The association of potassium intake with bone mineral density and the prevalence of osteoporosis among older Korean adults

Risk Factor Analysis of Diabetic Retinopathy Diagnosed with Non-mydriatic Fundus Camera: KNHANES V

PURPOSE: To clarify the relationship between various factors (sociodemographic factors, health behavioral risk factors and health status, and diabetic factors) related to diabetic retinopathy and to suggest improvements regarding the associated medical examination. METHODS: The subjects were 1,444 diabetic patients diagnosed in the 5th Korean National Health and Nutrition Examination Survey (KNHANES), aged 19 years or older, who underwent non-mydriatic fundus photography. The criteria for diagnosing diabetes were a fasting glucose level ≥ 126 mg/dL and a previous diagnosis of diabetes or currently undergoing treatment. The diagnosis of diabetic retinopathy followed the modified Airlie House classification. Univariate and multivariate analyses of diabetic retinopathy were performed. RESULTS: Among the 1,444 patients who were diagnosed with diabetes, 277 had diabetic retinopathy; the prevalence rate was 19.18%. The higher the body mass index, the lower the risk of diabetic retinopathy by 0.924 times (p = 0.001; 95% confidence interval [CI], 0.883–0.966). The longer the duration of diabetes, the greater the risk of diabetic retinopathy; the prevalence period group of more than 11 years had a 26.025-fold higher risk than the newly diagnosed group (p < 0.001; 95% CI, 10.840–62.482). The risk of diabetic retinopathy increased with the hemoglobin A1c (HbA1c) level; the risk was 5.973-fold higher in the group with HbA1c above 11.0% (p < 0.001; 95% CI, 2.984–11.956) compared with the group with HbA1c < 6.0%. The risk of diabetic retinopathy was 2.050-fold greater with insulin injections (p = 0.003; 95% CI, 1.284–3.275). CONCLUSIONS: The risk of diabetic retinopathy was higher in patients with a longer duration of diabetes, a high HbA1c level, and in those using insulin. These findings highlight the need for early education and ophthalmologic examinations for at-risk patients.

Change over a period of 9 years in self-reported oral health of a middle-aged population using 4-6th KNHANES data / 대한구강보건학회지

OBJECTIVES: To explore changes in self-reported oral health in middle-aged Koreans over a period of 9 years. METHODS: This study design was a cross-sectional analysis. This study analyzed the data of 18,845 middle-aged (45-64 years) subjects who participated in 4-6th Korea National Health and Nutrition Examination Surveys (KNHANES). A complex-sample chi-square test was used to analyze self-reported poor oral health according to sex, household income, and education. A complex-sample logistic regression analysis was used to identify the changes in the factors. SPSS 23.0 and the R ver. 3.5.1 statistical package were used for the analyses. RESULTS: Poor oral health have been decreased by 5.3% over the 9-year period. Middle-aged men were more likely to report their oral health as worse than women. The lower income and education groups reported their oral health as poor compared to the higher income and education groups. The factors affecting self-reported poor oral health over the 9-year period were sex, income, and education. CONCLUSIONS: More than half of the aged population reported their oral health as poor. Oral health policies should be established for the aged population, including the middle-aged population, for long-term plans.

The Association of Relative Handgrip Strength with Type 2 Diabetes among Koreans Aged 20 Years or More

BACKGROUND: Handgrip strength is a simple, convenient and economic tool measuring the muscle strength. A few studies investigated the relationship between diabetes and handgrip strength but the results are conflicting. This study investigated the association of handgrip strength with diabetes among the adult Koreans. METHODS: This cross-sectional study analyzed data from participants aged 20 years or more (n=8,082) who measured height, weight, handgrip strength and fasting blood glucose in the 2014–2015 Korea National Health and Nutrition Examination Survey. Relative handgrip strength (RHGS) was defined as the sum of the greatest handgrip strengths in both hands divided by body mass index. To investigate the association of diabetes with handgrip strength, complex sample multivariate logistic regression analyses were done after adjusting for socioeconomic (age, sex, education), lifestyle (smoking, alcohol drinking, physical activity, obesity) and comorbid (chronic obstructive pulmonary disease, stroke, coronary artery disease, arthritis) variables. Stratified analysis were done according to socioeconomic and lifestyle variables. RESULTS: The prevalence of diabetes was 8.3% (standard error, 0.4). After adjusting for socioeconomic, lifestyle, and comorbid variables, the risk of diabetes increased according to the decrease in sex-specific quartile of RHGS (P(trend)<0.001). Individuals with lower RHGS (per 1 standard deviation decrease) had higher odds of diabetes (adjusted odds ratio, 1.6; 95% confidence interval, 1.3–2.0). Furthermore, lower RHGS was associated with higher odds for diabetes throughout the strata of socioeconomic and lifestyle variables. CONCLUSIONS: This population-based, nationally representative study suggests that lower RHGS is associated with the increased risk of diabetes regardless of socioeconomic and lifestyle variables.

