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Korea National Health and Nutrition Examination Survey, 20th anniversary: accomplishments and future directions
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Kyungwon Oh
, Yoonjung Kim , Sanghui Kweon , Soyeon Kim , Sungha Yun , Suyeon Park , Yeon-Kyeng Lee , Youngtaek Kim , Ok Park , Eun Kyeong Jeong
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Epidemiol Health. 2021;43:e2021025. Published online April 19, 2021
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DOI: https://doi.org/10.4178/epih.e2021025
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Abstract
The Korea National Health and Nutrition Examination Survey (KNHANES) was initiated in 1998 to provide evidence for the development and evaluation of health policies and programs. The Korea Disease Control and Prevention Agency is responsible for the KNHANES and has conducted it as a series of surveys. Over the past 20 years, efforts to produce accurate, timely, and nationwide health statistics have been refined by establishing a continuous annual survey system with full-time field staff, incrementally expanding survey components, collaborating with relevant academic societies for quality control, and revising the survey methods. Additionally, the utility of the collected data was increased by linking the KNHANES data with related data from other government agencies or institutions and making the overall data publicly available on the official website of KNHANES (https://knhanes.kdca.go.kr). Additional long-term plans are being developed, including plans to continue producing nationwide health indicators and invigorating the utilization of the KNHANES data.
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Summary
Korean summary
국민건강영양조사는 국민건강증진법제16조에 근거하여 1998년부터 우리 국민의 건강수준, 건강행태, 식품 및 영양소 섭취 실태에 대한 국가단위 통계를 산출하는 조사사업이다. 본 연구에서는 건강지표 생산 확대, 조사 자료 활용도 향상 등 20년간의 성과를 요약하고 사회환경과 조사여건 변화를 반영한 건강통계 생산의 발전 방안을 제시하였다.
Key Message
The Korea National Health and Nutrition Examination Survey (KNHANES) is an ongoing surveillance system that was initiated in 1998 based on Ar¬ticle 16 of the National Health Promotion Act to produce nationwide statistics regarding the health status, health behaviors, and food and nutrient consumption of the Korean population. In this study, the 20-year accomplishments of the KNHANES including vigorous production of health indicators and improvement of data utilization are summarized, and future plans are presented to improve the health statistics to reflect changes in the social and survey environments.
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Trends in health behaviors over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey
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Soyeon Kim
, Sunhye Choi , Jihee Kim , Suyeon Park , Young-Taek Kim , Ok Park , Kyungwon Oh
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Epidemiol Health. 2021;43:e2021026. Published online April 19, 2021
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DOI: https://doi.org/10.4178/epih.e2021026
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6,759
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Abstract
OBJECTIVES This study aimed to examine the trends in health behaviors in Korean population using data from the Korea National Health and Nutrition Examination Survey (KNHANES).
METHODS The subjects were 96,408 adults aged 19 years or older who participated in the first (1998) through seventh (2016-2018) KNHANES health interview. The prevalence of health behaviors (cigarette smoking, alcohol drinking, and physical activity) and annual percent change (APC) were estimated using SAS and the Joinpoint program.
RESULTS The prevalence of current cigarette smoking in men decreased by 2.8%p (APC= -2.8, p< 0.001) annually over the 20-year period, and the prevalence of exposure to secondhand smoke at home substantially decreased compared to 2005 (APC= -8.8, p< 0.001). Compared to 2005, the prevalence of current alcohol drinking in women, but not men, increased (APC= 2.0, p< 0.001), and the prevalence of binge drinking decreased in men (APC= -0.7, p< 0.001) and increased in women (APC= 2.4, p< 0.001). The prevalence of aerobic physical activity decreased from 2014 in both gendersd (p< 0.001). The prevalence of healthy behaviors practice (non-smoking, alcohol abstinence, and aerobic physical activity) was down-trending (APC= -5.3, p< 0.001), especially among women (APC= -6.4, p< 0.001).
CONCLUSIONS Over the past 20 years, smoking behaviors improved. However, drinking behavior was unchanged and physical activity indicators markedly decreased. More active programs are necessary for improving health behaviors, which are major risk factors linked to chronic diseases.
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Summary
Korean summary
국민건강영양조사(1998-2018) 자료를 활용하여 지난 20년간 성인의 건강행태를 분석한 결과 흡연율과 간접흡연 노출률은 지속적으로 감소하였고, 신체활동 실천율 또한 감소하였다. 월간음주율과 폭음률의 경우 남자는 큰 변화가 없었던 반면 여자는 모두 증가하였다.
