Epidemiology and Health

Original Articles

Regional differences in the associations of diet quality, obesity, and possible sarcopenia using the seventh Korea National Health and Nutrition Examination Survey (2016-2018): Hyeongyeong Lee, Sohyun Park; Epidemiol Health. 2023;45:e2023059. Published online June 19, 2023; 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.

Summary

Citations

Citations to this article as recorded by

Association of Dietary Protein Sources and Their Adequacy, Body Composition and Risk of Sarcopenic Obesity in South Korean Populations: A Cross-Sectional Study
Jieun Kim, Kyoungsik Jeong, Sueun Lim, Siwoo Lee, Younghwa Baek
Metabolites.2024; 14(2): 130. CrossRef
Association of Combining Diet and Physical Activity on Sarcopenia and Obesity in Elderly Koreans with Diabetes
Sohye Kim, Soojeong Kim, Kyung Hee Hong
Nutrients.2024; 16(7): 964. CrossRef

Association between levels of physical activity and low handgrip strength: Korea National Health and Nutrition Examination Survey 2014-2019: Hyungsoon Ahn, Hwa Young Choi, Moran Ki; Epidemiol Health. 2022;44:e2022027. Published online February 21, 2022; DOI: https://doi.org/10.4178/epih.e2022027

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574 Download
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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aimed to investigate the association between levels of physical activity (PA) and low handgrip strength in Korean adults.

METHODS

Our cross-sectional study design included 24,109 Korean adults older than 19 years of age who participated in the Korea National Health and Nutrition Examination Survey 2014–2019. Low handgrip strength is described as hand strength less than the cut-off value of the 20th percentile of handgrip strength from a healthy population in each gender and age group. PA was categorized into three levels (inactive, active, and highly active) according to the World Health Organization’s global recommendations on PA for health. Multivariable logistic regression analysis was used to examine the association between levels of PA and low handgrip strength.

RESULTS

Odds ratios (ORs) for low handgrip strength were significantly higher in middle-aged women who were active (adjusted odds ratio [aOR], 1.40; 95% confidence interval [CI], 1.15 to 1.69) and inactive (aOR, 1.47; 95% CI, 1.23 to 1.76) than in those highly active in walking exercise. Most of older people had significantly higher ORs for low handgrip strength in active compared to highly active in the context of aerobic, muscle strengthening, and walking exercise.

CONCLUSIONS

Walking exercise was associated with a lower risk of sarcopenia in middle-aged women and older individuals. However, further studies are necessary to confirm the causal relationship between levels of PA and low handgrip strength.

Summary

Korean summary
본 연구는 국민건강영양조사 2014-2019년도 자료를 활용하여 한국인 만 19세 이상 건강한 성인을 대상으로 낮은 악력의 기준값을 성별 및 연령그룹별로 도출하고 유산소 운동, 근력 운동, 걷기 운동 수준과 낮은 악력의 연관성을 분석하였다. 분석 결과, 중년 여성과 노년층에서 걷기 운동이 근감소증 발생의 예방과 연관성이 있음을 알 수 있었다.

Key Message
The association between levels of physical activity and low handgrip strength was different by sex and age groups. For women, walking exercise was associated with low handgrip strength, but not for men. By age groups, muscle strengthening exercise could help prevent sarcopenia in the young population, aerobic exercise has the potential to prevent sarcopenia in middle-aged individuals, and walking exercise could reduce sarcopenia risk in older individuals.

Citations

Citations to this article as recorded by

Examining factors contributing to the socioeconomic inequalities in handgrip strength among older adults in India: a decomposition analysis
Manacy Pai, T. Muhammad
Scientific Reports.2024;[Epub] CrossRef
Relationship between Handgrip Strength and Incident Diabetes in Korean Adults According to Gender: A Population-Based Prospective Cohort Study
Sung-Bum Lee, Min-Kyeung Jo, Ji-Eun Moon, Hui-Jeong Lee, Jong-Koo Kim
Journal of Clinical Medicine.2024; 13(2): 627. CrossRef
Association Between Dietary Fiber Intake and Low Muscle Strength Among Korean Adults
Sunhye Shin
Clinical Nutrition Research.2024; 13(1): 33. CrossRef
Association between composite dietary antioxidant index and handgrip strength in American adults: Data from National Health and Nutrition Examination Survey (NHANES, 2011-2014)
Dongzhe Wu, Hao Wang, Wendi Wang, Chang Qing, Weiqiang Zhang, Xiaolin Gao, Yongjin Shi, Yanbin Li, Zicheng Zheng
Frontiers in Nutrition.2023;[Epub] CrossRef
Assessment of dynapenia and undernutrition in primary care, a systematic screening study in community medicine
Marie Treuil, Meliha Mahmutovic, Paolo Di Patrizio, Phi-Linh Nguyen-Thi, Didier Quilliot
Clinical Nutrition ESPEN.2023; 57: 561. CrossRef
Water Intake and Handgrip Strength in US Adults: A Cross-Sectional Study Based on NHANES 2011–2014 Data
Dongzhe Wu, Chaoyi Qu, Peng Huang, Xue Geng, Jianhong Zhang, Yulin Shen, Zhijian Rao, Jiexiu Zhao
Nutrients.2023; 15(20): 4477. CrossRef
Hand Grip Strength, Osteoporosis, and Quality of Life in Middle-Aged and Older Adults
Hyo Jin Park, Byoungduck Han, So-youn Chang, Seung Ho Kang, Dae Wook Lee, Seok Kang
Medicina.2023; 59(12): 2148. CrossRef
Lower grip strength and insufficient physical activity can increase depressive symptoms among middle-aged and older European adults: a longitudinal study
Han Zheng, Qingwen He, Hongyan Xu, Xiaowei Zheng, Yanfang Gu
BMC Geriatrics.2022;[Epub] CrossRef

