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Korea National Health and Nutrition Examination Survey, 20th anniversary: accomplishments and future directions
Kyungwon Oh, Yoonjung Kim, Sanghui Kweon, Soyeon Kim, Sungha Yun, Suyeon Park, Yeon-Kyeng Lee, Youngtaek Kim, Ok Park, Eun Kyeong Jeong
Epidemiol Health. 2021;43:e2021025.   Published online April 19, 2021
DOI: https://doi.org/10.4178/epih.e2021025
  • 19,047 View
  • 569 Download
  • 56 Web of Science
  • 61 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
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.
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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Comparison of methods of extracting information for meta-analysis of observational studies in nutritional epidemiology
Jong-Myon Bae
Epidemiol Health. 2016;38:e2016003.   Published online January 11, 2016
DOI: https://doi.org/10.4178/epih.e2016003
  • 18,002 View
  • 252 Download
  • 10 Web of Science
  • 8 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
A common method for conducting a quantitative systematic review (QSR) for observational studies related to nutritional epidemiology is the “highest versus lowest intake” method (HLM), in which only the information concerning the effect size (ES) of the highest category of a food item is collected on the basis of its lowest category. However, in the interval collapsing method (ICM), a method suggested to enable a maximum utilization of all available information, the ES information is collected by collapsing all categories into a single category. This study aimed to compare the ES and summary effect size (SES) between the HLM and ICM.
METHODS
A QSR for evaluating the citrus fruit intake and risk of pancreatic cancer and calculating the SES by using the HLM was selected. The ES and SES were estimated by performing a meta-analysis using the fixedeffect model. The directionality and statistical significance of the ES and SES were used as criteria for determining the concordance between the HLM and ICM outcomes.
RESULTS
No significant differences were observed in the directionality of SES extracted by using the HLM or ICM. The application of the ICM, which uses a broader information base, yielded more-consistent ES and SES, and narrower confidence intervals than the HLM.
CONCLUSIONS
The ICM is advantageous over the HLM owing to its higher statistical accuracy in extracting information for QSR on nutritional epidemiology. The application of the ICM should hence be recommended for future studies.
Summary
Korean summary
영양역학과 관련하여 관찰연구 결과를 체계적 고찰을 할 때, 통상적으로 섭취가 가장 낮은 군을 기준으로 하여 가장 높은 군의 effect size (ES) 정보를 추출하는 Highest versus Lowest Method (HLM)을 적용한다. 그러나 주어진 정보를 최대한 활용한다는 점에서 구간의 정보들을 통합한 ES 정보로 메타분석에 적용하는 Interval Collapse Method (ICM)법이 제안되었다. HLM에 비하여 더 많은 정보를 활용한 ICM 적용을 한 결과, ES 뿐만 아니라 SES에서도 일치성을 보이면서 표준오차가 작아지는 현상을 확인하였다. 영양역학의 메타분석을 위해 추출하는 방법 중 정보를 보다 더 많이 활용하는 ICM이 HLM에 비하여 통계적 정확성의 이득을 더 갖기 때문에, 향후 적극 활성화할 필요가 있다.

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Editorial
Methodological issues in estimating sodium intake in the Korea National Health and Nutrition Examination Survey
Hyun Ja Kim, Kyungwon Oh
Epidemiol Health. 2014;36:e2014033.   Published online November 28, 2014
DOI: https://doi.org/10.4178/epih/e2014033
  • 17,440 View
  • 178 Download
  • 13 Web of Science
  • 11 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
For policy goal setting, efficacy evaluations, and the development of related programs for reducing sodium intake, it is essential to accurately identify the amount of sodium intake in South Korea and constantly monitor its trends. The present study aimed to identify the status of sodium intake in South Korea and to review the methods and their validity for estimating sodium intake in each country; through this, we aim to determine more accurate methods for determining sodium intake and to monitor the trend in sodium intake for Korean citizens in the future. Using 24-hour dietary recall data from the 2012 Korea National Health and Nutrition Examination Survey (KNHANES) to estimate daily sodium intake, the average daily sodium intake among Koreans was 4,546 mg (men, 5,212 mg; women, 3,868 mg). In addition to the nutrition survey that uses the 24-hour dietary recall method, sodium intake can also be calculated from the amount of sodium excreted in 24-hour urine, 8-hour overnight urine, and spot urine samples. Although KNHANES uses the 24-hour dietary recall method to estimate the sodium intake, the 24-hour dietary recall method has the disadvantage of not being able to accurately determine the amount of sodium intake owing to its unique characteristics of the research method and in the processing of data. Although measuring the amount of sodium excreted in 24-hour urine is known to be the most accurate method, because collecting 24-hour urine from the general population is difficult, using spot urine samples to estimate sodium intake has been suggested to be useful for examining the trend of sodium intake in the general population. Therefore, we planned to conduct a study for estimating of 24-hour sodium excretion from spot urine and 8-hour overnight urine samples and testing the validity among subsamples in the KNHANES. Based on this result, we will adopt the most appropriate urine collection method for estimating population sodium intake in South Korea.
Summary
Korean summary
이 연구에서는 나트륨 섭취량 조사방법과 각 조사방법의 타당성을 고찰하여 나트륨 섭취량과 추이를 보다 정확하게 파악할 수 있는 방법을 모색해보고자 하였다. 국민건강영양조사에서는 24시간 회상법을 이용하여 우리나라 국민의 나트륨 섭취량을 산출하고 있으나, 정확성과 추이 비교에 제한점을 가지므로 소변을 이용하여 나트륨 섭취량을 추정하는 방법에 대한 검토가 필요하다. 이에, 국민건강영양조사의 일부 대상자에서 단회뇨, 야간뇨, 24시간 소변을 수집∙이용하여 24시간 소변 나트륨 배설량을 추정하는 식을 개발하고 그 타당도를 검증하는 연구를 수행하여 가장 적절한 소변 수집 방법을 국민건강영양조사에 도입할 계획이다.

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