Key Message
This study aimed to examine the trends in health behaviors in Korean population using data from the 1998-2018 Korea National Health and Nutrition Examination Survey (KNHANES). Over the past 20 years, the prevalence of cigarette smoking and exposure to secondhand smoke in Korean adults consistently decreased, as well as the prevalence of physical activity. There was no considerable change in men, whereas in women, the prevalence of alcohol drinking and binge drinking both increased.
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Trends in food and nutrient intake over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey
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Sanghui Kweon
, Jin Young Park , Myungsook Park , Yangha Kim , So Yeong Yeon , Leena Yoon , Sungha Yun , Suyeon Park , Ji Eun Yang , Youngtaek Kim , Ok Park , Kyungwon Oh
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Epidemiol Health. 2021;43:e2021027. Published online April 19, 2021
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DOI: https://doi.org/10.4178/epih.e2021027
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7,382
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Abstract
OBJECTIVES We aimed to examine the current status and trends of food and nutrient intake in the Korean population over the past 20 years using the data from the Korea National Health and Nutrition Examination Survey (KNHANES).
METHODS We conducted a survey of 116,284 subjects over the age of one year in Korea, who participated in the KNHANES between 1998 and 2018. We collected data on the subjects’ intake for the day before using the 24-hour recall method. The annual percent change (APC) in the food groups and nutrient intake were calculated using SAS and Joinpoint software.
RESULTS The intake of grains (APC=-0.4, p<0.05) and vegetables (APC=-0.8, p<0.05) was observed to decrease. In contrast, the intake of beverages, meat, dairy, and eggs increased. In particular, beverage intake increased by more than four times (APC=9.2, p<0.05). There was no significant change in energy intake. However, the proportion of energy intake from carbohydrates decreased by approximately 5%p (APC=-0.3, p<0.05), whereas that from fat increased by approximately 5%p (APC= 1.1, p<0.05). Additionally, there were decreases in the proportion of energy intake from breakfast and homemade meals and increases in the energy intake from snacks, dining out, and convenience food. The intake of vitamin C (APC=-3.2, p<0.05) and sodium (APC=-2.3, p<0.05) significantly decreased.
CONCLUSIONS Over the past 20 years, there has been decreases in the intake of grains, vegetables, carbohydrates, sodium, and vitamin C and increases in the intake of beverages, dairy, meat, eggs, and fat. Since nutritional status is an important factor in the prevention and management of chronic diseases, it should be continuously monitored.
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Summary
Korean summary
국민건강영양조사(1998-2018) 자료를 활용하여 우리 국민의 지난 20년간의 식품 및 영양소 섭취 현황 및 추이를 분석한 결과, 곡류, 채소류, 탄수화물, 나트륨, 비타민 C 섭취 감소, 음료류, 우유류, 육류, 난류, 지방 섭취 증가 등 식품 및 영양소 섭취에 변화가 있었다.
Key Message
We examined the current status and trends of food and nutrient intake in the Korean population using the data from the 1998-2018 Korea National Health and Nutrition Examination Survey. Over the past 20 years, there have been decreases in the intake of grains, vegetables, carbohydrates, sodium, and vitamin C and increases in the intake of beverages, dairy, meat, eggs, and fat.
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- Dietary Pattern Extraction Using Natural Language Processing Techniques
Insu Choi, Jihye Kim, Woo Chang Kim Frontiers in Nutrition.2022;[Epub] CrossRef - Dietary intake and major source foods of vitamin E among Koreans: findings of the Korea National Health and Nutrition Examination Survey 2016–2019
Jee-Seon Shim, Ki Nam Kim, Jung-sug Lee, Mi Ock Yoon, Hyun Sook Lee Nutrition Research and Practice.2022; 16(5): 616. CrossRef - Comparison of the levels of energy intake from dish and food groups by gender and age among Korean obese adults: data obtained from the 2013-2018 Korea National Health and Nutrition Examination Survey
Cheongmin Sohn, Woori Na, Chaeryeon Kim, Seunghee Choi, Oh Yoen Kim, Jounghee Lee, Mi Ock Yoon, Myoungsook Lee Journal of Nutrition and Health.2022; 55(6): 670. CrossRef
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Trends in the prevalence and management of major metabolic risk factors for chronic disease over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey
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Yoonjung Kim
, Sun Jin Nho , Gyeongji Woo , Hyejin Kim , Suyeon Park , Youngtaek Kim , Ok Park , Kyungwon Oh
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Epidemiol Health. 2021;43:e2021028. Published online April 19, 2021
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DOI: https://doi.org/10.4178/epih.e2021028
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Abstract
OBJECTIVES We aimed to explore trends in the prevalence and management of obesity, hypertension, diabetes, and hypercholesterolemia in Korean adults from 1998 to 2018 using data from the Korea National Health and Nutrition Examination Survey (KNHANES).
