Effects of a mobile healthcare service provided by public health centers on practicing of health behaviors and health risk factors

BACKGROUND/OBJECTIVES: This study evaluated whether a mobile health (mHealth) application can instigate healthy behavioral changes and improvements in metabolic disorders in individuals with metabolic abnormalities. SUBJECTS/METHODS: Participants were divided into an mHealth intervention group (IG), which used a mobile app for 24 weeks, and a conventional IG. All mobile apps featured activity monitors, with blood pressure and glucose monitors, and body-composition measuring devices. The two groups were compared after 24 weeks in terms of health-behavior practice rate and changes in the proportion of people with health risks, and health behaviors performed by the IG that contributed to reductions in more than one health risk factor were analyzed using multiple logistic regression. RESULTS: Preference for low-sodium diet, reading nutritional facts, having breakfast, and performing moderate physical activity significantly increased in the mHealth IG. Furthermore, the mHealth IG showed a significant increase of eight items in the mini-dietary assessment; particularly, the items “I eat at least two types of vegetables of various colors at every meal” and “I consume dairies, such as milk, yogurt, and cheese, every day.” The proportion of people with health risks, with the exception of fasting glucose, significantly decreased in the mHealth IG, while only the proportion of people with at-risk triglycerides and waist circumference of females significantly decreased in the control group. Finally, compared to those who did not show improvements of health risks, those who showed improvements of health risks in the mHealth IG had an odds ratio of 1.61 for moderate to vigorous physical activity, 1.65 for “I do not add more salt or soy sauce in my food,” and 1.77 for “I remove fat in my meat before eating.” CONCLUSIONS: The findings suggest that the additional use of a community-based mHealth service through a mobile application is effective for improving health behaviors and lowering metabolic risks in Koreans.

Association between Omega Fatty Acid Intake and Suicidality : Sex Differences in the General Korean Population / 정신신체의학

OBJECTIVES@#Epidemiological studies in other countries show that a low intake of omega-3 fatty acids (FAs) increases the risk of depression or suicidality. However, no studies have investigated the associations of suicidality with omega-3 FAs in Korea. Hence, this cross-sectional study aimed to investigate the effects of omega FAs on suicidality in the general South Korean population.@*METHODS@#The data in this study were sourced from adults (n=215,860) who completed the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI), and the associations between omega FAs and suicidality were analyzed using multivariate logistic regressions.@*RESULTS@#Our results demonstrated that high omega-3 FA intake was associated with a decreased risk of suicide (OR=0.83, 95% CI : 0.71–0.98) and the high omega-6 to omega-3 FA ratio was associated with an increased risk of suicide (OR=1.25, 95% CI : 1.02–1.54). Additionally, a high intake of omega-3 FAs was associated with a decreased risk of suicide in men, but not in women (OR=0.72, 95% CI : 0.59–0.88).@*CONCLUSIONS@#Overall, our findings suggest that a lower intake of omega-3 FA is associated with the increased risk of suicidality in the general Korean population, especially in men.

The Differences in Obesity Rates According to Status of Co-Residence with Their Parents in Korean Adolescents: The Implication of the Gender of Single Parent Living with Adolescents

BACKGROUND: Many studies have reported that adolescents living with single parent have a high risk of obesity. However, those studies did not explore the implication of the gender of single parent living with adolescents. This study investigated the differences in obesity rates according to status of co-residence with their parents in Korean adolescents. The family living with single parent was classified into the family living with single father and the family living with single mother. METHODS: This cross-sectional study involved 59,602 adolescents who participated in the 2017 Korea Youth Risk Behavior Web-based Survey. The data on height, weight, status of co-residence with parents, and the other variables were obtained through online questionnaires. RESULTS: In male adolescents, the family living with single mother was related to a high proportion of obesity (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.09–1.40) and overweight (OR 1.17, 95% CI 1.03–1.34). However, in female adolescents, the family living with single father was related to a high proportion of obesity (OR 1.49, 95% CI 1.23–1.82). In addition, female adolescents living with neither parent were more likely to be obese (OR 1.47, 95% CI 1.13–1.91) and overweight (OR 1.31, 95% CI 1.00–1.70). CONCLUSIONS: This study showed a risk of obesity in adolescents living with single parent differs according to the gender of single parent living with adolescents. Not adolescents living with a same-gender parent, but those living with an opposite-gender parent have a high risk of obesity.

