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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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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