METHODS The study participants included 79,753 individuals aged ≥ 30 years who had participated in the health examination and health interview of the first (1998) to the seventh (2016-2018) KNHANES. The prevalence and management as well as annual percent change (APC) in chronic diseases were analyzed using SAS and the Joinpoint software program.
RESULTS The prevalence of obesity in men significantly increased from 26.8% in 1998 to 44.7% in 2018 (APC= 1.9, p< 0.001), whereas that in women decreased slightly from 30.5% in 1998 to 28.3% in 2018 (APC= -0.5, p< 0.001). The prevalence of hypertension in men was 33.2% in 2018, with no significant change, whereas that in women slightly decreased to 23.1% in 2018 (APC= -0.9, p< 0.001). The prevalence of diabetes in men increased slightly from 10.5% in 2005 to 12.9% in 2018 (APC= 1.6, p< 0.001), whereas that in women remained at approximately 8%, with no significant change. The prevalence of hypercholesterolemia in both men and women increased 3-fold in 2018 (20.9% in men [APC = 8.2, p < 0.001] and 21.4% in women [APC= 7.1, p< 0.001]) compared to that in 2005. The awareness rate, treatment rate, and control rate of hypertension and hypercholesterolemia increased 2-3 fold. Regarding diabetes, the treatment rate increased, but the control rate did not change.
CONCLUSIONS Over the past 20 years, the prevalence of obesity (in men), diabetes, and hypercholesterolemia has increased and management indicators, such as the awareness rate, treatment rate, and control rate of chronic diseases, have improved continuously.
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Summary
Korean summary
국민건강영양조사(1998-2018) 자료를 활용하여 우리나라 성인의 비만, 고혈압, 당뇨병, 고콜레스테롤혈증 유병률 및 관리수준을 분석한 결과, 20년 동안 비만(남자), 당뇨병, 고콜레스테롤혈증 만성질환의 유병 수준은 악화되고 있는 반면, 만성질환의 인지율, 치료율, 치료자 중 조절률 등 관리지표는 지속적으로 개선되고 있었다.
Key Message
We examined trends in the prevalence and management of obesity, hypertension, diabetes, and hypercholesterolemia in Korean adults from the 1998-2018 Korea National Health and Nutrition Examination Survey. Over the past 20 years, the prevalence of obesity (in men), diabetes, and hypercholesterolemia has increased and management indicators, such as the awareness rate, treatment rate, and control rate of chronic diseases, have improved continuously.
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Citations
Citations to this article as recorded by 
- Adherence to Cancer Prevention Guidelines and Cancer Incidence and Mortality: A Population-Based Cohort Study
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Hyeon Chang Kim, Hokyou Lee, Hyeok-Hee Lee, Eunsun Seo, Eunji Kim, Jiyen Han, Ja-Young Kwon, Hyeon Chang Kim, Song Vogue Ahn, Sun Ha Jee, Sungha Park, Hae-Young Lee, Min Ho Shin, Sang-Hyun Ihm, Seung Won Lee, Hokyou Lee, Jong Ku Park, Il Suh, Tae-Yong Lee Clinical Hypertension.2022;[Epub] CrossRef - Sex-Specific Trends in the Prevalence of Hypertension and the Number of People With Hypertension: Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) 1998–2018
Eunsun Seo, Sunjae Jung, Hokyou Lee, Hyeon Chang Kim Korean Circulation Journal.2022; 52(5): 382. CrossRef - Benefits of adherence to the Korea Healthy Eating Index on the risk factors and incidence of the metabolic syndrome: analysis of the 7th (2016–2018) Korea National Health and Nutrition Examination Survey
Sun A Choi, Sung Suk Chung, Jeong Ok Rho Journal of Nutrition and Health.2022; 55(1): 120. CrossRef - Obesity, hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey
Ga Bin Lee, Yoonjung Kim, Suyeon Park, Hyeon Chang Kim, Kyungwon Oh Epidemiology and Health.2022; 44: e2022041. CrossRef - Current Status of the National Health Screening Programs in South Korea
Hee-Taik Kang Korean Journal of Family Medicine.2022; 43(3): 168. CrossRef - Non-linear association between serum folate concentrations and dyslipidemia: Korea National Health and Nutrition Examination Survey 2016-2018
Taiyue Jin, Eun Young Park, Byungmi Kim, Jin-Kyoung Oh Epidemiology and Health.2022; 44: e2022046. CrossRef - Prevalence and management of hypertension in Korean adults
Hyeon Chang Kim Journal of the Korean Medical Association.2022; 65(10): 633. CrossRef - Effects of early medication treatment and metformin use for cancer prevention in diabetes patients: a nationwide sample cohort study in Korea using extended landmark time analysis
Hwa Jeong Seo, Hyun Sook Oh Epidemiology and Health.2021; 43: e2021103. CrossRef
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Surveillance System for Communicable Disease in Korea.
