status and dietary behavior of North Korean adolescent refugees based on Nutrition Quotient for Korean adolescents: a preliminary study: Young Goh, Seong-Woo Choi, So-Yeong Kim, Jeong-Hwa Choi; Korean J Community Nutr 2023;28(1):1-10. Published online February 28, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.1.1

Abstract PDF: Objectives
This study aimed to investigate the nutritional status and dietary behavior of adolescents from North Korean refugee (NKR) families residing in South Korea (SK), who are known to be at a higher risk of malnutrition due to their lower socioeconomic status and facing other psychological challenges.
Methods
A total of 178 adolescents (91 males and 87 females) from NKR families were included in the analysis, and their demographic details such as age, birthplace, parental nationality, and duration of their settlement in SK were collected through questionnaires. Anthropometric measurements were also taken to determine their growth and nutritional status according to the 2017 Korean National Growth Charts for children and adolescents. The study used the Nutrition Quotient for Korean Adolescents (NQ-A) questionnaire to assess the dietary behavior of the participants.
Results
Approximately 11.8% and 10.1% of participants were identified with malnutrition and obesity, respectively. The total mean score for the NQ-A was 50.1. The mean scores for the individual factors of balance, diversity, moderation, environment, and practice were 49.2, 44.7, 43.8, 51.2, and 61.5, respectively. Approximately 47.2% of participants had a low NQA grade. However, there was no significant difference in the NQ-A scores according to their nutritional status or duration of time in SK.
Conclusions
Adolescents from NKR families exhibited both malnutrition and obesity. However, their dietary behavior, as assessed using the NQ-A, did not vary with their nutritional status. The unique challenges and related dietary behavior of North Korean adolescent refugees should be taken into consideration, when developing targeted strategies for nutritional education and health management programs.

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[Korean]
Problems Encountered in Analyzing the Market Size, Purchase, and Consumption of HMR in the Republic of Korea: Sung Ok Kwon, Injoo Choi, Yoojeong Joo, Jihyun Yoon; Korean J Community Nutr 2022;27(6):480-491. Published online December 31, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.6.480

Abstract PDF

Objectives
This study examined the problems encountered when analyzing the market size, purchase, and consumption of HMR (home meal replacements) in the Republic of Korea.
Methods
The macro data relevant to the market size and purchase status of HMR were critically summarized. The micro data retrieved from the 2019 & 2020 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed to understand the consumption of HMR.
Results
The Korea Agro-Fisheries & Food Trade Corporation and the Ministry of Food and Drug Administration reported the market size of HMR, whereas the Korean Rural Economic Institute and the Rural Development Administration reported the purchase expense and frequencies of HMR. Since the values on the market size and purchase status were calculated or surveyed using different scopes of HMR, there have been reliability issues for the data presented. Additionally, lack of consensus on the use of Korean terms corresponding to HMR was found to be a problem. To examine the consumption of HMR, analysis of the food intake data from KNHANES presented results with very low validity due to the inappropriate survey and coding scheme not reflecting the inclusion of new food types.
Conclusions
Several problematic discrepancies were encountered in the statistics on HMR. The fundamental cause of these problems was the absence of agreement on the scope of HMR and the Korean terms corresponding to it. Considering the increasing importance of HMR in Korean diets, urgent cooperative efforts are required between the government and academia to derive an agreed Korean term and establish the scope of HMR.

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Usage and Quality Satisfaction of Convenience Food at Convenience Stores according to the Eating Behavior of University Students in Southern Gyeonggi Province
Se-In Oh, Ok-Sun Kim
Journal of the East Asian Society of Dietary Life.2023; 33(6): 492. CrossRef

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[Korean]
Development of Korean NOVA Food Classification and Estimation of Ultra-Processed Food Intake Among Adults: Using 2018 Korea National Health and Nutrition Examination Survey: Hae Jin Park, Sohyun Park, Jee Young Kim; Korean J Community Nutr 2022;27(6):455-467. Published online December 31, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.6.455

Abstract PDF

Objectives
In this study, we suggest a Korean NOVA food classification that can be applied to food consumption among Korean. Based on this suggestion, the nutritional intake of Korean adults from ultra-processed foods (UPFs) was estimated.
Methods
Korean commercial food was categorized based on the NOVA food classification criteria through the Korea Food Code and expert meetings. Then, the nutrient intake status of 6,991 participants in the 2018 National Health and Nutrition Examination Survey was analyzed according to the food processing level. Then, 4,152 adult participants (age 19-65) were divided into quartiles on the basis of their intake of UPFs, and the nutrient intakes from UPFs were compared.
Results
Korean NOVA Food Classification defines with priority Group I (Unprocessed/ Minimally processed foods) and Group II (Processed culinary ingredients) foods based on the food cooking or consumption. Then, Group III (Processed foods) and Group IV (UPFs) are classified according to whether the characteristics of the raw materials used are maintained or whether the food was consumed before the 1970s. Our analysis results showed that most of the calories in the diet were consumed by Group I (52.7%), followed by Group IV (29.3%). After categorization of the adult participants into four groups according to their energy consumption from UPFs, we found that the highest consumption group (Q4) was younger and had higher percentage of men than women. The comparative analysis of the consumption of ultra-processed foods by Korean adults revealed that participants of a younger age and men consumed higher energy from UPFs than older participants and women, respectively (P < 0.01). Furthermore, the larger intake of UPFs was associated with an increasing trend for a higher intake of energy, sugar, saturated fat (P for trend < 0.001), total fat (P for trend = 0.021), and sodium (P for trend = 0.005), whereas the intake of carbohydrate, protein, and dietary fiber had a decreasing trend (P for trend < 0.001).
Conclusions
With the current increase in the consumption of processed and ultra-processed foods, it is important to carefully consider not only nutrient intake but also the level of food processing.