Factors Associated with Unmet Healthcare Needs of the Older Korean Population: The Seventh Korea National Health and Nutrition Examination Survey 2017

BACKGROUND: South Korea has the fastest growing aging population in the world, and older people require more healthcare services. Unmet healthcare needs still exist in Korea due to several complex reasons. This study aimed to evaluate the factors associated with unmet healthcare needs of the older Korean population. METHODS: This cross-sectional study included 1,194 older adults, aged 65 years and older, who participated in the Seventh Korea National Health and Nutrition Examination Survey conducted in 2017. Sociodemographic factors, lifestyle and health status, comorbidity, and unmet healthcare needs were included in this study's analysis. Multiple logistic regression analysis was used to evaluate the association between unmet healthcare needs and other factors. RESULTS: The prevalence of unmet healthcare needs in this study population was 7.8%. After adjusting for age, sex, education level, household income, living alone, private health insurance, regular walking, body mass index, unintended weight loss, and osteoarthritis, women (adjusted odds ratio [aOR], 1.921; 95% confidence interval [CI], 1.061–3.479) and unintended weight loss (aOR, 2.218; 95% CI, 1.105–4.453) were more likely to have unmet healthcare needs than their counterparts. The group with general obesity (aOR, 1.691; 95% CI, 1.015–2.816) was more likely to have unmet healthcare needs than the group with normal body mass index. CONCLUSIONS: Among the older Korean population, being a woman, general obesity, and unintended weight loss may be risk factors for unmet healthcare needs.

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 / 대한지역사회영양학회지

OBJECTIVES: This study evaluated dietary intakes of total fat and fatty acids among the Korean adult population. METHODS: This cross-sectional study used the 2016–2017 Korea National Health and Nutrition Examination Survey data. A total of 10,772 subjects aged ≥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: 1928–1977) and 46.1 g (45.2–47.1), 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 (19–29 y), about 63% of the subjects obtained ≥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.

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) / 대한지역사회영양학회지

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.

Food and Nutrient Intake Level by the Risk of Osteoporosis and Cardiovascular Disease in Postmenopausal Women: The use of the 5th Korean National Health and Nutrition Examination Surveys (2010–2011) / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to investigate the food, nutrient intake, and diet quality of postmenopausal women at high risk of osteoporosis (OP) and cardiovascular disease (CVD) compared with those of control subjects. METHODS: A total of 1,131 post-menopausal women aged over 45 years, who took the 2010–2011 Korean National Health and Nutrition Examination Survey (KNHANES), were included for analysis. These participants were classified into the following groups: the OP group, with a risk of OP (n=135); the CVD group, with a risk of CVD (n=373); the OP+CVD group, with a risk of OP and CVD concurrently (n=218); and the control group (n=405) according to bone mineral density (BMD) and CVD risk. Anthropometric measurements, blood profiles, dietary intake, and dietary quality indices were measured and compared among the four groups. RESULTS: Waist circumference, total body fat percentage, blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and LDL-cholesterol were higher, and HDL-cholesterol and BMD were lower in the OP+CVD group than in the control group. In the food frequency questionnaire, the OP+CVD group had significantly higher frequencies of grain (except for multi-grain) and lower frequencies of fruit and dairy product. The frequency of consumption of red meat, processed meat, and carbonated beverages was higher in OP+CVD group. In nutrient density analysis, proteins and vitamin B2 levels were significantly lower in the OP+CVD group than in the control group. The nutritional quality index (INQ) values of calcium were in the order of 0.63, 0.58, 0.56, and 0.55 in each group, and it was urgent to improve the dietary intake for calcium in postmenopausal women. In addition, vitamin B2 was inadequately consumed by all groups. CONCLUSIONS: These results suggest that it is necessary to increase the intake of vitamin B2 and calcium and decrease the frequency of intake of red meat, processed meat, and carbonated beverages in postmenopausal women with the risk of OP and CVD.

