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Regional differences in the associations of diet quality, obesity, and possible sarcopenia using the seventh Korea National Health and Nutrition Examination Survey (2016-2018)
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Hyeongyeong Lee
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Epidemiol Health. 2023;45:e2023059. Published online June 19, 2023
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DOI: https://doi.org/10.4178/epih.e2023059
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Abstract
OBJECTIVES
Sarcopenic obesity is closely related to aging and the prevalence of various chronic diseases and frailty. The purpose of this study was to analyze whether diet quality is related to obesity, sarcopenia, and sarcopenic obesity, and if so, to explore the difference in that relationship between urban and rural settings.
METHODS Using data from the Korea National Health and Nutrition Examination Survey of 2016-2018, a total of 7,151 participants aged 40 years or older were analyzed. Sarcopenia was diagnosed using handgrip strength. Diet quality was assessed using Korea Healthy Eating Index (KHEI) scores, and obesity was determined based on participants’ abdominal circumference. Multinomial logistic analysis was used for testing statistical significance.
RESULTS Rural participants had significantly lower KHEI scores and a higher prevalence of sarcopenic obesity than urban participants. The study findings demonstrate that participants without obesity, sarcopenia, or sarcopenic obesity had significantly higher KHEI scores in both rural and urban settings. Multinomial regression analysis further revealed that a higher KHEI score was associated with a lower risk of sarcopenia and sarcopenic obesity among urban residents, while only the risk of obesity was lower with higher diet quality scores among rural residents.
CONCLUSIONS Since diet quality and health status were lower in rural areas, it is important to address this regional disparity with appropriate policy measures. To mitigate urban health disparities, urban residents in poor health with few resources should also be supported.
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Food literacy and its relationship with food intake: a comparison between adults and older adults using 2021 Seoul Food Survey data
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Seulgi Lee, Sohyun Park, Kirang Kim
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Epidemiol Health. 2023;45:e2023062. Published online July 3, 2023
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DOI: https://doi.org/10.4178/epih.e2023062
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OBJECTIVES
This study was conducted to examine the differences in food literacy between adults and older adults and the association of food literacy with food group intake.
METHODS In total, 4,039 participants from the 2021 Survey for Food Consumption in Seoul were included in this study. The intake of whole grains, high-protein foods, total vegetables, vegetables excluding kimchi and pickles, fresh fruits, and milk and dairy products was assessed using a simple food frequency questionnaire. Food literacy was measured using a food literacy measurement questionnaire.
RESULTS With the exception of milk and dairy, adults had a significantly higher proportion of insufficient food intake than older adults (p<0.001). Both adults and older adults with sufficient food group consumption had higher food literacy scores. Notably, the difference in food literacy scores by level of food intake was highest for fresh fruits (p<0.001). After adjusting for confounding factors affecting food literacy scores, a higher score was associated with a lower probability of having insufficient food intake in all food groups for both adults and older adults. Specifically, those in the highest food literacy score quartile were less likely to have insufficient intake of vegetables (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.28 to 0.43) and fresh fruits (OR, 0.32; 95% CI, 0.24 to 0.43), compared to the lowest quartile.
CONCLUSIONS Improving food literacy is an important factor for promoting healthy food intake in older adults as well as adults. Therefore, it is necessary to develop intervention programs to work toward this goal.
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Summary
Korean summary
건강정보 이해능력(health literacy)은 노인에서 만성질환이나 인지능력과의 관련성이 보고되고 있으나 영양정보 이해능력(food literacy)에 대한 연구는 미비하다. 급변하는 식이 환경에서 식사 및 영양과 관련된 정보를 올바르게 이해하고 판단할 수 있는 영양정보 이해능력은 노인성 질환 예방에 중요하다. 본 연구에서 영양정보 이해능력과 식품군 섭취와의 상관성을 분석한 결과 영양정보 이해능력이 높은 노인이 건강한 식품 섭취 부족 위험이 낮았다. 특히 과일 섭취 부족 위험은 영양정보 이해능력이 높은 노인에서 뚜렷하게 낮았다. 국내 영양정보 이해능력 연구는 초기 단계로 주로 성인 대상으로 연구가 이루어져서 본 연구에서의 결과는 그 의의가 크며, 영양정보 이해능력 향상은 성인과 마찬가지로 노인에서도 건강한 식품 섭취를 위한 중요한 요인으로서 이를 위한 프로그램 개발이 필요할 것으로 사료된다.
Key Message
The study on food literacy among older adults in Korea is significant as previous research has mostly focused on adults. The results showed that older adults with higher food literacy score had lower risk of insufficient food intake as compared with those with lower food literacy score. Specifically, the risk of insufficient fresh fruits intake was the lowest among older adults with higher food literacy score. Therefore, improving food literacy is an important factor for promoting healthy food consumption among older adults.
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Higher energy consumption in the evening is associated with increased odds of obesity and metabolic syndrome: findings from the 2016–2018 Korean National Health and Nutrition Examination Survey (7 th KNHANES)
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Sarang Jeong, Hajoung Lee, Sukyoung Jung, Jee Young Kim, Sohyun Park
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Epidemiol Health. 2023;e2023087. Published online September 19, 2023
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DOI: https://doi.org/10.4178/epih.e2023087
[Accepted]
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OBJECTIVES
Chrono-nutrition emphasizes meal timing in preventing obesity and metabolic disorders. This study explores the impact of temporal dietary patterns(TDPs) on obesity and metabolic syndrome(MetS) in Korean adults aged 20 to 65 years.