The Distribution of Weight Status according to Familial Socioeconomic Status in Korean Adolescents: The Twelfth Korea Youth Risk Behavior Web-based Survey, 2016

BACKGROUND: The influence of socioeconomic status (SES) on weight status varies depending on the countries' levels of social and economic development. There are many studies on a risk of adolescent obesity according to familial SES in Korea. However, it is not clarified what effects familial SES has on a risk of underweight in Korean adolescents. This study investigated the distribution of weight status including obesity and underweight according to familial SES in Korean adolescents. METHODS: This cross-sectional study involved 63,741 adolescents who participated in the 2016 Korea Youth Risk Behavior Wed-based Survey. The data on height, weight, familial SES, current smoking status, current alcohol intake, physical activity, breakfast skipping, perceived stress, depressive mood, and living with family were obtained through online questionnaires. The assessment of familial SES was based on perceived household economic status and parental education level. RESULTS: In boys, low household economic status was related to a high proportion of obesity (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04–1.25) and underweight (OR 1.31, 95% CI 1.14–1.51). Girls with low household economic status were more likely to be obese (OR 1.81, 95% CI 1.61–2.03) and overweight (OR 1.41, 95% CI 1.23–1.60) but, although not statistically significant, less likely to be underweight (OR 0.88, 95% CI 0.75–1.04). CONCLUSIONS: This study showed that adolescents with low familial SES were at a high risk of obesity and underweight. A risk of underweight was increased in boys with low familial SES but in girls with high familial SES.

The Distribution of Weight Status according to Familial Socioeconomic Status in Korean Adolescents: The Twelfth Korea Youth Risk Behavior Web-based Survey, 2016

BACKGROUND@#The influence of socioeconomic status (SES) on weight status varies depending on the countries' levels of social and economic development. There are many studies on a risk of adolescent obesity according to familial SES in Korea. However, it is not clarified what effects familial SES has on a risk of underweight in Korean adolescents. This study investigated the distribution of weight status including obesity and underweight according to familial SES in Korean adolescents.@*METHODS@#This cross-sectional study involved 63,741 adolescents who participated in the 2016 Korea Youth Risk Behavior Wed-based Survey. The data on height, weight, familial SES, current smoking status, current alcohol intake, physical activity, breakfast skipping, perceived stress, depressive mood, and living with family were obtained through online questionnaires. The assessment of familial SES was based on perceived household economic status and parental education level.@*RESULTS@#In boys, low household economic status was related to a high proportion of obesity (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04–1.25) and underweight (OR 1.31, 95% CI 1.14–1.51). Girls with low household economic status were more likely to be obese (OR 1.81, 95% CI 1.61–2.03) and overweight (OR 1.41, 95% CI 1.23–1.60) but, although not statistically significant, less likely to be underweight (OR 0.88, 95% CI 0.75–1.04).@*CONCLUSIONS@#This study showed that adolescents with low familial SES were at a high risk of obesity and underweight. A risk of underweight was increased in boys with low familial SES but in girls with high familial SES.

The Differences in Obesity Rates According to Status of Co-Residence with Their Parents in Korean Adolescents: The Implication of the Gender of Single Parent Living with Adolescents

BACKGROUND@#Many studies have reported that adolescents living with single parent have a high risk of obesity. However, those studies did not explore the implication of the gender of single parent living with adolescents. This study investigated the differences in obesity rates according to status of co-residence with their parents in Korean adolescents. The family living with single parent was classified into the family living with single father and the family living with single mother.@*METHODS@#This cross-sectional study involved 59,602 adolescents who participated in the 2017 Korea Youth Risk Behavior Web-based Survey. The data on height, weight, status of co-residence with parents, and the other variables were obtained through online questionnaires.@*RESULTS@#In male adolescents, the family living with single mother was related to a high proportion of obesity (odds ratio [OR] 1.24, 95% confidence interval [CI] 1.09–1.40) and overweight (OR 1.17, 95% CI 1.03–1.34). However, in female adolescents, the family living with single father was related to a high proportion of obesity (OR 1.49, 95% CI 1.23–1.82). In addition, female adolescents living with neither parent were more likely to be obese (OR 1.47, 95% CI 1.13–1.91) and overweight (OR 1.31, 95% CI 1.00–1.70).@*CONCLUSIONS@#This study showed a risk of obesity in adolescents living with single parent differs according to the gender of single parent living with adolescents. Not adolescents living with a same-gender parent, but those living with an opposite-gender parent have a high risk of obesity.