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Associations of Ultra-Processed Food Intake with Body Fat and Skeletal Muscle Mass by Sociodemographic Factors
Sukyoung Jung, Jaehee Seo, Jee Young Kim, Sohyun Park
Diabetes & Metabolism Journal.2024; 48(4): 780. CrossRef
Navigating Ultra-Processed Foods with Insight
Ji A Seo
Diabetes & Metabolism Journal.2024; 48(4): 713. CrossRef
Association of ultra-processed food with diabetes and impaired fasting glucose in elderly populations (urban and rural): a cross-sectional study
Seung Jae Lee, Mi Sook Cho
Korean Journal of Community Nutrition.2024; 29(1): 51. CrossRef
Sustainable diets: a scoping review and descriptive study of concept, measurement, and suggested methods for the development of Korean version
Sukyoung Jung
Korean Journal of Community Nutrition.2024; 29(1): 34. CrossRef
Eating patterns in Korean adults, 1998–2018: increased energy contribution of ultra-processed foods in main meals and snacks
Sukyoung Jung, Jee Young Kim, Sohyun Park
European Journal of Nutrition.2024; 63(1): 279. CrossRef
Higher consumption of ultra-processed food is associated with cardiovascular risk in Korean adults: KNHANES 2016–2018
Sukyoung Jung, Eunjin Jang, Hyeongyeong Lee, Jee Young Kim, Sohyun Park
Frontiers in Nutrition.2023;[Epub] CrossRef

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[Korean]
Association between Sarcopenia and Energy and Protein Intakes in Community-dwelling Elderly: Woori Na, Dayoung Oh, Seohyeon Hwang, Bonghee Chung, Cheongmin Sohn; Korean J Community Nutr 2022;27(4):286-295. Published online August 31, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.4.286

Abstract PDF

Objectives
Sarcopenia is one of the most representative factors of senescence, and nutritional status is known to affect sarcopenia. This study was performed to analyze the relationships between energy and protein intake and sarcopenia.
Methods
The study subjects were 3,236 individuals aged ≥ 65 that participated in the Korea National Health and Nutrition Examination Survey (KNHANES) 2008 ~ 2011. General characteristics and anthropometric and 24-hour dietary recall data were analyzed. Sarcopenia was diagnosed using a formula based on appendicular skeletal muscle mass (ASM) and body weight. Logistic regression was performed to determine relationships between sarcopenia risk and energy and protein intakes.
Results
For energy intake, the odds ratio (OR) of sarcopenia in women was significantly higher those with the lowest intake [OR = 1.680, 95% confidence interval (CI) = 1.213-2.326] than those with the highest intake (P for trend = 0.001). Regarding protein intake per kg of body weight, the odds ratio of sarcopenia was significantly higher for those that consumed < 0.8 g/kg of protein daily than those that consumed > 1.2g/kg for men (OR = 2.459, 95% CI = 1.481-4.085) and women (OR = 2.178, 95% CI = 1.423-3.334).
Conclusions
This study shows a link between sarcopenia and energy and protein intake levels and suggests that energy and protein consumption be promoted among older adults to prevent sarcopenia.

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Muscle Mass Changes After Daily Consumption of Protein Mix Supplemented With Vitamin D in Adults Over 50 Years of Age: Subgroup Analysis According to the Serum 25(OH)D Levels of a Randomized Controlled Trial
Yeji Kang, Namhee Kim, Yunhwan Lee, Xiangxue An, Yoon-Sok Chung, Yoo Kyoung Park
Clinical Nutrition Research.2023; 12(3): 184. CrossRef

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[Korean]
Dietary Iron Intake of Koreans Estimated using 2 Different Sources of Iron Contents are Comparable: Food & Nutrient Database and Iron Contents of Cooked Foods in the Korean Total Diet Study: Jeeyeon Lee, Sung Ok Kwon, Yoonjae Yeoh, Min Jeong Seo, Gae Ho Lee, Cho-il Kim; Korean J Community Nutr 2022;27(3):245-253. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.245

Abstract PDF

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 FNDKNHANES.
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.

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Dietary sodium and potassium intake of Koreans estimated using 2 different sources of their contents in foods, Food & Nutrient Database and the Korean Total Diet Study: a comparative study
Jee Yeon Lee, Sung Ok Kwon, Soo Hyun Lee, Min Jeong Seo, Gae Ho Lee, Cho-il Kim
Korean Journal of Community Nutrition.2023; 28(3): 235. CrossRef

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[Korean]
Dietary Behaviors Associated with Health Perception of Korean Adolescents from Multicultural Families: based on data from the 2017 ~ 2019 Korea Youth Risk Behavior Surveys: YueRong Hu, SuJin Song; Korean J Community Nutr 2022;27(3):192-204. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.192