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 / 대한지역사회영양학회지

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.

Relationship between Obesity and Lifestyle Factors in Young Korean Women: the Seventh Korea National Health and Nutrition Examination Survey 2016

BACKGROUND: The purpose of this study was to examine whether lifestyle-related factors are associated with obesity in a selected sample of young Korean women. METHODS: This cross-sectional study involved 822 women aged 19–39 years who participated in the Seventh Korea National Health and Nutrition Examination Survey conducted in 2016. Obesity status was defined as general and abdominal obesity. Multiple logistic regression analyses were used to evaluate the association between lifestyle-related factors and obesity status. RESULTS: The prevalence of obesity was 20.3% for general obesity and 17.4% for abdominal obesity. There were negative associations between the energy intake/body weight ratio and general and abdominal obesity. High-risk drinking was significantly associated with general obesity (adjusted odds ratio, 1.747; 95% confidence interval, 1.112–2.745), but was not associated with abdominal obesity. CONCLUSIONS: Among young Korean women aged 19–39 years, high-risk drinking may be a risk factor for general obesity.

Food and Nutrient Intake Level by the Risk of Osteoporosis and Cardiovascular Disease in Postmenopausal Women: The use of the 5th Korean National Health and Nutrition Examination Surveys (2010–2011) / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to investigate the food, nutrient intake, and diet quality of postmenopausal women at high risk of osteoporosis (OP) and cardiovascular disease (CVD) compared with those of control subjects. METHODS: A total of 1,131 post-menopausal women aged over 45 years, who took the 2010–2011 Korean National Health and Nutrition Examination Survey (KNHANES), were included for analysis. These participants were classified into the following groups: the OP group, with a risk of OP (n=135); the CVD group, with a risk of CVD (n=373); the OP+CVD group, with a risk of OP and CVD concurrently (n=218); and the control group (n=405) according to bone mineral density (BMD) and CVD risk. Anthropometric measurements, blood profiles, dietary intake, and dietary quality indices were measured and compared among the four groups. RESULTS: Waist circumference, total body fat percentage, blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and LDL-cholesterol were higher, and HDL-cholesterol and BMD were lower in the OP+CVD group than in the control group. In the food frequency questionnaire, the OP+CVD group had significantly higher frequencies of grain (except for multi-grain) and lower frequencies of fruit and dairy product. The frequency of consumption of red meat, processed meat, and carbonated beverages was higher in OP+CVD group. In nutrient density analysis, proteins and vitamin B2 levels were significantly lower in the OP+CVD group than in the control group. The nutritional quality index (INQ) values of calcium were in the order of 0.63, 0.58, 0.56, and 0.55 in each group, and it was urgent to improve the dietary intake for calcium in postmenopausal women. In addition, vitamin B2 was inadequately consumed by all groups. CONCLUSIONS: These results suggest that it is necessary to increase the intake of vitamin B2 and calcium and decrease the frequency of intake of red meat, processed meat, and carbonated beverages in postmenopausal women with the risk of OP and CVD.

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 / 대한지역사회영양학회지

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.