The Relationship between Smoking and Unhealthy Weight Control Behaviors among Korean Adolescents: The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014 / 가정의학회지

BACKGROUND: Adolescent smoking is positively related to weight control attempts, especially by unhealthy methods. The co-occurrence of smoking and unhealthy weight control behaviors may cause serious health problems in adolescents. This study examined the relationship of smoking with unhealthy weight control behaviors among Korean adolescents. METHODS: This cross-sectional study involved 31,090 students of grades 7 to 12, who had tried to reduce or maintain their weight during the 30 days prior to The Tenth Korea Youth Risk Behavior Web-based Survey, 2014. Data on height, weight, weight control methods, smoking, alcohol intake, living with one's family, and perceived economic status were obtained through self-report questionnaires. ‘Unhealthy weight control behaviors’ were subcategorized into ‘extreme weight control behaviors’ and ‘less extreme weight control behaviors.’ RESULTS: The smoking rates were 13.3%±0.4% in boys and 3.8%±0.2% in girls. Current smokers were more likely to engage in extreme weight control behaviors (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.09 to 2.00 in boys, and OR, 2.05; 95% CI, 1.59 to 2.65 in girls) and less extreme weight control behaviors (OR, 1.23; 95% CI, 1.07 to 1.40 in boys, and OR, 1.47; 95% CI, 1.22 to 1.76 in girls) compared to non-smokers among both boys and girls. CONCLUSION: Current smoking is independently related to a high likelihood of engaging in unhealthy weight control behaviors among Korean adolescents. This relationship is stronger for girls than for boys. Extreme weight control behaviors have a stronger relationship with current smoking than less extreme weight control behaviors.

The Mediating Role of Parental Support in the Relationship between Life Stress and Suicidal Ideation among Middle School Students / 가정의학회지

BACKGROUND: Youth suicide is increasingly being recognized as a major social problem in South Korea. In this study, we aimed to explore the effects of parental support on the relationship between life stress and suicidal ideation among middle-school students. METHODS: This study analyzed data from a cross-sectional study on mental health conducted by the South Korea National Youth Policy Institute between May and July of 2013. Questionnaire responses from 3,007 middle-school students regarding stress factors, thoughts of suicide during the past year, and parental support were analyzed in terms of 3 subscale elements: emotional, academic, and financial support. RESULTS: Among the participants, 234 male students (7.8%) and 476 female students (15.8%) reported experiencing suicidal ideation in the past year. Life stress significantly influenced suicidal ideation (P<0.001), and parental support and all of the subscale elements had a significant influence on decreasing suicidal ideation. As shown in model 1, life stress increased suicidal ideation (adjusted odds ratio [aOR], 1.318; P<0.001), and, in model 2, the effect of life stress on suicidal ideation decreased with parental support (aOR, 1.238; P<0.001). CONCLUSION: Parental support was independently related to a decrease in suicidal ideation, and life stress was independently related to an increase in suicidal ideation. Parental support buffered the relationship between life stress and suicidal ideation.

Influenza Vaccination Status in Korean Adult Population in Relation with Socioeconomic and Medical Factors

BACKGROUND: Influenza causes morbidity and mortality, resulting in the medical and socioeconomic costs. We aimed to analyse whether socioeconomic and medical factors may affect influenza vaccination status divided into 2 groups; one aged 19 to 64 years old and the other aged 65 or over who are eligible for free vaccination. METHODS: The study included 1,412 individuals aged 19 and over who responded to influenza vaccination survey, based on 2013 National Health and Nutrition Examination Survey. Related factors were categorized into socioeconomic factors and medical factors. Univariate analyses were conducted to examine the correlations between vaccination rate and each variables. Multivariate analysis was obtained after adjusting variables which were statistcally significant. RESULTS: Influenza vaccination rate was significantly different in the population aged 19 to 64 (24.9%) and the population aged 65 or over (80.5%). In the former population, high vaccination rate was associated with healthcare usage (odds ratio [OR]=1.37, 95% confidence interval [CI]=1.03-1.83), underlying chronic diseases (OR=2.21, 95% CI=1.43-3.40), and public assistance recipient households (OR=2.21, 95% CI=1.03-4.78), while low vaccination rate was correlated with no use of medical check up (OR=0.70, 95% CI=0.52-0.94) and heavy alcoholics (OR=0.41, 95% CI=0.24-0.70). In the latter population aged 65 or over, high vaccination rate was associated with healthcare usage (OR=1.82, 95% CI=1.28-2.59), and underlying malignancies (OR=4.79, 95% CI=1.07-21.54), whereas low vaccination rate was associated with public assistance recipient households (OR=0.33, 95% CI=0.14-0.76), and no use of medical check up (OR=0.37, 95% CI=0.19-0.73). CONCLUSIONS: In the population below 65 years old, vaccination rate would be expected to rise by the recommendation of medical care providers and expanding the coverage of free vaccination. In elderly, individualized care for those who have less access to medical care and high susceptibility is highly recommended.