Abstract PDF

Objectives
This study examined the association between dietary behaviors and perceived health status among Korean adolescents from multicultural families.
Methods
This cross-sectional study included 2,459 Korean adolescents from multicultural families (aged 13 ~ 18 years) who participated in the 2017 ~ 2019 Korea Youth Risk Behavior Surveys. Information on the sociodemographic variables, dietary behaviors, and lifestyle variables was selfreported using a web-based questionnaire. The dietary behaviors analyzed in this study were the breakfast and food intake frequencies, including fruit, vegetable, milk, fast food, carbonated drink, sweet drink, and high caffeine/energy drinks. The adolescents’ health perception was self-rated as healthy, average, or unhealthy. The dietary behaviors associated with health perception were examined using a multiple logistic regression after adjusting for the confounding variables.
Results
In this study population, 7.6% of adolescents perceived their health status as unhealthy, and 25.4% perceived it as average. The adolescents who were girls, middle school students, and in households with a low economic status showed significantly higher percentages of poor health perception (P-values < 0.001). Skipping breakfast was significantly associated with a negative health perception. Compared to the adolescents who consumed fruits every day, those who did not consume fruits during the previous week showed a higher odd ratio (OR) for a negative health perception [OR = 2.29, 95% confidence interval (CI) = 1.32–3.97]. The adolescents who frequently consumed carbonated drinks ( 5 times/week) perceived their health status as unhealthy relative to those who did not consume carbonated drinks (OR = 2.15, 95% CI = 1.25–3.71). Skipping breakfast was significantly associated with an increased OR for a negative health perception in girls but not in boys. Compared to adolescents with a normal weight, those with overweight/ obesity (OR = 1.75, 95% CI = 1.21–2.52) and underweight (OR = 2.19, 95% CI = 1.25–3.82) showed higher ORs for negative health perception. Positive associations of overweight/obesity and underweight with negative health perception were observed in boys but not in girls.
Conclusions
Dietary behaviors and weight status were associated with the health perception in Korean adolescents from multicultural families. These findings suggest that nutrition interventions on breakfast intake and healthy food choices for this population might effectively improve their weight and perceived health status.

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The unequal weight of COVID-19 pandemic: national trends in body mass index among Korean adolescents by immigrant-origin and gender from 2013 to 2022
Nari Yoo, Yumin Hong, Yoonyoung Choi
International Journal of Adolescence and Youth.2024;[Epub] CrossRef

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[Korean]
Trends in Dietary Protein Intake and Its Adequacy among Korean Adults: Data from the 2010 ~ 2019 Korea National Health and Nutrition Examination Survey (KNHANES): Hyunji Ham, Kyungho Ha; Korean J Community Nutr 2022;27(1):47-60. Published online February 28, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.1.47

Abstract PDF

Objectives
This study aimed to evaluate dietary protein intake and its adequacy among Korean adults during recent 10 years.
Methods
Based on the 2010 ~ 2019 Korea National Health and Nutrition Examination Survey (KNHANES) data, a total of 51,296 adults aged 19 years old or more who participated in a one-day 24-hr dietary recall were included. Dietary protein intake was estimated as percentages of total energy (% of energy) and grams per body weight (g/kg/ day) and compared with the 2020 Dietary Reference Intakes for Koreans to evaluate the adequacy of protein intake. In addition, proportions of people whose protein intakes were less than the estimated average requirement (EAR) and above the upper limit of the acceptable macronutrient distribution range (AMDR) (> 20% of energy) were calculated according to sociodemographic characteristics.
Results
Protein intake was increased from 14.7% of energy in 2010 to 15.6% of energy in 2019 among Korean adults. However, there was no increase in protein intake relative to the recommended nutrient intake (% RNI) during the recent 10 years. Protein intake relative to the RNI was decreased from 130.2% in 2010 to 121.1% in 2019 (P for trend < 0.0001) among total participants, and a significant decreasing trend was observed in all age groups except for over 65 years old. However, protein intake relative to the RNI was lowest in the elderly (98.6%). Proportions of low protein intake (< EAR) and high protein intake (> AMDR) increased in the past 10 years (P for trend < 0.0001 for all), and these were associated with socioeconomic statuses, such as education and household income levels.
Conclusions
These findings suggest that protein adequacy in Korean adults has not been improved over the past decade compared with recommended levels. Nutritional education and intervention programs should consider different intake levels according to sociodemographic characteristics.

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High-Protein Products in 2013 and 2023: Shifts in Diverse Aspects Over the Last Ten Years
Hye Ran Lee, Ihyeon Cho, Hyejin Yi, Hee Jung Park
Food Supplements and Biomaterials for Health.2024;[Epub] CrossRef
Regional differences in protein intake and protein sources of Korean older adults and their association with metabolic syndrome using the 2016–2019 Korea National Health and Nutrition Examination Surveys: a cross-sectional study
You-Sin Lee, Yoonna Lee
Korean Journal of Community Nutrition.2024; 29(3): 173. CrossRef
Development of Protein Enhanced Diet for Socially Vulnerable Elderly
Jihye Hong, Hyung-Geun Jeon, Seulgi Kim, Gitae Park
Journal of the East Asian Society of Dietary Life.2024; 34(1): 39. CrossRef
Consumption of protein supplements/protein-fortified foods among young adults in Jeju
Hyoju Lee, Youjeong Jang, Sumin Kim, Kyungho Ha
Journal of Nutrition and Health.2024; 57(2): 261. CrossRef
Relationship between protein intake and grip strength in qualitative and quantitative aspects among the elderly in Korea: results from the Korea National Health and Nutrition Examination Survey
Mi‑Hyun Kim, Mi‑Kyeong Choi, Yun‑Jung Bae
BMC Geriatrics.2023;[Epub] CrossRef
Current status of nutrient intake in Korea: focused on macronutrients
Seung-Won Oh
Journal of the Korean Medical Association.2022; 65(12): 801. CrossRef

