Nutritional researchers world-wide are using large-scale sample survey methods to study nutritional health epidemiology and services utilization in general, non-clinical populations. This article provides a review of important statistical methods and software that apply to descriptive and multivariate analysis of data collected in sample surveys, such as national health and nutrition examination survey. A comparative data analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) was used to illustrate analytical procedures and design effects for survey estimates of population statistics, model parameters, and test statistics. This article focused on the following points, method of approach to analyze of the sample survey data, right software tools available to perform these analyses, and correct survey analysis methods important to interpretation of survey data. It addresses the question of approaches to analysis of complex sample survey data. The latest developments in software tools for analysis of complex sample survey data are covered, and empirical examples are presented that illustrate the impact of survey sample design effects on the parameter estimates, test statistics, and significance probabilities (p values) for univariate and multivariate analyses.
Cluster Analysis ; Korea ; Multivariate Analysis ; Nutrition Surveys ; Population Characteristics ; Software ; Statistics as Topic ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to identify associated factors of chewing discomfort among community-dwelling elderly. METHODS: The study was cross-sectional design and secondary data analysis using the 6th Korea National Health and Nutrition Examination Survey. Among the total of 7,550 participants, data was analyzed with 1,126 adults aged 65 years and over. Chewing discomfort was assessed by the perceived chewing discomfort. Multivariate logistic regression analysis was used to find the associated factors of chewing discomfort. RESULTS: Along with 61.7% of the participants reported having chewing discomfort, 85.2% reported to perceive poor oral health and 35.0% had oral pain. In multivariate logistic regression, perceived oral health (OR 3.22, 95% CI 2.24~4.63), oral pain (OR 2.46, 95% CI 1.76~3.43), activity limitation (OR 1.71, 95% CI 1.05~2.80), teeth requiring treatment (OR 1.61, 95% CI 1.14~2.26), number of remaining teeth (OR 1.60, 95% CI 1.22~2.10) and educational level (OR 1.56, 95% CI 1.15~2.12) were the significant predictors of chewing discomfort. CONCLUSION: The prevalence in chewing discomfort was high in elderly Koreans and various factors were associated with chewing discomfort. To improve chewing ability, it is suggested that the national level of policies offer strategical oral health programs in this population.
Adult ; Aged* ; Humans ; Korea ; Logistic Models ; Mastication* ; Nutrition Surveys ; Oral Health ; Prevalence ; Statistics as Topic ; Tooth

To find out what foods and dishes are being consumed by people with dyslipidemia, we have researched which food groups and dish groups are utilized in order to use for nutrition educations. The data was obtained from participants in 2001 KNHNS using the 24hours recall method. Ages over 30 years old are used for the analysis. Food and dish group intakes are analyzed by gender, age, residence, education, and economic status. Dyslipidemia are divided into A, B and C groups using guideline of dyslipidemia. The differences in food consumption were analyzed and assessed by GMDVF, DDS and DVS. SAS and SPSS were used for the data analysis. Overall, In food group, people in B and C (with dyslipidemia) have higher intake levels of vegetables, while people in A (without dyslipidemia) have higher intake levels of fruits (p < 0.05). In dish group, people in B and C (with dyslipidemia) have higher intake levels of rice dish, soups and kimchi, while people A (without dyslipidemia) have higher intake levels of breads and snacks, salad and fruits (p < 0.05). In the dietary patterns of main food group (GMDVF), the pattern excluding dairy (11011) revealed the highest proportion in all groups. DDS = 4 has the highest proportion in all groups. The proportions of subjects with the low dietary diversity score increased in B and C (with dyslipidemia). Food groups that most people do not consume were dairy and fruits. The level of DVS in A (without dyslipidemia) is higher than in B and C (with dyslipidemia). With these results, it is shown that people with dyslipidemia had worse quality patterns of food intake than those without dyslipidemia. Thus we should emphasize the balanced diet and educate people how to choose foods. So it is necessary to develop food guide for people with dyslipidemia.
Adult ; Bread ; Diet ; Dyslipidemias* ; Eating ; Education ; Fruit ; Humans ; Nutrition Surveys* ; Snacks ; Statistics as Topic ; Vegetables