The Effect of Maté Extract on Body Weight and Fat Reduction in Obese Women: A Randomized Placebo-controlled Clinical Trial

BACKGROUND: This study was performed to investigate the effects of Maté extract on body weight and fat content in obese women [25.0 kg/m² ≤body mass index (BMI) <30 kg/m²] aged 20-65 years after 6 weeks of its administration. METHODS: The randomized, double-blind, placebo-controlled study was conducted in 33 women. Participants took the supplement, either 2 Maté tablets or 2 placebo tablets, twice daily before meals for 6 weeks. Body weight, body mass index (BMI), waist circumference (WC), and various safety parameters were monitored. Body composition was measured by dual-energy X-ray absorptiometry at baseline and after 6 weeks.

Development of a Smartphone Application for 4th-6th Grade Elementary Students Aimed to Prevent Childhood Obesity

BACKGROUND: There is high interest in a new approach to improve children's lifestyle habits in order to prevent childhood obesity. A smartphone application (app) is a new technology platform that can be used to prevent childhood obesity. METHODS: The key messages for healthy eating habits and physical activities were selected by experts in nutrition, physical activity, and psychology and were adjusted for use in elementary school students. Gamification techniques were used to increase app user engagement. A total of 249 students in grades 4-6 were asked to rate their satisfaction for the app after 4 weeks of use. RESULTS: The main menu of "HAPPY ME" was composed of user profile, "EVERYDAY QUEST," exercise diary, diet diary, settings, and notifications. The app users were asked to complete 6-9 daily missions regarding healthy eating habits and physical activities through "EVERYDAY QUEST." The mean satisfaction scores for each variable were distributed from 3.6 to 4.0 points, and most of the students responded that they would continue to use the app (4.0 points). CONCLUSION: We developed a smartphone app (HAPPY ME) for 4th-6th grade elementary students aimed to provide educational information about healthy eating habits and physical activities in order to prevent childhood.

Weight Control Methods Related to Cotinine-Verified Smoking among Korean Adult Women: Korea National Health and Nutrition Examination Survey, 2008-2011 / 가정의학회지

BACKGROUND: Korean women are known to have a very low smoking rate. However, the actual smoking rate among Korean women is higher than 10% and may continue to increase gradually. In addition, some Korean women use extreme weight control methods that have potentially harmful effects. This study was conducted to elucidate weight control methods related to cotinine-verified smoking among Korean adult women. METHODS: This cross-sectional study involved 4,189 women aged > or =19 years who had attempted weight control during the past 1 year from the Korea National Health and Nutrition Examination Survey, 2008-2011. Smoking status was assessed using both self-report questionnaires and assays of urinary cotinine, and weight control methods were investigated using self-report questionnaires. RESULTS: The smoking rate based on the measurement of urinary cotinine was 12.4% +/- 0.8% among Korean women. Cotinine-verified smokers were more likely to attempt fasting (odds ratio, 2.19; 95% confidence intervals, 1.03 to 4.67), taking prescription diet-pills (odds ratio, 2.37; 95% confidence intervals, 1.47 to 3.82), and taking nonprescription diet-pills (odds ratio, 3.46; 95% confidence intervals, 1.71 to 6.98), and were less likely to attempt eating less food or modifying dietary patterns (odds ratio, 0.71; 95% confidence intervals, 0.51 to 0.99) compared to non-smokers. CONCLUSION: Korean adult women's smoking is independently related to a high likelihood of using weight control methods with potentially harmful effects, such as fasting and taking diet-pills, and a low likelihood of choosing weight control methods, including dietary modification, that require constant effort for a prolonged time.