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[Korean]
Regional Differences in Dietary Total Fat and Saturated Fatty Acid Intake and Their Associations with Metabolic Diseases among Korean Adults: Using the 2016~2019 Korea National Health and Nutrition Examination Surveys: SuJin Song, Jae Eun Shim; Korean J Community Nutr 2021;26(6):495-507. Published online December 31, 2021; DOI: https://doi.org/10.5720/kjcn.2021.26.6.495

Abstract PDF

Objectives
This study examined regional differences in the intake of dietary total fat and saturated fatty acid (SFA) and their food sources among Korean adults. We also investigated the associations of SFA intake with metabolic diseases by region.
Methods
This study included 13,926 adults ( 19y) who participated in the 2016 ~ 2019 Korea National Health and Nutrition Examination Surveys. The regions were divided into urban and rural areas according to the administrative districts where the participants lived. Using dietary data obtained from a 24-h recall, intake of total fat and SFA and their food sources were assessed by region. Metabolic diseases included obesity, abdominal obesity, and elevated total cholesterol and their association with SFA intake by region were examined using multiple logistic regression.
Results
Of the participants, 19.6% lived in rural areas. In urban areas, the total fat and SFA intakes were higher than in rural areas: 21.2% of energy (%E) came from total fat and 6.9%E from SFA in urban areas, whereas 18.0%E came from total fat and 5.8%E from SFA in rural areas. The percentage of participants who exceeded the dietary reference intakes for total fat and SFA in urban areas was 16.5% and 41.9%, respectively, but 43.4% of participants in rural areas showed lower intake levels for total fat compared to the reference level. Young adults did not show regional differences in fat intake, and the percentage of subjects who exceeded the reference for SFA was high both in urban (58.5%) and rural (55.7%) areas. Among middle-aged and older adults, intake of fatty acids except for n-3 fatty acid was significantly higher in urban areas than in rural areas. About 69% of older adults in rural areas showed a lower intake of total fat compared to the reference level. The food sources for total fat and SFA were meat, soybean oil, eggs, and milk in both areas. The intake of fat from eggs, milk, mayonnaise, and bread was higher in urban areas, but the intake of fat from white rice and coffee mix was higher in rural areas. The SFA intake was positively associated with elevated serum total cholesterol in urban areas (4th quartile vs. 1st quartile, OR: 1.22, 95% CI: 1.06-1.40, P for trend: 0.043), but not in rural areas.

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Regional differences in protein intake and protein sources of Korean older adults and their association with metabolic syndrome using the 2016–2019 Korea National Health and Nutrition Examination Surveys: a cross-sectional study
You-Sin Lee, Yoonna Lee
Korean Journal of Community Nutrition.2024; 29(3): 173. CrossRef
Estimating and evaluating usual total fat and fatty acid intake in the Korean population using data from the 2019–2021 Korea National Health and Nutrition Examination Surveys: a cross-sectional study
Gyeong-yoon Lee, Dong Woo Kim
Korean Journal of Community Nutrition.2023; 28(5): 414. CrossRef
Associations of Dietary Intakes of Total and Specific Types of Fat with Blood Lipid Levels in the Filipino Women’s Diet and Health Study (FiLWHEL)
Heejin Lee, Hyojin Kim, Sherlyn Mae P. Provido, Minji Kang, Grace H. Chung, Jae W. Lee, Sangmo Hong, Sung Hoon Yu, Chang Beom Lee, Jung Eun Lee
Global Heart.2023; 18(1): 29. CrossRef
Regional Differences in Metabolic Risk in the Elderly in Korea
Ji-Myung Kim, Yun-Jung Bae
International Journal of Environmental Research and Public Health.2022; 19(18): 11675. CrossRef

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[Korean]
Association between Eating Alone Patterns and Mental Health Conditions by Region among Korean Adults: Kyung Won Lee, Dayeon Shin; Korean J Community Nutr 2021;26(6):441-454. Published online December 31, 2021; DOI: https://doi.org/10.5720/kjcn.2021.26.6.441