Association of appendicular skeletal muscle mass with carotid intima-media thickness according to body mass index in Korean adults: Ji Eun Heo, Hyeon Chang Kim, Jee-Seon Shim, Bo Mi Song, Hye Yoon Bae, Ho Jae Lee, Il Suh; Epidemiol Health. 2018;40:e2018049. Published online October 7, 2018; DOI: https://doi.org/10.4178/epih.e2018049

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203 Download
15 Web of Science
14 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
The combined effects of obesity and appendicular skeletal muscle (ASM) on atherosclerosis, especially in middleaged populations, remain poorly understood. This cross-sectional study investigated the effects of ASM on carotid intima-media thickness (IMT) according to body mass index (BMI) in middle-aged Korean adults.

METHODS

Herein, 595 men and 1,274 women aged 30-64 years completed questionnaires and underwent health examinations as part of the Cardiovascular and Metabolic Disease Etiology Research Center cohort. ASM was measured via bioelectrical impedance analysis and adjusted for weight (ASM/Wt). IMT was assessed using B-mode ultrasonography; highest quartile of IMT was defined as gender-specific top quartile of the IMT values. Higher BMIs was defined as a BMI over 25.0 kg/m2 .

RESULTS

Compared to the highest ASM/Wt quartile, the lowest ASM/Wt quartile was significantly associated with highest quartile of IMT in men with lower BMIs (adjusted odds ratio [aOR], 2.78; 95% confidence interval [CI], 1.09 to 7.13), but not in those with higher BMIs (aOR, 0.59; 95% CI, 0.24 to 1.91). In women, there was no significant association of low skeletal muscle mass with highest quartile of IMT, regardless of BMI.

CONCLUSIONS

Low appendicular skeletal muscle mass is associated with carotid arterial wall thickening in men with lower BMIs, but not in men with higher BMIs. Our findings suggest that the risk of atherosclerosis may be low in middle-aged Korean men with appropriate body weight and skeletal muscle mass maintenance.

Summary

Korean summary
한국 중년 성인을 대상으로 사지근육양과 죽상경화증(경동맥 내중막 두께≥75 percentile)의 관련성을 체질량지수(≥25, <25 kg/m2)로 층화하여 평가하였다. 체질량지수 25 kg/m2 미만인 남자에서는, 사지근육양이 낮으면 죽상경화증의 위험이 유의하게 높았으나, 체질량지수 25 kg/m2 이상인 남자에서는 관련성이 없었다. 반면 여자에서는 체질량지수에 상관없이 사지근육양과 죽상경화증의 독립적인 관련성이 관찰되지 않았다.

Citations

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Contribution of low skeletal muscle mass in predicting cardiovascular events: A prospective cohort study
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European Journal of Internal Medicine.2023; 114: 113. CrossRef
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Yayun Lu, Jianguang Tian, Liangyu Wu, Qing Xia, Qinzhong Zhu
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Biomedicine & Pharmacotherapy.2022; 147: 112636. CrossRef
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Association of High Muscle Mass with Carotid Atherosclerosis: A Community-Based Population Cohort Study
Y. Xu, T. Hu, Y. Shen, Y. Wang, Xiaojing Ma, Yuqian Bao
The Journal of nutrition, health and aging.2022; 26(12): 1087. CrossRef
Sarcopenia, sarcopenic overweight/obesity and risk of cardiovascular disease and cardiac arrhythmia: A cross-sectional study
Ming-Feng Xia, Ling-Yan Chen, Li Wu, Hui Ma, Xiao-Ming Li, Qian Li, Qiqige Aleteng, Yu Hu, Wan-Yuan He, Jian Gao, Huan-Dong Lin, Xin Gao
Clinical Nutrition.2021; 40(2): 571. CrossRef
Muscle mass and grip strength in relation to carotid intima-media thickness and plaque score in patients with type 2 diabetes
Jang Yel Shin, Jung Soo Lim
Nutrition, Metabolism and Cardiovascular Diseases.2021; 31(10): 2935. CrossRef
Low muscle mass is associated with carotid atherosclerosis in patients with type 2 diabetes
Da Hea Seo, Yong-ho Lee, Young Ju Suh, Seong Hee Ahn, Seongbin Hong, Young Ju Choi, Byoung Wook Huh, Seok Won Park, Eunjig Lee, So Hun Kim
Atherosclerosis.2020; 305: 19. CrossRef
Associations of skeletal muscle mass with atherosclerosis and inflammatory markers in Korean adults
Soon-Kyu Yoon, Ha-Na Kim, Sang-Wook Song
Archives of Gerontology and Geriatrics.2020; 90: 104163. CrossRef
Impact of sarcopenia on glycemic control and atherosclerosis in Japanese patients with type 2 diabetes: Cross‐sectional study using outpatient clinical data
Shuhei Nakanishi, Masahiro Iwamoto, Hisanori Shinohara, Hideyuki Iwamoto, Hideaki Kaneto
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