Obesity and Obesity-Related Lifestyles of Korean Breast Cancer Survivors

BACKGROUND: Obesity not only does increase the incidence of breast cancer, but also affects the course of treatment, recurrence and mortality. This study aims to evaluate on the obesity status of Korean breast cancer survivors and their obesity-related lifestyles. METHODS: The study included 125 Korean female breast cancer survivors aged over 19 year old enrolled in the 2009-11 Korean National Health and Nutrition Examination Survey. Women who answered 'yes' to the question 'have you ever been diagnosed breast cancer by a physician?' was defined as a breast cancer survivors. Height, weight, and waist circumference were measured and Body mass index (BMI) was calculated. Body fat percent was assessed by dual X-ray absorptiometry (DXA). Standardized surveys by trained interviewers were used to investigate survivors' obesity-related lifestyles such as physical activities, sleeping hours and nutrients intake. RESULTS: 48.4% of Korean breast cancer survivors were obese. 44.7% had abdominal obesity and 89.2% had body fat percent over 30. Their physical activity level was generally low; only 22.5% maintained health-enhancing level of physical activities. Fat intake (14.4 [0.8] %) was as low and carbohydrate intake (74.2 [1.2] %) was high. However, daily dietary fiber intake was low (10.5 [1.1] g). Factors that were found to be significantly related with obesity in Korean breast cancer survivors were low education level (P=0.042), smoking (P<0.001), having chronic diseases (P=0.002) and short sleeping hours (P<0.001). CONCLUSIONS: It is mandatory for physician to evaluate obesity status of breast cancer survivors as soon as their diagnosis and give proper intervention to maintain healthy weight and healthy obesity related lifestyle.

The Cutoff Value of Waist Circumference for Predicting Metabolic Risks in Pre- and Post-Menopausal Korean Women: Analysis of 2010 Korean National Health and Nutrition Examination Survey Data / 가정의학회지

BACKGROUND: With metabolic syndrome (MS) being a major risk factor for cardiovascular disease, and central obesity being a major predisposing factor for MS, intensive research is currently being performed on cutoff values according to race and sex. Menopause is an especially significant factor in designating cutoff values for female central obesity, as menopause brings sudden bodily changes that induce central obesity and increased prevalence of MS. Therefore this study aimed to investigate the cutoff values for the obesity index and its validity in predicting the criteria for MS in Korean women according to menstrual status. METHODS: The study focused on 3,103 women 20 years of age or older participating in the 2007 Korea National Health and Nutrition Examination Survey. Definitions of non-adipose components of MS were defined by the International Diabetes Federation, and menstrual status was judged on the basis of survey results. The sensitivity, specificity, and positive and negative predictive values of the central obesity index (body mass index [BMI], waist circumference [WC], waist-to-height ratio [WHtR]) according to menstrual status for two or more non-adipose components of MS were calculated based on the Youden index. RESULTS: Area under the curve (AUC) values predicting the presence of two or more metabolic risk factors were higher in pre-menopausal women, with AUC values for BMI, WC, and WHtR being, in pre- and post-menopausal women, 23.1 kg/m2 vs. 23.9 kg/m2, 76.1 cm vs. 82.5 cm, and 0.49 vs. 0.53, respectively. The WC cut off (76 cm) for pre-menopausal women was found to be more sensitive and more effective at screening for MS risks than the cutoff value given by the Korea Society for the Study of Obesity. CONCLUSION: The central obesity index showed better predictability for MS risk in pre-menopausal women. Because the central obesity index cutoff values are lower in pre-menopausal women, the possibility of metabolic risk can be considered for pre-menopausal women with WC lower than 85 cm. Assessment and control of other risks are needed accordingly for preventing the development of MS.