METHODS We utilized dynamic time warping method and Kernel k-means clustering to investigate diet quality and the odds ratios(ORs) of obesity and MetS with different TDPs using data from the 7th Korea Nutrition and Health Examination Survey.
RESULTS Participants were divided into three groups based on relative energy intake over 24 hours. After adjusting for age and gender, Cluster 3(with the highest proportion of energy intake in the evening) had the lowest Healthy Eating Index scores compared to other clusters. Following adjustment for key covariates, Cluster 3 showed the highest values for Body Mass Index, waist circumference, blood pressure, total cholesterol, and triglycerides. Compared to Cluster 1(with a lower proportion of energy intake in the evening), Cluster 2 and Cluster 3 had ORs for obesity of 1.12 (95% Confidence Interval(CI), 0.97–1.30) and 1.19 (95% CI, 1.03–1.37), respectively. For MetS, the ORs were 1.26 (95% CI, 1.08–1.48) and 1.37 (95% CI, 1.17–1.61) when comparing Cluster 2 and 3 to Cluster 1.
CONCLUSIONS This study reveals that individuals with higher energy intake in the evening have increased odds of obesity and MetS, even after adjusting for major covariates, including age and total energy intake.
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Positive association of unhealthy plant-based diets with the incidence of abdominal obesity in Korea: a comparison of baseline, most recent, and cumulative average diets
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Sukyoung Jung, Sohyun Park
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Epidemiol Health. 2022;44:e2022063. Published online August 2, 2022
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DOI: https://doi.org/10.4178/epih.e2022063
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Abstract
OBJECTIVES
Different approaches for analyzing repeated dietary measurements may yield differences in the magnitude and interpretation of findings. We aimed to compare 3 dietary measurements (baseline, most recent, and cumulative average) in terms of the association between plant-based diet indices (PDIs) and incident abdominal obesity in Korean adults aged 40-69 years.
METHODS This study included 6,054 participants (54% women) free of abdominal obesity (defined as waist circumference ≥90 cm for men and ≥85 cm for women) at baseline. As exposures, baseline, most recent, and cumulative average measurements for PDI, healthy-PDI (hPDI), and unhealthy-PDI (uPDI) were created. A Cox proportional-hazard model was used to estimate the hazard ratios (HRs) for abdominal obesity.
RESULTS During 45,818 person-years of follow-up (median, 9 years), we identified 1,778 incident cases of abdominal obesity. In the multivariable-adjusted analysis, a higher uPDI was associated with a higher risk of abdominal obesity in both total and stratified analyses. The findings were consistent across all approaches (Q5 vs. Q1: HRbaseline=1.70; 95% confidence interval [CI], 1.46 to 1.98; HRmost recent=1.52; 95% CI, 1.30 to 1.78; HRcumulative average=1.76; 95% CI, 1.51 to 2.06 in the total set). PDI showed no meaningful association with abdominal obesity risk in any analyses. hPDIaverage had a suggestive inverse association with abdominal obesity risk in men, and hPDIbaseline had a positive association with abdominal obesity risk in women.
CONCLUSIONS Greater adherence to unhealthy plant-based diets may increase the risk of developing abdominal obesity in Korean adults. The findings were generally consistent across all approaches.
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Summary
Korean summary
본 연구는 한국인 유전체역학조사사업의 안성안산코호트 조사에 참여한 40-69세 한국 성인 6,054명을 대상으로 식물성 기반의 식이 지수와 복부비만 간 연관성이 식이 노출 기간(기반, 최근, 누적 노출)에 따라 어떻게 다른지 비교 분석하였다.
건강하지 않은 식물성 기반의 식이 지수 점수가 높을수록 복부비만 발생 위험이 증가하였고, 식이 노출 기간에 관계없이 일관된 결과를 보였다.
식물성 기반의 식이가 반드시 건강에 유익한 것은 아니며, 정제된 곡물, 탄산음료, 사탕 등 간식류를 많이 먹는 식이 패턴은 식물성 기반 식이라 할지라도 복부비만 위험을 증가시킬 수 있으므로 주의가 필요하다.
Key Message
Unhealthy plant-based diets, including refined grains, sugar-sweetened beverages, sweets and desserts, and salty plant foods, can have a negative effect on abdominal obesity in Korean adults regardless of its exposure duration.
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Citations
Citations to this article as recorded by  - Scoping review of the association of plant-based diet quality with health outcomes
Richard M. Rosenfeld, Hailey M. Juszczak, Michele A. Wong
Frontiers in Nutrition.2023;[Epub] CrossRef
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Trend of the Anthropometric Indices Among Adolescents in a Urban and a Rural Area Over the Period 1996~2005.
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SoHyun Park, Minjung Ko, Shin Ah Kim, Mi Kyung Kim, Soo Hun Cho, Bo Youl Choi
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Korean J Epidemiol. 2006;28(2):189-198.
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This study investigated the secular trend of anthropometric parameters of 2,153 high school students in one urban and one rural area in Korea. The cross-sectional data was collected in 1996 and 2005 in Seoul and Gyung-gi province.
As a result, the height of boys has increased by 2cm, whereas the weight has increased by 6.3kg from 1996 to 2005.
By contrast, those parameters, including height or weight, did not change in girls. The prevalence of obesity has been more than doubled from 9.3% in 1996 to 20.5% in 2005 in boys; while that of girls was almost same for the same period (1998, 11.1%; 2005, 11.4%). In particular, the greater increase of obesity among boys was found in urban, which implicates the importance of environmental factor in determining weight gains among adolescents. This result emphasizes that the tailored intervention is strongly warranted, in particular among boys residing in urban area.
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