Changes in nutritional status of Korean older adults during COVID-19 Pandemic by household income and demographic factors -using the Korea National Health and Nutrition Examination Survey(2019-2020): a cross-sectional study / 대한지역사회영양학회지

Objectives@# The study aim was to identify changes in the nutritional status of older adults during the COVID-19 pandemic according to household income and demographic characteristics. @*Methods@# Study participants were 2,408 adults aged 65 and over who participated in the 2019–2020 Korea National Health and Nutrition Examination Survey (KNHANES). To examine changes in nutrient intake levels resulting from COVID-19, data of 2019 and of 2020 were compared. Study participants were divided into three groups based on household income level to compare these changes. The changes were compared according to household income level, age group, and household type. @*Results@# Percentages of recommended intakes for energy, protein, and most micronutrients were the lowest for the low-income group of both males and females in 2020. The Mean Adequacy Ratio (MAR) score was the lowest for the low-income group in both years. When comparing nutrient density for 2019 and 2020 by income group, the male low-income group experienced a decrease in nutrient densities of vitamin A, thiamine, calcium, and iron. For the same group, a decreased percentage for energy intake from protein was noted. Fruit intake was lowest in the low-income group for both males and females. Low-income males had the lowest intake levels for meat, fish, eggs, and legumes in both 2019 and 2020 and the lowest milk and milk product intake levels in 2020. Older adults living alone or single older adults with children had lower MAR scores than those living with a spouse. Older adults living alone experienced decreases in energy and thiamine and iron intake levels in 2020 compared to their intake levels in 2019. @*Conclusions@# Because of the COVID-19 pandemic, nutrition intake levels worsened for older adult males in the low-income group and older adults living alone. This finding shows the need for a more systematic nutritional support strategy for the vulnerable older adults population in national disaster situations.

Effect of nutrition education in reducing sodium intake and increasing potassium intake in hypertensive adults

BACKGROUND/OBJECTIVES@#Hypertension is the major risk factor for cardiovascular disease, a leading cause of deaths in Korea. The objective of this study was to evaluate the effect of a nutrition education in reducing sodium intake and increasing potassium intake in hypertensive adults. @*SUBJECTS/METHODS@#Subjects who participated in this study were 88 adults (28 males and 60 females) who were pre-hypertension or untreated hypertensive patients aged ≥ 30 yrs in Gyeonggi Province, Korea. These subjects were divided into 2 groups: a lowsodium education (LS) group and a low-sodium high-potassium education (LSHP) group. Nutrition education of 3 sessions for 12 weeks was conducted. Blood pressure, blood and urine components, nutrient intake, and dietary behavior were compared between the two education groups.RESULT: Blood pressure was decreased in both groups after the nutrition education (P < 0.05). In the LSHP group, levels of blood glucose (P< 0.05), total cholesterol (P< 0.01), and lowdensity lipoprotein-cholesterol (P< 0.05) were decreased after the program completion. Sodium intake was decreased in both groups after the nutrition education (P< 0.05). However, Na/K ratio was only decreased in the LS group (P< 0.05). Intake frequency of fish & shellfish was only significantly reduced in the LS group (P< 0.05), while intake frequencies of cooked rice, noodles & dumplings, breads & snacks, stew, kimchi, and fish & shellfish were reduced in the LSHP group (P< 0.05). Total score of dietary behavior appeared to be effectively decreased in both groups after the education program (P< 0.001). @*CONCLUSIONS@#This education for reducing sodium intake was effective in reducing blood pressure and sodium intake. The education for enhancing potassium intake resulted in positive changes in blood glucose and serum cholesterol levels.

The Relationship between Dietary Sodium-to-Potassium Ratio and Metabolic Syndrome in Korean Adults: Using Data from the Korean National Health and Nutrition Examination Survey 2013-2015