Sociodemographic Characteristics of Underweight Korean Adults: Korea National Health and Nutrition Examination Survey, 2007-2010 / 가정의학회지

BACKGROUND: Underweight is associated with increased risk of mortality and morbidity. It is reported that the prevalence of underweight is increasing among Korean young women. However, there have been few studies on sociodemographic factors related to being underweight. This study was conducted to elucidate the sociodemographic characteristics of Korean underweight adults. METHODS: This study is a cross-sectional study of 7,776 adults aged 25 to 69 years using data from the Korea National Health and Nutrition Examination Survey, 2007-2010. Study subjects were composed of underweight and normal-weight adults excluding overweight adults. Body mass index was calculated from measured height and weight. Health behaviors such as smoking, drinking, and physical activity were surveyed through self-administered questionnaires, and socioeconomic status, marital status, and history of morbidity were surveyed through face-to-face interviews. RESULTS: Women had a higher frequency of underweight (10.4% vs. 7.0%, P < 0.001) than men. Among men, current smoking (odds ratio [OR], 1.62) and past history of cancer (OR, 2.55) were independently related to underweight. Among women, young age (OR, 2.06), former smoking (OR, 1.69), and being unmarried (OR, 1.56) were identified as independently related factors of underweight. In addition, among both men and women, alcohol drinking (men OR, 0.57; women OR, 0.77) and past history of chronic diseases (men OR, 0.55; women OR, 0.43) were independently related to a lower frequency of underweight. CONCLUSION: We showed that various sociodemographic factors were associated with underweight. It was ascertained that there were differences in the sociodemographic factors related to underweight between Korean men and women.

Weight Control Attempts in Underweight Korean Adults: Korea National Health and Nutrition Examination Survey, 2007-2010 / 가정의학회지

BACKGROUND: Underweight refers to the weight range in which health risk can increase, since the weight is lower than a healthy weight. Negative attitudes towards obesity and socio-cultural preference for thinness could induce even underweight persons to attempt weight control. This study was conducted to investigate factors related to weight control attempts in underweight Korean adults. METHODS: This was a cross-sectional study on 690 underweight adults aged 25 to 69 years using data from the Korea National Health and Nutrition Examination Survey, 2007-2010. Body image perception, weight control attempts during the past one year, various health behaviors, history of chronic diseases, and socioeconomic status were surveyed. RESULTS: Underweight women had a higher rate of weight control attempts than underweight men (25.4% vs. 8.1%, P < 0.001). Among underweight men, subjects with the highest physical activity level (odds ratio [OR], 7.75), subjects with physician-diagnosed history of chronic diseases (OR, 7.70), and subjects with non-manual jobs or other jobs (OR, 6.22; 12.39 with reference to manual workers) had a higher likelihood of weight control attempts. Among underweight women, subjects who did not perceive themselves as thin (OR, 4.71), subjects with the highest household income level (OR, 2.61), and unmarried subjects (OR, 2.08) had a higher likelihood of weight control attempts. CONCLUSION: This study shows that numbers of underweight Korean adults have tried to control weight, especially women. Seeing that there are gender differences in factors related to weight control attempts in underweight adults, gender should be considered in helping underweight adults to maintain a healthy weight.

Prevalence of Dietary Supplement Use in Korean Children and Adolescents: Insights from Korea National Health and Nutrition Examination Survey 2007-2009

The purpose of this study was to estimate the prevalence of dietary supplement (DS) use in Korean children and adolescents and to examine the related factors associated with DS use from the 4th Korea National Health and Nutrition Examination Survey. Total 6,131 participants aged between 2 and 18 yr were included in the analysis. We estimated the prevalence of DS use mainly from the DS questionnaire data of the Nutrition Survey. Reported supplements were classified according to the Health Functional Food Code. We also assessed the relationship between DS use and anthropometry, socioeconomic factors, health behaviors, and chronic diseases. Approximately 34% of Korean children and adolescent was taking DS. Younger age (P = 0.003), higher household income (P < 0.001), presence of chronic diseases (P = 0.05), regular meal consumption (P = 0.002), frequent snack consumption (P = 0.001), and normal body mass index rather than overweight (P = 0.10) or obesity (P = 0.03) were associated with the DS use after adjustment for related factors. Vitamin/mineral supplements (343.5/103 persons) were the most commonly taken DS in Korean children and adolescents, followed by Omega-3 (28.8), ginseng (18.3), colostrums (14.1) and chlorella/spirulina (10.0). In conclusion, DS use is common as much as in 34% of Korean children and adolescents and is associated with age, household income level, chronic diseases, meal regularity, and obesity status.