Abstract PDF

Objectives
This study investigated the association between the frequency and pattern of eating alone and the mental health status according to region in Korean adults.
Methods
The data of 10,040 Korean adults aged ≥ 19 years from the Korea National Health and Nutrition Examination Survey (KNHANES) 2017 and 2019 were used. Participants were divided into 4 groups based on their frequency of eating alone: none (all meals together), 1, 2, and 3 meals/day alone. The regions were divided into urban and rural areas. Mental health status was assessed by stress recognition, depressive symptoms, and suicidal ideation. Multivariable logistic regressions were conducted to estimate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) on the association of the frequency and pattern of eating alone with poor mental health after controlling for covariates.
Results
Among Korean adults, 74.1% ate more than one meal a day alone. Individuals having 3 meals a day alone tended to be less educated, single, single person households, or living in urban areas (all P < 0.05). In rural areas, those having 3 meals/ day alone had higher odds of stress recognition (AOR: 1.55, 95% CI: 1.02-2.35) than those having all meals together. In urban areas, individuals eating alone 3 times/day had higher odds of stress recognition (AOR: 1.60, 95% CI: 1.31-1.96), depressive symptoms (AOR: 1.61, 95% CI: 1.23-2.12), and suicidal ideation (AOR: 2.14, 95% CI: 1.42-3.22) compared to those having all meals together. Urban residents having dinner alone had higher odds of depressive symptoms (AOR: 1.29, 95% CI: 1.05-1.58) and suicidal ideation (AOR: 1.66, 95% CI: 1.19-2.33) than those having dinner with others.
Conclusions
Our findings showed that the frequency and patterns of eating alone were differentially associated with increased odds of poor mental health according to region of residence. Nutrition education is needed for those frequently eating alone, particularly those living in urban areas, to highlight the advantages of eating together and to ensure that they have balanced and healthy meals even if they eat alone.

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Association of ultra-processed food with diabetes and impaired fasting glucose in elderly populations (urban and rural): a cross-sectional study
Seung Jae Lee, Mi Sook Cho
Korean Journal of Community Nutrition.2024; 29(1): 51. CrossRef
How Does the Frequency of Eating-Alone among Older People in Korea Affect Their Health and Dietary Behavior?
Yongseok Kwon, Kyung Hee Hong, Yoo-Kyung Park, Sohye Kim
Nutrients.2023; 15(9): 2085. CrossRef
Impact assessment of a primary care physician counseling program for youth population
Yun-Su Kim, Shin-Ae Kim
Medicine.2022; 101(46): e31916. CrossRef

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[Korean]
Association of Dietary Quality with Subjective Health-Related Perception and Chronic Diseases According to Age Segmentation of Korean Elderly: Sojeong Lee, Seungmin Lee; Korean J Community Nutr 2021;26(5):363-381. Published online October 31, 2021; DOI: https://doi.org/10.5720/kjcn.2021.26.5.363

Abstract PDF

Objectives
This study examined the Korean elderly’s dietary intake status, subjective health-related perception and chronic disease prevalence among age groups. Associations of dietary quality with subjective health-related perception and chronic diseases were also examined.
Methods
Based on data from the 7th National Health and Nutrition Examination Survey, a total of 3,231 elderly were selected and categorized into 4 age groups of ‘65 ~ 69’, ‘70 ~ 74’, ‘75 ~ 79’ and ‘over 80’. Nutrient intakes, proportions of those with insufficient nutrient intakes, Korean Healthy Eating Index (KHEI), some subjective health-related perceptions and prevalence of major chronic diseases were compared according to the age groups. Differences in the subjective health-related perceptions and odds ratios of the chronic diseases according to the quartile levels of KHEI within the same age group were analyzed.
Results
With the increase of age, several nutrient intakes (P < 0.001) and KHEI scores significantly decreased (P < 0.01). In women, activity restriction increased (P < 0.05), and EQ-5D score decreased with age (P < 0.001). Prevalence of hypertension (P < 0.0001), hypercholesterolemia (P < 0.05) and anemia (P < 0.01) significantly increased, while hypertriglyceridemia (P < 0.01) significantly decreased only in men. Obesity prevalence decreased, while underweight prevalence increased (P < 0.05). Subjective health status, EQ-5D score and PHQ-9 score significantly improved as KHEI score increased in certain age groups of women (P< 0.05). Odds ratio of hypercholesterolemia significantly increased with the increase of KHEI score in 65 ~ 69-year-old women. However, hypertension and anemia significantly decreased with the increase of KHEI score in 75 ~ 79-year-old women (P < 0.05).
Conclusions
The study findings suggest that nutrition management and policy for the Korean elderly need to apply a segmented age standard that can better reflect their dynamic characteristics.

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Association between Healthy Eating Index and Mental Health in Middle-Aged Adults Based on Household Size in Korea
Ji-Myung Kim, EunJung Lee
International Journal of Environmental Research and Public Health.2022; 19(8): 4692. CrossRef
Blood Biochemical Characteristics, Dietary Intake, and Risk Factors Related to Poor HbA1c Control in Elderly Korean Diabetes Patients: Comparison between the 4th(2007-2009) and the 7th(2016-2018) Korea National Health and Nutrition Examination Surveys
Sung-Won Oh, Sook-Bae Kim
Korean Journal of Community Nutrition.2022; 27(5): 406. CrossRef
Comparison of the Nutrient Intake and Health Status of Elderly Koreans According to their BMI Status: Focus on the Underweight Elderly Population
You-Sin Lee, Yoonna Lee
Korean Journal of Community Nutrition.2022; 27(5): 422. CrossRef

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[English]
Development of a Zinc Database to Estimate the Zinc Intake Levels in the Korean Toddlers and Preschool Children: Su-In Yoon, Jae Eun Shim; Korean J Community Nutr 2021;26(2):103-110. Published online April 30, 2021; DOI: https://doi.org/10.5720/kjcn.2021.26.2.103