To present statistical methods on appropriate data analysis from complex surveys and errors arising from ignorance of weights or design of samples. We took Chinese National Nutrition and Health Survey in 2002 as an example to analyze the prevalence of hypertension among population aged 15 and over. We used four combinations of analyses, including with or without weighting or considering sample designs. If weights is omitted, it would result in biased prevalence estimates and also influence the estimates of standard errors. While omitting sample designs would result in underestimating the standard error estimates and then testing the false positive hypothesis. Through appropriate analysis, we found Chinese people in large-sized cities had the highest prevalence of hypertension (28.77%, 95%CI: 25.69% - 31.84%) while people in the poorest rural area having the lowest prevalence of hypertension (14.21%, 95%CI: 12.64% - 15.79%). The prevalence of hypertension among people in small and medium-sized cities and other rural areas ranged from 20.48% to 24.37% with statistically insignificant difference. It is necessary to use appropriate methods to analyze data from complex surveys.
Health Status ; Humans ; Hypertension ; epidemiology ; Nutrition Surveys ; Prevalence ; Sampling Studies ; Statistics as Topic

Flavonoids have been hypothesized to reduce the risk of chronic diseases, but the lack of a flavonoid database hampered epidemiological studies addressing this issue in Korea. In this study, we developed a flavonoid database, based on a systematic review. A total of 1549 food items containing flavonoids were selected using the Korean Nutrient Database. Among them, flavonoid contents for only 649 food items were evaluated with analytical values and the remaining 900 items were replaced with adaptations or calculations from similar items. The developed flavonoid database covered 93.2% of fruits and fruit juices, 76.1% of vegetables, 98.4% of legumes and legume products, and 85.0% of all plant foods overall (1,549 items) as reported by the 24-hr dietary recall method regarding the 2008 Korean National Health and Nutrition Examination Survey. We found that this flavonoid database, overall, included 95.6% of all mainly consumed plant foods by Koreans. This flavonoid database is expected to be useful in regards to the correlation study of flavonoid intake and chronic diseases.
Anthocyanins ; Chronic Disease ; Fabaceae ; Flavones ; Flavonoids ; Flavonols ; Fruit ; Isoflavones ; Korea ; Nutrition Surveys ; Plants ; Statistics as Topic ; Vegetables

OBJECTIVETo investigate the nutrition status, breast feeding and complementary feeding among children under 2 years of age in Beijing.

METHODSA stratified cluster randomly sampling method was used. After having got the compliance a questionnaire survey was carried out to 422 children < 2 year-old in total 18 districts of Beijing.

RESULTSThe average infant birth weight was 3325 g, the rate of weight (2500 g and > or = 4000 g were 2.8% and 13.0% respectively. The rate of exclusive breast-feeding, partial breast-feeding, bottle-feeding of infant under 4 months was 56.6%, 33.9% and 9.5% respectively. The average weaning time was 7.4 months. The rate of complementary feeding of infant up to 6 months was 99.4%. The average ages for addition of complementary feeding such as cereal, vegetable and fruit, egg, oil, nutrients in rural areas were later than those in urban.

CONCLUSIONIt is important to promote breast feeding and improve complementary feeding by education and intervention.

Bottle Feeding ; statistics & numerical data ; Breast Feeding ; statistics & numerical data ; China ; Humans ; Infant ; Infant Food ; statistics & numerical data ; Infant, Newborn ; Nutrition Surveys ; Rural Population ; statistics & numerical data ; Surveys and Questionnaires ; Urban Population ; statistics & numerical data

OBJECTIVES: We present data from the Korean National Health and Nutritional Examination Survey (KNHANES) 2008-2009 on the combination of vitamin D deficiency and arsenic exposure on diabetes mellitus (DM) in a representative sample of the adult Korean population. METHODS: This study was based on data obtained from the KNHANES 2008-2009, which was conducted for 3 years (2007-2009) using a rolling sampling design that involved a complex, stratified, multistage, probability-cluster survey of a representative sample of the non-institutionalized civilian population in South Korea. RESULTS: Data analysis revealed that subjects who showed both vitamin D levels in the 1st quartile (Q) and urinary arsenic levels in the 4th Q, had a 302% increased risk of having DM, as compared with those whose vitamin D and urinary arsenic levels were in the 4th Q and 1st Q, respectively. CONCLUSION: The present study reconfirmed an association of DM with low vitamin D levels and arsenic exposure, and further showed a combination of vitamin D deficiency and arsenic exposure on DM in the general Korean population. To the best of our knowledge, this is the first report describing a combination of vitamin D deficiency and arsenic exposure on DM. The present findings have important public health implications.
Adult ; Arsenic* ; Diabetes Mellitus* ; Humans ; Nutrition Surveys* ; Public Health ; Republic of Korea ; Statistics as Topic ; Vitamin D Deficiency* ; Vitamin D* ; Vitamins*