Relationship between shift work and liver enzymes: a cross-sectional study based on the Korea National Health and Examination Survey (2007–2015)

BACKGROUND: Shift work has well-known adverse effects on health. However, few studies have investigated the relationship between shift work and hepatic disorders. This study aimed to evaluate the association between shift work and abnormal level of liver enzymes. METHODS: The aggregated data from the 2007–2009, 2010–2012, and 2013–2015 cycles of the Korea National Health and Nutrition Examination Survey was used for this study. The χ2 test and multiple logistic regression analysis were used to assess relationship between shift work and abnormal level of liver enzymes stratified by gender. RESULTS: The odds ratio (OR) of abnormal serum level of alanine aminotransferase (abnormal ALT) in female shift workers was higher with 1.31 (95% confidence interval: 1.00–1.71) compared with day workers after adjusting for covariates. After dividing into subgroups of the shift work pattern, the ORs of abnormal liver enzymes for each pattern compared with day work were not significantly higher. CONCLUSIONS: This study provides limited support for the hypothesis that shift work is related to liver enzyme abnormalities, but offers some evidence in favor of the idea that shift work affects female workers more than males on abnormal ALT. Further studies are needed to define the relationship between shift work and abnormal liver enzymes to be carried out as well as the gender difference in the association.

Study on relationship between caffeine intake level and metabolic syndrome and related diseases in Korean adults: 2013 ~ 2016 Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study examined the relationship between caffeine intake and metabolic syndrome in Korean adults using the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey data (KNHANES). METHODS: The caffeine database (DB) developed by Food and Drug Safety Assessment Agency in 2014 was used to estimate the caffeine consumption. The food and beverage consumption of the 24 hr recall data of 2013 ~ 2016 KNHANES were matched to items in the caffeine DB and the daily caffeine intakes of the individuals were calculated. The sample was limited to non-pregnant healthy adults aged 19 years and older, who were not taking any medication for disease treatment. RESULTS: The average daily caffeine intake was 41.97 mg, and the daily intake of caffeine of 97% of the participants was from coffee, teas, soft drinks, and other beverages. Multivariate analysis showed that the caffeine intake did not affect metabolic syndrome, hypertension, low HDL-cholesterol, and abdominal obesity. Diabetes and hypertriglyceridemia, however, were 0.76 (95% CI: 0.63 ~ 0.93), and 0.87 (95% CI: 0.77 ~ 0.98) in third quintile (Q3), and 0.66 (95% CI: 0.53 ~ 0.82) and 0.83 (95% CI: 0.73 ~ 0.94) in fourth quintile (Q4) compared to Q1, respectively. Therefore, caffeine intake of 3.66 ~ 45.81 mg per day is related to a lower risk of diabetes and hypertriglyceridemia. CONCLUSION: The study showed that adequate caffeine intake (approximately 45 mg) was associated with a lower prevalence of diabetes and hypertriglyceridemia. Therefore, it can be used as a guideline for the adequate level of caffeine intake for maintaining health.

Food and nutrient intake status of Korean elderly by perceived anxiety and depressive condition: data from Korean National Health and Nutrition Examination Survey 2013 ~ 2015 / 한국영양학회지

PURPOSE: This study examined the food and nutrient intake of Korean elderly according to the anxiety and depressive condition using the data from the Korea National Health and Nutrition Survey (KNHANES) from 2013 to 2015. METHODS: The participants were 3,504 elderly people over 65 years of age (1,523 in men and, 1,981 in women). The dietary information was analyzed using the 24-hour recall data. The anxiety and depressive state was assessed using the self-reported scale EQ-5D in the quality of life dimension. The subjects were divided into the anxiety · depression group (AD) and non-anxiety · depression group (NAD) according to their anxiety and depressive conditions. RESULTS: In the male elderly, the AD group had a significantly lower education and economic level and higher proportion in living alone than the NAD group. The percentage of eating lunch and dinner alone in the male AD group was higher than that of the NAD group. The female AD group showed less a lower frequency of dinner than the NAD group. The male AD group had a lower consumption of total foods, fish and shellfishes, seaweeds, mushrooms, oils and fats, and seasonings than the NAD group. With regard to the nutrient intake, the male elderly NAD group had more sufficient nutrient intakes than the AD group. In particular, the daily intakes of dietary fiber, riboflavin, niacin, potassium and iron were significantly lower in the AD group. To compare with the nutrient density of the two groups, the vitamin C and niacin intakes were lower in the AD group than in the NAD group. Overall, the nutritional status of the male AD group was significantly lower than that of the NAD group. Meanwhile, the female elderly had showed a smaller difference in nutrient intake according to their anxiety and depressive condition. CONCLUSION: These results of this study show that more nutritional education and emotional support are needed to improve the nutritional status and health of the male elderly with anxiety or depression.