Abstract PDF

Objectives
The objective of this study was to develop a zinc database (DB) to estimate the intake levels of zinc in Korean toddlers and preschool children using the data from the Korea National Health and Nutrition Examination Survey (KNHANES). Methods: A total of 3,361 food items for the DB representing the usual diet of Korean toddlers and preschool children were selected based on KNHANES (2009~2013) and the food composition table of Rural Development Administration (RDA). The existing values of zinc in foods were collected from the latest food composition tables of RDA (9th revision) and the US Department of Agriculture (legacy release). The zinc contents were filled preferentially with these collected values. The missing values were replaced with the calculated values or imputed values using the existing values of similar food items from the data source. The zinc intake levels of Korean toddlers and preschool children were estimated using KNHANES and zinc DB Results: A total of 1,188 existing values, 412 calculated values, and 1,727 imputed values were included in the zinc DB. The mean intake levels of zinc for 1-2-year-old children and 3-5-year-olds were 5.17 ± 2.94 mg/day and 6.30 ± 2.84 mg/day, respectively.There was no significant difference in the zinc intake levels between boys and girls in each group. Conclusions: This newly developed zinc DB would be helpful to assess the zinc nutritional status and investigate the association between the zinc intakes and related health concerns in Korean toddlers and preschool children.

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Food sources of zinc and nutritional status with usual dietary zinc intake in Korean toddlers and preschool children
SuJin Song, Jae Eun Shim
Nutrition Research and Practice.2023; 17(6): 1211. CrossRef

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[English]
Vegetable and Nut Food Groups are Inversely Associated with Hearing Loss- a Cross-sectional Study from the Korea National Health and Nutrition Examination Survey: Sunghee Lee, Jae Yeon Lee; Korean J Community Nutr 2020;25(6):512-519. Published online December 31, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.6.512

Abstract PDF: Objectives
A cross-sectional study was conducted to investigate the associations between food groups and hearing loss. Methods: Data of 1,312 individuals were used from the Korea National Health and Nutrition Examination Survey 2013. Hearing loss was determined with a pure tone average (PTA) of greater than 25 dB in either ear. The PTA was measured as the average hearing threshold at speech frequencies of 0.5, 1, 2, and 4 kHz. The dietary intake was examined with a food frequency questionnaire with 112 food items. The food items were classified into 25 food groups. A weighted logistic regression was used to investigate the association. Results: Individuals in the highest tertile of vegetables and nuts food groups were less likely to have hearing loss than those in the lowest tertile [Odds Ratio (OR) = 0.58 (95% Confidence interval (CI) 0.38-0.91), P = 0.019; OR = 0.59 (95% CI 0.39-0.90), P = 0.020, respectively], after adjusting for confounding variables of age, sex, body mass index, drinking, smoking, diabetes, hypertension, and physical activity. Conclusions: In this cross-sectional study, we observed that high intake of vegetables and nuts food groups revealed significant inverse associations with hearing loss, after adjusting for confounding variables among 1,312 participants.

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[English]
Evaluation of Nutritional Status of Vitamins and Minerals According to Consumption of Dietary Supplements in Korean Adults and the Elderly: Report Based on 2017 Korea National Health and Nutrition Examination Survey data: Ji-Myung Kim; Korean J Community Nutr 2020;25(4):329-339. Published online August 31, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.4.329

Abstract PDF

Objective
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.

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Effect of Dietary Supplements on Vitamin and Mineral Intake Among Koreans: Data From the 2018-2020 Korea National Health and Nutrition Examination Survey
Moon Yeong Hwang, Jiyoun Hong
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Estimated dietary vitamin D intake and major vitamin D food sources of Koreans: based on the Korea National Health and Nutrition Examination Survey 2016–2019
Ki Nam Kim, Jung-Sug Lee, Jee-Seon Shim, Mi Ock Yoon, Hyun Sook Lee
Nutrition Research and Practice.2023; 17(3): 451. CrossRef
A Study on the Dietary Behavior of Korean Adults: Focus on Dietary Supplement Intake, Household Size, and COVID-19
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Korean Journal of Community Nutrition.2022; 27(6): 468. CrossRef

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Original Articles

[English]
Relation between the Total Diet Quality based on Korean Healthy Eating Index and the Incidence of Metabolic Syndrome Constituents and Metabolic Syndrome among a Prospective Cohort of Korean Adults: Saerom Shin, Seungmin Lee; Korean J Community Nutr 2020;25(1):61-70. Published online February 29, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.1.61

Abstract PDF PubReader ePub

OBJECTIVES
This study examined the association of the total diet quality with the incidence risk of metabolic syndrome constituents and metabolic syndrome among Korean adults.
METHODS
Based on a community-based cohort of the Korean Genome and Epidemiology Study (KoGES) from 2001 to 2014, data from a total of 5,549 subjects (2,805 men & 2,744 women) aged 40~69 years at the baseline with a total follow-up period of 38,166 person-years were analyzed. The criteria of the National Cholesterol Education Program Adult Treatment Panel was employed to define metabolic syndrome. The total diet quality was estimated using the Korean Healthy Eating Index (KHEI). Hazard ratios (HR) and 95% confidence intervals (CI) for risk of metabolic syndrome constituents and metabolic syndrome in relation to KHEI quintile groups was calculated by multivariate Cox proportional hazards regression model.
RESULTS
After adjusting for age, energy intake, income, education, physical activity, smoking, and drinking, the incidence of abdominal obesity and high blood pressure was significantly lower, by approximately 29.7% (P < 0.01) and 25.2% (P < 0.01), respectively, in the fifth KHEI quintile compared to the first quintile in men. A significant decreasing trend of the metabolic syndrome incidence was observed across the improving levels of KHEI (HRq5vs.q1: 0.775, 95% CIq5vs.q1: 0.619~0.971, P for trend < 0.01). In women, the incidence of abdominal obesity and metabolic syndrome was significantly lower, by approximately 29.8% (P < 0.01) and 22.5% (P < 0.05), respectively, in the fifth KHEI quintile compared to the first quintile adjusting for multiple covariates. On the other hand, the linear trend of metabolic syndrome risk across the KHEI levels did not reach the significance level.
CONCLUSIONS
A better diet quality can prevent future metabolic syndrome and its certain risk factors among Korean men and women.