PURPOSE: To identify the effectiveness of policy evaluation, consistent monitoring is necessary. This study aimed to carry out mid-term evaluation of objectives and programs related to comprehensive plans for sodium intake reduction by 2020 for Seoul city and then reestablish the objectives of the sodium intake reduction plans. METHODS: Literature reviews, data analysis, and reviews of expert focus-groups were performed to evaluate objectives, to develop a new goal, and to identify the priority subjects of the sodium intake reduction programs. In order to examine target populations for the programs, awareness and behaviors related to sodium intakes among Seoul citizens were examined by sex, age, and income level using the 2008~2013 Korea National Health and Nutrition Examination Survey data. RESULTS: Current objectives of the sodium intake reduction plan by 2020 for Seoul city were not appropriate, so objectives were reset to 3,600 mg of sodium intake by 2020 among Seoul citizens with 2% reduction per year. Although sodium intake showed a decreasing trend by year, it was still high, especially in men. The sodium intake reduction programs currently in progress have not been assessed at multiple levels across multiple sectors and have only been assessed fragmentarily. For dietary behavior related to sodium intakes by sex, age, and income level, sodium intake was higher in the group with less than 100 g of fruit intake compared to the group with 100 g or more. Subjects aged 30~59 years and the low household income group showed relatively higher sodium intakes. Based on the data analysis and the expert review, the priority subject of the sodium intake reduction programs was determined to be adult men. In terms of a program strategy for sodium intake reduction, multi-level and setting approaches, including work sites, home, and restaurants, were suggested to reduce sodium intakes of the target subject. CONCLUSION: The suggested objectives should be consistently monitored by data analysis, and the determined programs need to be phased in over 5 years.
Adult ; Family Characteristics ; Fruit ; Health Services Needs and Demand ; Humans ; Korea ; Local Government* ; Male ; Nutrition Surveys ; Restaurants ; Seoul* ; Sodium* ; Statistics as Topic

OBJECTIVES: This study investigated the socioeconomic factors that affect quality of life (QL) in healthy adults and to study the relationship between QL and health-related habits and food intake. METHODS: Subjects consisted of 1,154 healthy adults without any known disease, aged 19 to 65 years from the 2013 Korean National Health and Nutrition Examination Survey data. We used SPSS statistical program version 20.0 for data analysis. RESULTS: The average age and QL score of the study population were 36.7 years and 0.99 points, respectively. Males had a significantly higher QL score than the females (p < 0.001), and employed subjects and those employed in permanent positions had significantly higher scores as compared respectively with unemployed subjects and those employed in temporary positions (p < 0.001, p < 0.05). The group that responded "almost every day" to the "frequency of binge drinking" and "frequency of disruption of daily life due to drinking" had significantly lower QL scores as compared to other groups (p < 0.05). Further, the scores were significantly higher for individuals who practiced "intense physical activities" and "walking" (p < 0.001). The groups that responded that they were "very stressed" showed significantly lower QL scores in comparison to the other groups (p < 0.05). There were no significant differences in QL scores according to anthropometric or biochemical indices. When subjects were divided into two groups based on average QL scores, the frequency of intake of "barbecued beef" was significantly higher while the frequency of intake of "fried eggs or rolled omelet," and "soy milk" was significantly lower in the high QL group. CONCLUSIONS: Based on these findings, it is evident that in healthy adults without any known underlying illnesses, psychological factors such as economic activity, occupational environment, and stress are considered to have a greater impact on their QL than are nutrient intake, blood biochemical indices, and anthropometric status.
Adult* ; Eating* ; Eggs ; Female ; Humans ; Korea* ; Male ; Nutrition Surveys* ; Ovum ; Psychology ; Quality of Life* ; Socioeconomic Factors ; Statistics as Topic

PURPOSE: The purpose of this study was to investigate the relationship between obesity, body image perception, and weight control for obesity management in adult women. METHODS: The subjects of this study were 3,617 women aged over 19 years, who participated in the Seventh Korea National Health and Nutrition Examination Survey 2016. Data were analyzed through complex sampling design data analysis. RESULTS: Right body image perception according to obesity was apparent between 70.6–81.7% of women and 76.5% of women with abdominal obesity perceived that they were normal. Obese women performed more weight control than non-obese women. Women with only abdominal obesity performed less weight control than non-obese women, and 47.3% of them performed weight control. Women who perceived themselves as obese performed more weight control than women who perceived themselves as non-obese (odds ratio, 2.08; confidence interval, 1.69–2.57), but body mass index was not observed to be associated with weight control. CONCLUSIONS: Education on abdominal obesity should be provided to increase awareness about abdominal obesity and its effective management, especially in women with only abdominal obesity. In addition, interventions for right body type perception should be provided for proper weight control along with prevention and management of obesity.
Adult ; Body Image ; Body Mass Index ; Education ; Female ; Humans ; Korea ; Nutrition Surveys ; Obesity ; Obesity, Abdominal ; Somatotypes ; Statistics as Topic