Association of the Anxiety/Depression with Nutrition Intake in Stroke Patients

Stroke patients often experience a walking dysfunction caused by decreased mobility, weakened muscular strength, abnormal posture control, and cognitive dysfunction. Anxiety/depression is the most important and prevalent neuropsychiatric complication of stroke survivors. Brain injury and the presence of malnutrition after stroke contribute to metabolic status and clinical outcome of patients. We examined the level of nutrition intake in stroke patients according to their degree of anxiety/depression. The data were obtained from 2013 to 2015 through the Korea National Health and Nutrition Examination Survey (KNHANES). Study subjects were categorized to either a group having no problem of anxiety/depression (n = 274) or a group having a problem of anxiety or depression (n = 104). The EuroQoL-5 Dimensions Health Questionnaire (EQ-5D) index score was derived from the first description of an individual health status based on the EQ-5D classification system, including mobility, self-care, usual daily activities, pain/discomfort, and anxiety/depression. The mean age was 67.4 years in the normal group and 68.0 years in the anxiety or depression group. In the anxiety or depression group, 39.4% were men vs. 53.3% in the normal group. The total energy intake (p = 0.013), riboflavin (p = 0.041), and niacin (p = 0.038) was significantly higher in stroke patients with no anxiety/depression than those in stroke patients with having an anxiety/depression. The group having no problem of anxiety/depression had significantly higher EQ-5D index compared to the group having a problem of anxiety/depression group (p < 0.001) had. The results suggest the association between nutrition intake, usual activities and pain/discomfort status in the stroke patients with having an anxiety/depression.

Factors Related to the Self-Rated Health Status among Korean Elderly: Analysis of the 2016 Korean National Health and Nutrition Examination Survey

This study examined the sociodemographic factors, health-related habits, chronic diseases, dietary habits, and nutrient intake according to the self-rated health status in a group aged over 65 years by analyzing the nationally representative Korean survey data. A total of 1,510 subjects were analyzed among the participants of the 2016 Korean National Health and Examination Survey (KNHANES). Statistical analyses for complex samples were performed using the SPSS software package (version 19.0) The study subjects were divided into two groups (healthy group vs. unhealthy group) based on their self-rated health status. The percentage of the healthy group was 66.5%. Gender, age, education level, household income, job (P < 0.001, respectively), marital status, and basic living allowance (P < 0.05, respectively) were significant sociodemographic variables of the self-rated health status. Alcohol consumption (P < 0.01), aerobic physical activity, stress, quality of life, not feeling very well, depression and activity restriction (P < 0.001, respectively) were also significant health-related variables of the self-rated health status. Blood glucose, anemia (P < 0.05, respectively), and chewing problems (P < 0.001) were significant chronic disease-related variables of the self-rated health status. Adequate intakes of protein, dietary fiber, phosphorus, thiamin, niacin, vitamin C (P < 0.001, respectively), calcium, sodium, potassium (P < 0.01, respectively), iron, vitamin A, and riboflavin (P < 0.05, respectively) were also significant variables of the self-rated health status. In complex samples multiple logistic regression analysis, the self-rated health status was influenced significantly by the aerobic physical activity (P < 0.01), stress level (P < 0.05), depression (P < 0.001), quality of life (P < 0.001), not feeling very well (P < 0.001), activity restriction (P < 0.001), chewing problem (P < 0.05), and adequate intake of iron (P < 0.05). These results suggest that activity restriction, mental health, adequate iron intake, and physical activity may be associated with the self-rated health status in the elderly.