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Jina Yoon, Dayeon Shin
Journal of Nutrition and Health.2024; 57(1): 88. CrossRef
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Seong-Uk Baek, Taeyeon Kim, Yu-Min Lee, Jong-Uk Won, Jin-Ha Yoon
Nutrients.2024; 16(10): 1516. CrossRef
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Hae Young Kim, Jeong-Hwa Choi
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Hyeonjin Cho, Sunwoo Han, Jiwon Jeong, Hyein Jung, Sangah Shin
Journal of Nutrition and Health.2023; 56(1): 70. CrossRef
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Min Kwon, Jinheum Kim, Eunjeong Cha
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The association of the Korean Healthy Eating Index with chronic conditions in middle-aged single-person households
EunJung Lee, Ji-Myung Kim
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Association between the Korean Healthy Eating Index and Serum Vitamin D Level in Korean Adults: 2013–2015 Korea National Health and Nutrition Examination Survey
So-Yoon Choi, Yu-Jin Kwon, Ji-Won Lee
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[English]
Effect of Geographic Area on Dietary Quality across Different Age Groups in Korea: Hyun Ja Kim, Kirang Kim; Korean J Community Nutr 2019;24(6):453-464. Published online December 31, 2019; DOI: https://doi.org/10.5720/kjcn.2019.24.6.453

Abstract PDF PubReader

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 2013â€“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 Â± 0.4 score for 20s and 61.2 Â± 0.3 score for 30s) and increased with age (p<0.001), showing the highest score in the 60s (67.9 Â± 0.3 score), and then decreased again in the 70s and older (64.6 Â± 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 Â± 0.2 score for urban area and 62.2 Â± 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.

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[English]
Evaluation of the Nutrition Status and Metabolic Syndrome Prevalence of the Members according to the Number of Household Members based on the Korea National Health and Nutrition Examination Survey (2013–2014): Jin Young Lee, Soo Kyong Choi, Jung Sook Seo; Korean J Community Nutr 2019;24(3):232-244. Published online June 30, 2019; DOI: https://doi.org/10.5720/kjcn.2019.24.3.232

Abstract PDF PubReader

OBJECTIVES
This study evaluated the nutritional status and prevalence of metabolic syndrome of the people who participated in the KNHANES according to the number of household members. They were assessed by using information from the 2013~2014 Korea National Health and Nutrition Examination Survey (KNHANES).
METHODS
A total of 6,088 persons aged 19 years and over participated in 2013~2014 KNHANES, and they were classified into three groups according to the number of household members (single-person, two-person, three-person & over). The dietary behavior, nutritional status, health-related factors and the prevalence of metabolic syndrome of the subjects were investigated with using information from the survey questionnaires of KNHANES. The nutrient intake data of the subjects were obtained by the 24-hour recall method and this was analyzed for evaluating the nutrition adequacy ratio and the index of nutritional quality. The prevalence of metabolic syndrome among the subjects, and according to the study groups, was estimated using the blood and physical measurement data of the subjects.
RESULTS
As for EQ-5D index available for all the health states generated by the EQ-5D descriptive system, the single-person household member was the lowest among all the household types. The index of nutrition quality for protein, crude fiber, calcium, phosphorus, potassium, riboflavin and vitamin C in the single-person household was lower than that of the two-person or the three-person and over households (p<0.001). The mean adequacy ratio of single-person households was significantly decreased compared with that of the other types of households (p<0.001). The prevalence of metabolic syndrome was higher in the single-person households than that in the multiple-person households (p<0.001).
CONCLUSIONS
These results showed that dietary behaviors, nutrition status and health status might be influenced by the number of household members. The results from this study would be useful for improving Korean people's dietary life and health status by implementing evidence-based, specialized intervention for the members of diverse types of households.

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Relationships of Dietary Factors with Obesity, Hypertension, and Diabetes by Regional Type among Single-Person Households in Korea
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[English]
Evaluation of Total Fat and Fatty Acids Intakes in the Korean Adult Population using Data from the 2016–2017 Korea National Health and Nutrition Examination Surveys: SuJin Song, Jae Eun Shim; Korean J Community Nutr 2019;24(3):223-231. Published online June 30, 2019; DOI: https://doi.org/10.5720/kjcn.2019.24.3.223

