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.

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.

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.

Association of Diabetes with Serum Vitamin D in Korean Adults : Analysis of the Korea National Health and Nutrition Examination Survey (2013~2014)

Insufficient vitamin D intake is a major health problem around the world. Recently, many studies have suggested that vitamin D intake may influence insulin resistance. However, little is known about the association between vitamin D and diabetes mellitus. The aim of this study was to investigate the association between serum 25-hydroxy vitamin D (25(OH)D) levels and diabetes mellitus in Korean adults. This study was a cross-sectional analysis of 3,686 participants of the Korean National Health and Nutrition Examination Survey (KNHANES) 2013~2014 aged 19 years and higher. The results showed that the mean serum 25-hydroxy vitamin D (25(OH)D) level in Korean adults was 16.77 ng/mL, and 74.2% of them had an insufficient serum 25-hydroxy vitamin D (25(OH)D) level (below 20 ng/mL). In normal and pre-diabetic groups, the serum 25-hydroxy vitamin D (25(OH)D) level significantly increased with age (P30 ng/mL), after adjusting for variables that may affect fasting blood glucose, but this result was not significant. In conclusion, although no significant association was observed between diabetes prevalence and vitamin D levels in this study, further studies are needed because the effect of vitamin D on diabetes remains controversial. This nutrient plays a crucial role in the body, and levels are insufficient in the Korean population.

Relationship between Diabetes Mellitus and Anemia in Korean Adults-Based on the Korean National Health and Nutritional Examination Survey VI

Anemia, defined as a reduction in the hemoglobin concentration of blood, is common in diabetes mellitus (DM) patients, can be potentially caused by diabetes complications such as nephropathy. Recent research suggests that diabetes mellitus (DM) itself may be a major risk factor of anemia. However, there are few Korean studies on the relationship between diabetes mellitus (DM) and anemia. This study was performed to investigate the association between anemia and diabetes mellitus (DM) in Korean adults. A total of 10,151 Korean adults over aged 19 years (4,422 male, 5,729 female) were selected from the participants of the Korean National Health and Nutrition Examination Survey VI (KNHANES VI). Korean adults with anemia had a higher prevalence of diabetes mellitus (DM) than the normal adults (11.4% vs. 30.4% in male, 8.8% vs. 9.4% in female). The unadjusted odds ratio (OR) for anemia was greater in adults with DM than in normal male (OR=3.28; 95% CI: 2.27~4.73). After adjusting for other risk factors including age, education, family income, smoking, drinking, and menstrual status, anemia and diabetes were not associated (OR=1.33; 95% CI: 0.84~2.09). Similarly, there was no association between anemia and diabetes in female. In conclusion, this study shows that the prevalence of anemia is similar in diabetic and non-diabetic Korean adults after adjusting for multiple risk factors. Further research is required to elucidate the mechanism of anemia caused as a consequence of diabetes mellitus (DM).

Visual Acuity and Falls in South Korea: Korean National Health and Nutrition Examination Survey 2008-2012

PURPOSE: To assess the influence of visual acuity (VA) and ocular condition on falls. METHODS: We analyzed 28,899 Korean adults using cross-sectional data from the Korean National Health and Nutrition Examination Survey (2008-2012). Associations between best corrected VA based on better or worse seeing eye and ocular condition and falls were identified using multivariable logistic regression. We included sociodemographic factors and comorbidities including hypertension, diabetes, arthritis, acute myocardial infarction/angina, and stroke as independent variables. VA was divided into 1.0, 0.8, 0.5-0.63, and <0.5. RESULTS: Among 28,899 subjects, falls occurred in 511. In multivariable logistic regression analysis, low VA based on the better seeing eye was significantly associated with falls (VA 1.0 as a reference group; adjusted odds ratio [aOR] = 1.31, 95% confidence interval [CI], 1.00-1.72 in VA of 0.8; aOR = 1.86, 95% CI, 1.07-3.24 in VA of 0.5-0.63; and aOR = 1.21, 95% CI, 0.58-2.54 in VA of <0.5; p = 0.025 for trend). There was no association between VA based on the worse seeing eye and falls. Early age-related macular degeneration was associated with falls in univariable analysis (OR = 2.24) and age- and sex-adjusted analysis (aOR = 1.52), but not in multivariable analysis. In terms of age subgroups, subjects with VA of 0.5-0.63 were more likely to have experienced falls compared with subjects with VA of 1.0 (aOR = 5.83, 95% CI, 1.58-21.54) among subjects 50 years of age or younger. An increasing trend of falls with decreasing VA among subjects between 50 and 70 years of age was observed (p = 0.033 for trend). However, no such association was observed in elderly subjects ≥70 years of age. CONCLUSIONS: VA should be considered for preventing falls because lower VA is associated with increased risk of falls.

Prevalence and Risk Factors for Undercorrected Refractive Errors among South Korean: KNHANES 2008-2012

PURPOSE: To assess the prevalence and risk factors of undercorrected refractive error in South Korea. METHODS: We analyzed 36,162 participants for estimating prevalence using the Korean National Health and Nutrition Examination Survey (KNHANES, 2008-2012). Undercorrected refractive error was defined as an improvement of at least 2 lines in best corrected visual acuity compared with the presenting visual acuity in the right eye. Proportion of undercorrected refractive error by occupation was presented, and associated sociodemographic factors were evaluated by multivariable logistic regression. RESULTS: The prevalence of undercorrected refractive error among all participants and among adults was 8.5% (n/N, 6,954/36,162) and 18.8% (n/N, 3,980/19,884), respectively. The proportion of undercorrected refractive error was higher among those with did not wear spectacles or contact lenses (23.1%) than among spectacle or contact lens wearers (8.1%). The proportion of participants who gained more than four or more lines of best corrected visual acuity was 7.2% (n = 2,606) for the all age group. In terms of occupation, farming, fishing, and forestry occupations (22.8%, 570/2,499) and laborer (20.2%, 497/2,457) were more likely to have undercorrected refractive error. Age groups of 10s, 70s, or 80s (30s as a reference group), female sex, lower income, lower education level, and living without a spouse were associated with undercorrected refractive error. CONCLUSIONS: People of older age, female sex, and lower socioeconomic status were more likely to have undercorrected refractive error. This suggests that a public-health approach is needed for preventing visual impairment via proper vision correction.