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Ok Park
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Korean J Epidemiol. 2006;28(1):22-27.
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Korea has experienced sporadic cases or outbreaks of emerging and reemerging infectious diseases since the 1980s.
Confirmed outbreaks have included leptospirosis and legionellosis in 1984, HIV infection in 1985, enterohemorrhagic E-coli infection in 1998, staphylococcus aureus infection with decreased vancomycin susceptibility in 1999, brucellosis in 2002, and botulism in 2003. Korea has also suffered from reemerging diseases such as vivax malaria along the Demilitarized Zone (DMZ) since 1993. Owing to globalization, imported cases of diarrheal diseases, malaria, and dengue have been increasing. In addition, the overall incidence of acute infectious diseases such as shigellosis, scrub typhus, and mumps, which had been decreasing since 1970 until the late 1990s, began to increase again after the late 1990s. The range of emerging and reemerging diseases poses serious public health threats to the public. The Korean government has been striving to build capacity to detect and respond to these infectious disease threats in a timely manner since the late 1990s. For this, the government revised the Communicable Disease Prevention Law, reorganized the government structure for communicable disease control, and developed human resources through field epidemiology and various other training programs. SARS and highly pathogenic avian influenza provided momentum to accelerate these endeavors. Korea has thus far achieved significant improvements in the field of infectious disease surveillance. There are, however, gaps that need to be addressed including insufficient capacity for disease surveillance and response for emerging infectious disease at the local government level, inadequate operation of various surveillance systems, insufficient integration among surveillance systems, and low participation rate for notification among physicians.
Therefore, the Korean government plans to improve infectious disease surveillance by implementing the following procedures: establishment of a web-based reporting system, integration of EDI and laboratory surveillance systems, extension of the electronic reporting system to the private sector, continuous development of human resources to build capacity, and enhancement of collaboration with the private sector.
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Key Message
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Sentinel Surveillance System for Pediatric Communicable Diseases.
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Young Ohk Yoo, Eun Kyeong Jeong, Ok Park, Byung Chul Chun
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Korean J Epidemiol. 2004;26(2):32-42.
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Abstract
PURPOSE The purpose of this study is to review the process for establishing a pediatric communicable diseases sentinel surveillance system, and the results of operation based on the accumulated data to understand the descriptive epidemiologic characteristics of pediatric communicable diseases.METHODS A sentinel surveillance system for pediatric communicable diseases was developed in May 2001 with the 202 doctors in pediatric clinics who participated voluntarily.
The target diseases for sentinel surveillance were measles, mumps, rubella, chicken pox and aseptic meningitis. The case definitions of those diseases for surveillance were divided into confirmed cases and suspected cases by the diseases definitions of national notifiable diseases system. The participants should report as soon as possible when they diagnosed measles, mumps, rubella cases including suspected ones. But chicken pox and aseptic meningitis cases were reported once a week in regular base including zero report.
We collected the data from May 2001 to December 2003 and showed the descriptive epidemiologic characteristics of each disease.RESULTS The average reporting proportion among survellance doctors has been increased, about 88% in 2003. For measles, 206 cases were reported in 2001, 10 cases in 2002, and 2 cases in 2003. Children under the age of 2 (53.4 %) showed the highest. Among the measles cases, 86.4% had no previous vaccination history. In case of mumps, 246 cases in 2001, 241 in 2002, and 566 cases in 2003 were reported. Mumps showed seasonality, highest from April to June in each year.
The sex ratio was about 1.5(M:F = 6:4). Among the reported cases, 76.9 % had previous MMR immunization history at least one time. For Rubella, 9 cases in 2001, 3 in 2002, and no case were reported in 2003. The chicken pox case proportion per 100 pediatric consultations showed peak in from May to June and from November to January. 3-5 year-old children (45.7%) were showed high proportion by age.CONCLUSION This study described the process of establishing and operating a system for the pediatric communicable disease sentinel surveillance. We analyzed the desriptive epidemiologic characteristic of the reported data from May 2001 to December 2003. These data maybe useful to build the policy of public health management for communicable diseases control system and vaccine preventable diseases.
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Key Message
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