Abstract PDF PubReader

OBJECTIVES
This study evaluated dietary intakes of total fat and fatty acids among the Korean adult population.
METHODS
This cross-sectional study used the 2016â€“2017 Korea National Health and Nutrition Examination Survey data. A total of 10,772 subjects aged â‰¥19 y for which dietary data were available were selected. Data pertaining to energy and nutrient intakes were obtained by a 24-h recall method. Total fat and fatty acids intakes were evaluated based on the Acceptable Macronutrient Distribution Ranges (AMDR) of 2015 Dietary Reference Intakes for Koreans by sex and age groups. All statistical analyses accounted for the complex sampling design effect and sampling weights.
RESULTS
The mean intakes of energy and total fat were 1,952 kcal (95% CI: 1928â€“1977) and 46.1 g (45.2â€“47.1), respectively, and about 21% of the energy was obtained from fat in this study population (21.7% in men and 20.2% in women). The mean percentages of energy from saturated, monounsaturated, and polyunsaturated fatty acids were 6.4%, 6.7%, and 5.2%, respectively. About 18% of adults exceeded the AMDR for fat (30% of energy), whereas 37.6% exceeded the AMDR for saturated fatty acids (7% of energy). The proportions of subjects who consumed more than the AMDR for fat and saturated fatty acids decreased across age groups in both sexes. Among young adults (19â€“29 y), about 63% of the subjects obtained â‰¥7% of their energy from saturated fatty acids. About 61% of older adults obtained less than 15% of their energy from total fat.
CONCLUSIONS
Increased intake of fat energy was prominent in saturated fatty acids. Our findings suggest current information on total fat and fatty acids intakes in Korean adults and can be used to provide dietary guidelines for the improvement of public health.

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[English]
Analysis of the Difference in Nutrients Intake, Dietary Behaviors and Food Intake Frequency of Single- and Non Single-Person Households: The Korea National Health and Nutrition Examination Survey (KNHANES), 2014–2016: Na Yeon Kang, Bok Mi Jung; Korean J Community Nutr 2019;24(1):1-17. Published online February 28, 2019; DOI: https://doi.org/10.5720/kjcn.2019.24.1.1

Abstract PDF PubReader

OBJECTIVES
This study was performed to compare the dietary life of single- and non single-person households in the Korea National Health and Nutrition Examination Survey (KNHANES).
METHODS
A nationally representative sample of 20,421 19-64-year-olds who had 24-hour recall data was taken from the 2014-2016 Korea National Health and Nutrition Examination Survey (KNHANES). Single- and non single-persons were compared for nutrient intake, dietary behaviors, food consumption patterns, nutrition education and confirm nutrition label.
RESULTS
The dietary intakes of dietary fiber and iron were lower in single-person households than in non single-person households. The lower the level of education and income, the lower the nutrient intake of single-person households. In the case of those aged 19 to 29, the breakfast skipping rate was higher in single-person households than in non single-person households. The higher the education level, the higher the breakfast skipping rate and the eating out frequency in the single-person households. In the food intake survey, the frequency of healthy food intake in single-person households was much lower than that of non single-person households. The confirmation rate of nutrition labeling was lower in single-person households than in non single-person households.
CONCLUSIONS
This study shows that single-person households have poorer health-nutritional behaviors than multi-person households. Therefore, a nutrition education program based on the data of this study needs to be developed for health promotion of single-person households.

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[English]
Milk Intake Patterns with Lactose and Milk Fat in Korean Male Adults: Jung Hyun Kim, Min Sook Kyung, Sung Hee Min, Myung Hee Lee; Korean J Community Nutr 2018;23(6):488-495. Published online December 31, 2018; DOI: https://doi.org/10.5720/kjcn.2018.23.6.488

Abstract PDF PubReader

OBJECTIVES
This study examined the milk intake patterns with lactose and milk fat in Korean male adults using the following variables: milk intake level, awareness of lactose, and milk fat, health problems, and necessity of milk intake. In addition, the factors affecting milk intake were analyzed by multiple regression analysis.
METHODS
The subjects were 532 males aged 20 years or older among the nationwide milk purchasing group. The subjects were 223 (41.9%) in the 20â€“29 year age group, 188 (35.3%) in the 30â€“49 year age group and 121(22.7%) in the over 50 year age group. The survey was conducted using ANOVA and multiple comparative analysis to examine the differences in age and multiple regression analysis was performed to investigate the factors affecting the intake of milk.
RESULTS
The intake of milk in the subjects was 538.14 Â± 494.23 ml per week. There were statistically significant differences in the subjects' age according to processed milk, low fat, nonfat milk, cheese, and ice cream. The perception of milk and lactose and milk fat was recognized as a good food for skeletal health when milk was consumed. Among the milk nutrients, lactose was highly recognized at the age of 20â€“29, and milk fat was recognized in those over 50 years. In addition to lactose and milk fat, calcium was the most highly recognized among the milk nutrients. Health problems associated with milk were skeletal health, obesity, and lactose intolerance. The perception of lactose intolerance was related to lactose intolerance and fatness, and the dietary behavior was unaffected.
CONCLUSIONS
This study examined the milk intake patterns of adult Korean males. Many variables were found to be related to the intake of milk. In this study, the milk intake was high when there was no problem with the perception and dietary behaviors of milk nutrition (lactose and milk fat). This study focused on lactose and milk fat, which are major nutrients in milk, and it is a new perspective study among milk-related research.

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Association of milk and dairy product consumption with the incidence of cardio-cerebrovascular disease incidence in middle-aged and older Korean adults: a 16-year follow-up of the Korean Genome and Epidemiology Study
Yeseung Jeong, Kyung Won Lee, Hyekyeong Kim, Yuri Kim
Nutrition Research and Practice.2023; 17(6): 1225. CrossRef

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