Depression and Related Risk Factors in the Elderly with a Focused on Health Habits, Mental Health, Chronic Diseases, and Nutrient Intake Status: Data from the 2014 Korea National Health and Nutrition Examination Survey

Depression is a major health problem that can lead to mortality. This study was conducted to assess the risk factors associated with depression in a group aged over 65 years by analyzing nationally representative Korean survey data. A total of 1,209 subjects were analyzed among the participants of the 2014 Korean National Health and Nutrition Examination Survey. Statistical methods for a complex sample were applied by using SPSS program(windows ver. 24.0). Depression assessments were carried out by using the 9-item depression module of the Patient Health Questionnaire-9 (PHQ-9). Depression (PHQ-9≥5) was more frequently found in females (33.2%) compared to males (16.1%). However, there was no evidence suggesting that characteristics such as residence area, income level and age, except for educational level, were related with depression. The results of the logistic regression analysis showed that i) health habits such as smoking (OR: 2.26) and lack of aerobic physical activity (OR: 1.62), ii) mental health status such as bad self-rating of health status (OR: 4.30), more stress (OR: 8.31), and bad health-related quality of life (by EQ_5D, OR: 3.41), iii) chronic diseases such as obesity (OR: 0.66), hypercholesterolemia (OR: 1.57), anemia (OR: 1.91), and iv) low intake of energy (OR: 1.84) and calcium (OR: 1.71) were significantly associated with depression. This study suggests that certain characteristics of health habits, mental health status, chronic diseases and nutrient intake may be associated with depression. Prospective research on long-term control is needed to establish causal connections among those factors with depression.

Development of Strategies to Improve the National Nutrition Survey System / 대한지역사회영양학회지

OBJECTIVES: The current survey environment is changing and participation rates in national nutrition surveys are decreasing. Therefore, the purpose of this study was to develop strategies for improving the nutrition survey system in the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: To develop an alternative system for conducting the KNHANES nutritional survey, we conducted focus group interviews with stakeholders of the survey, SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis, and expert reviews. In addition, spatial analysis of potential sites for conducting surveys instead of relying on household visits was performed, and the perception of nutritional surveys in the population eligible for KNHANES was evaluated. RESULTS: Based on the results of the focus group interviews, SWOT analysis, and expert reviews, we propose two options for survey sites: vehicles specifically prepared for nutritional surveys and public facilities such as community service centers or public health centers. Among public facilities, community service centers were found to be more appropriate sites than public health centers because they were considered more accessible. About 90% of respondents would participate in the survey in public facilities and about 74% would in vehicles. CONCLUSIONS: Conducting national nutrition surveys in specially designed vehicles and public facilities could be a viable alternative to home visits. Next, the validity of these newly proposed nutrition survey methods needs to be compared to the results of the current national nutrition survey.

Study of the Coverage of Nutrition Labeling System on the Nutrient Intake of Koreans - using the 2013 Korea National Health and Nutrition Examination Survey (KNHANES) Data / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to examine the coverage of the current mandatory nutrition labeling system on the nutrient intake of Koreans. METHODS: KNHANES dietary intake data (2013) of 7,242 subjects were used in the analysis. KNHANES dietary intake data were collected by a 24-hour recall method by trained dietitians. For analysis, all food items consumed by the subjects were classified into two groups (foods with mandatory labeling and other foods). In the next step, all food items were reclassified into four groups according to the food type and nutrition labeling regulations: raw material food, processed food of raw material characteristics, processed foods without mandatory labeling, and processed foods with mandatory labeling. The intake of energy and five nutrients (carbohydrate, protein, fat, saturated fat, and sodium) of subjects from each food group were analyzed to determine the coverage of the mandatory nutrition labeling system among the total nutrient intake of Koreans. RESULTS: The average intake of foods with mandatory labeling were 384g/day, which was approximately one quarter of the total daily food intake (1,544 g/day). The proportion of energy and five nutrients intake from foods with mandatory labeling was 18.1%~47.4%. The average food intake from the 4 food groups were 745 g/day (48.3%) for the raw food materials, 54 g/day (3.5%) for the processed food of raw material characteristics, 391 g/day (25.3%) for the processed foods without mandatory labeling, and 354 g/day (22.9%) for the processed foods with mandatory labeling. CONCLUSIONS: Although nutrition labeling is a useful tool for providing nutritional information to consumers, the coverage of current mandatory nutrition labeling system on daily nutrient intake of the Korean population is not high. To encourage informed choices and improve healthy eating habits of the Korean population, the nutrition labeling system should be expanded to include more food items and foodservice menus.