Marital Status and Health Behavior in Middle-aged Korean Adults / 가정의학회지

BACKGROUND: Marital status is as an important sociodemographic variable for health studies. We assessed the association between marital status and health behavior in middle-aged Korean adults. METHODS: This is a cross-sectional study of 2,522 Korean middle-aged adults (1,049 men, 1,473 women) from the 2010 Korean National Health and Nutrition Examination Survey. The subjects were classified as living with a partner or living without a partner (never married, separated, widowed, and divorced). We assessed the relationship between marital status and five health behaviors (smoking, high-risk alcohol intake, regular exercise, regular breakfast consumption, and undergoing periodic health screening). RESULTS: Age, income level, educational level, and occupational classification were all significantly associated with marital status. The risk of undergoing health screening (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.32 to 0.90) and having regular breakfast (OR, 0.50; 95% CI, 0.27 to 0.92) were significantly lower in men living without a partner than with a partner. Women living without a partner had a higher smoking risk (OR, 2.27; 95% CI, 1.09 to 4.73) and a higher risk of high-risk alcohol consumption (OR, 5.33; 95% CI, 1.65 to 17.24) than their counterparts. CONCLUSION: Korean middle-aged adults living with partners are more likely to have healthier behavior than living without a partner. The association between marital status and health behaviors differed by sex.

Socioeconomic Indicators Associated with Initiation and Cessation of Smoking among Women in Seoul / 가정의학회지

BACKGROUND: While smoking prevalence in Korean men has been decreasing, it is increasing in Korean women. Little is known about women's smoking inequalities in Korea. This study was conducted to investigate the association of socioeconomic indicators with the initiation and cessation of smoking among Korean women. METHODS: This was a cross-sectional study on 9,089 women aged 25-64 years from the 2008 Seoul Community Health Survey. The data on smoking and socioeconomic status were obtained through face-to-face interviews. Smoking initiation rate was defined as the proportion of the individuals who had started smoking at least one cigarette among all subjects. Smoking cessation rate was calculated by dividing the number of individuals who had quit smoking by the number of ever smokers. Education level, total family income and occupation were investigated as socioeconomic indicators. RESULTS: Education level was significantly associated with both initiation and cessation of smoking. Lower educated women had a higher likelihood of smoking initiation (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.17 to 2.51) but lower likelihood of smoking cessation (OR, 0.38; 95% CI, 0.22 to 0.66) than higher educated women. Smoking initiation rate was higher in manual workers (OR, 1.65; 95% CI, 1.20 to 2.27) than in non-manual workers. However, there were no significant differences of both initiation and cessation of smoking according to total household income. CONCLUSION: This study shows that there are smoking inequalities among Korean women. It is thought that education level and occupation are important determinants of women's smoking status.

Marital Status and Health Behaviors in Middle-Aged Korean Adults: from the 2007-2010 Korea National Health and Nutrition Examination Survey

BACKGROUND: Marital status is not only an important sociodemographic variable for health studies but influences health behavior and health condition of individuals. This study assessed a representative sample to see whether marital status is associated with health behavior in middle-aged Korean adults, and if the association differed by sex. METHODS: This is a cross-sectional study of 9,535 Korean middle-aged adults who participated in the 2007-2010 Korean National Health and Nutrition Examination Survey. Our data were from this survey. The subjects were classified as married and living with a partner, widowed, separated/divorced, or never married. We assessed the relationship between marital status and five health behaviors (smoking, high risk alcohol intake, regular exercise, regular breakfast consumption, and periodic health screening) after controlling covariates. RESULTS: In men, the separated/divorced group had a higher risk for high risk alcohol consumption (odds ratio [OR], 1.52; 95% confidence interval [CI], 1.05-2.19) and lower tendencies to have breakfast regularly (OR, 0.44; 95% CI, 0.29-0.67) and to undergo health screening (OR, 0.54; 95% CI, 0.37-0.79) than the married and living with a partner group while men were more likely to exercise regularly (OR, 1.81; 95% CI, 1.13-2.88). In women, both of the separated/divorced group and had a significantly higher risk for smoking and high risk alcohol consumption than married and living with a partner group by 3-6 times. The separated/divorced women group was less likely to have breakfast regularly (OR, 0.55; 95% CI, 0.41-0.74). Significant interactions between sex and marital status were observed with smoking (P<0.001), high risk alcohol intake (P<0.001), regular breakfast consumption (P<0.001), and periodic health screening (P=0.003). CONCLUSIONS: The association between marital status and health behaviors differed by sex. Even in the single group, differences were seen according to the subtypes of the single group.