Background@#The dietary sodium-to-potassium ratio (Na:K) is known to have a stronger association with cardiovascular disease compared with a single intake of sodium or potassium. Accordingly, this study sought to examine the relationship between sodium-potassium intake balance and metabolic syndrome, which increases the occurrence of cardiovascular disease. @*Methods@#Data from the Korea National Health and Nutrition Examination Survey 2013-2015 were used, and the subjects were 13,164 adults aged 19 years and over. This study examined sodium and potassium intake and Na:K based on Korean adults' age and sex, and analyzed food groups that contribute to adequate sodium and potassium intake based on an Na:K of 1. Correlations between Na:K, metabolic syndrome, and risk factors were examined through a multiple logistic regression analysis. @*Results@#Korean adults' average daily intake of sodium was 3,976 mg, while that of potassium was 3,076 mg.Meanwhile, the Na:K was identified to be 2.33. The food group that contributed the most to potassium intake was fruits in subjects whose Na:K was below 1, and vegetables in those whose Na:K was over 1. Compared with the lowest quartile, the highest quartile in Na:K was up 19% in the probability that one would suffer from metabolic syndrome (P for trend=0.001). Also, more Na:K led to a significant increase in the risk of elevated blood pressure and elevated blood sugar (P for trend=0.015 and 0.012). @*Conclusions@#A rise in Na:K is related to a risk of hypertension and high blood sugar, and such a rise raises the prevalence rate of metabolic syndrome.

The Association between Dietary Fiber Intake and Prevalence of Metabolic Syndrome in Middle-aged Adults in Gyeonggi Province

BACKGROUND: The aim of this study was to assess the dietary fiber intake of middle-aged adults in Gyeonggi and to evaluate its relation with the metabolic syndrome. METHODS: From April 2013 to October 2014, 279 (60 men, 210 women) middle-aged adults subject older than 30 years of age were recruited. Two-day dietary intake data were collected from each subject using the 24-hour recall method. Metabolic syndrome was diagnosed by anthropometric measurements, blood pressure, and blood analysis. RESULTS: When the subjects were divided into tertile groups by dietary fiber intake per 1,000 kcal, the middle tertile group showed higher fiber intake of 118.8% above the reference intake of 12 g/1,000 kcal, and the highest tertile group showed a higher fiber intake of 165.0% above the reference intake. The group with greater dietary fiber intake showed more mineral and vitamin intake but less energy, fat, and cholesterol intake. The major food groups that contributed to the dietary fiber in the lowest and the middle tertiles were vegetables, grains, fruits, and legumes, but in the highest tertile, legumes contributed more than fruits. The risk of metabolic syndrome (odds ratio [OR] 0.38, 95% confidence interval [CI] 0.18-0.77), abdominal obesity (OR 0.45, 95% CI 0.23-0.85,) and hypertriglyceridemia (OR 0.42, 95% CI 0.21-0.83) were significantly reduced in the middle tertile compared to the lowest tertile. CONCLUSIONS: The results suggest that there is a correlation between dietary fiber intake and risk factors for metabolic syndrome. It is highly expected that consuming sufficient amount of fruits and vegetables as a major source of dietary fiber can prevent and manage metabolic syndrome and chronic disease.

The Risk of Metabolic Syndrome by Dietary Patterns of Middle-aged Adults in Gyeonggi Province / 대한지역사회영양학회지

OBJECTIVES: The aim of this study was to assess how nutrient intakes are related to risk factors for metabolic syndrome according to dietary patterns in the middle-aged adults. METHODS: The subjects (n = 187; 47 men, 140 women) consisted of middle-aged adults over 30 years old in Ilsan area. The metabolic syndrome was diagnosed according to the data collected from each subject, including anthropometric measurements and blood analyses. The dietary patterns were derived from the average of two-day dietary intake data. RESULTS: Factor analysis identified three major dietary patterns which were "Meats and alcohol", "Mixed grains, vegetables and fruits", and "Rice, Kimchi and fish & shellfish". The daily intakes of energy, protein, and sodium increased across quartiles of "Meats and alcohol" pattern scores (p < 0.05), whereas the intakes of carbohydrates, potassium, calcium, and fiber increased across quartiles of "Mixed grains, vegetables and fruits" pattern scores (p < 0.001). The "Meats and alcohol" pattern scores were positively correlated with protein and sodium intakes but inversely correlated with carbohydrates, fiber and potassium intakes which were adjusted for age, sex and energy (p < 0.05). The highest quartile pattern score of "Meats and alcohol" pattern had elevated odds ratio of abdominal obesity and metabolic syndrome (p < 0.05). The risk of hypertriglyceridemia decreased in the highest quartile of "Mixed grains, vegetables and fruits" pattern (OR 0.35, 95% CI 0.12-1.00). CONCLUSIONS: Our results suggested that reducing the consumption of meat and alcohol along with increasing fruits, vegetables and mixed grains would be helpful for preventing the metabolic syndrome and chronic diseases.