Vegetable and fruit intake in one person household: The Korean National Health and Nutrition Examination Survey (2010~2012) / 한국영양학회지

PURPOSE: The aim of the current study was to compare the vegetable and fruit intake between one person households and those living with family. METHODS: The 24-hour recall data of 14,914 persons over 20 years old who participated in the Korean National Health and Nutrition Examination Survey (KNHANES) from 2010 to 2012 were used for the final analysis. Consumption of non-salted vegetables and fruits (> or = 400 g/day), fruits (> or = 200 g/day), and kimchi (> or = 120 g/day) was compared between one person households and those living with family. Logistic regression models were used to assess the associations between potential determinants and adequate vegetable and fruit intake. RESULTS: After additional adjustments for age, household income, and total energy intake, no statistically significant differences in likelihood of low intake of non-salted vegetable and fruit and kimchi were observed between one person households and those living with family. (Non-salted vegetables and fruits: odds ratio (OR) = 1.15, 95% confidence interval (CI) = 0.79-1.68 for the men; OR = 1.25, 95% CI = 0.98-1.59 for women). However one person households have greater likelihood of low intake of kimchi than those living with family in women (OR = 1.72, 95% CI = 1.31-2.26). CONCLUSION: Although there were no differences in likelihood of low intake of non-salted vegetables and between individuals living alone and those living with family, women of one person households were great likelihood of low intake of kimchi compared to those living with family.

Trends in the major dish groups and food groups contributing to sodium intake in the Korea National Health and Nutrition Examination Survey 1998-2010

The purpose of this study was to evaluate trends in the sources of dietary sodium intake in a representative Korean population in the Korea National Health and Nutrition Examination Survey (KNHANES) conducted in 1998, 2001, 2005, 2007, 2008, 2009, and 2010. The study consisted of 53,570 men and women aged 7 years or older participating in the KNHANES during the corresponding years. Overall sodium intake and the mean percent contribution of each dish and food group to dietary sodium intake across 1998-2010 were calculated. The means of sodium intake ranged between 4,572.6-5,498.9 mg/d across 1998-2010. The major dish groups contributing to dietary sodium intake were kimchi (1,154.8-1,521.2 mg/d), noodles and dumplings (505.3-760.5 mg/d), soups (465.3-714.8 mg/d), and stews and casseroles (387.0-579.8 mg/d). The combined mean percent contribution from the top four dish groups contributing to dietary sodium intake showed a slight decrease over the period; 64.4% in 1998, 64.5% in 2001, 59.3% in 2005, 58.2% in 2007, 56.3% in 2008, 56.7% in 2009, and 54.4% in 2010. The major food groups contributing to dietary sodium intake were seasonings (1,852.9-2,435.9 mg/d), vegetables (1,425.6-1,792.1 mg/d), grains (482.2-778.1 mg/d), and fish and shellfish (257.2-351.4 mg/d). In addition, the combined mean percent contribution from the top four food groups showed a slight decrease over the period; 92.8% in 1998, 93.2% in 2001, 93.8% in 2005, 92.1% in 2007, 91.7% in 2008, 90.9% in 2009, and 90.7% in 2010. In summary, we did not observe a reduction in dietary sodium intake over time, however, the percent contributions from the top major dish groups or food groups to dietary sodium intake showed a decrease over the last decade.

A Comparison of Food and Nutrient Intakes between Instant Noodle Consumers and Non-Consumers among Korean Children and Adolescents

Instant noodle is one of the most popular foods in Korea. The objective of this study was to examine the association of instant noodle consumption and food and nutrient intake among children and teenagers in Korea. We used dietary data from 24-h recall of 1,748 subjects aged 7-19 years who participated in the 2005 Korea National Health and Nutrition Examination Survey. Those who consumed instant noodle once or more during the survey period were categorized as "instant noodle consumer (INC)" and were compared for food and nutrient intakes with the others (non-INC). The average age of the INC was 13.4 and that of the non-INC was 12.4; girls consumed more instant noodles than boys (p < 0.05). There was no significant difference in BMI between the two groups. With the exception of grains, as compared to the non-INC, the INC consumed significantly less amounts of potatoes, vegetables, mush-rooms, fruits, spices, seafood, and milk and dairy products. With respect to nutrient intakes, the INC-group showed significantly higher nutrient intakes of energy, fat, carbohydrate, sodium, thiamine, and riboflavin; however, as compared to the non-INC-group, the INC-group showed significantly less intakes of calcium, niacin, and vitamin C. The overall result suggests that consuming instant noodles may lead to excessive intake of fat and sodium, but it may cause an increased intake of thiamine and riboflavin. Therefore, nutrition education that helps children and teenagers choose a balanced meal while consuming instant noodle should be carried out. In addition, manufactures of instant noodles should consider nutritional aspects in product development processes.