Objectives: This study aimed to develop a NOVA-based scoring approach for evaluating ultra- processed food (UPF) intake among Korean adults and to examine its performance. Previous studies have reported that young adults have the highest levels of UPF consumption. Accordingly, this study focused on adults aged 19–40 years and developed scoring components reflecting dietary patterns specific to Korean eating habits. Methods: Using 24-hour dietary recall data from adults aged 19–40 years in the Korea National Health and Nutrition Examination Survey (2021–2023), foods were classified according to the Korean-adapted NOVA system. The top 10 food groups accounting for ≥ 80% of cumulative UPF-derived energy were selected to construct the scoring components. The tool was operationalized using food frequency questionnaire (FFQ) data from the Gangwon cohort study (2022–2024). Intake frequencies were converted into scores ranging from 0 (“rarely or never”) to 5 (“≥ 1 time/day”), and summed to generate the NOVA–UPF score (range: 0–50). Results: Among 237 young adults (aged 20–49 years), the mean NOVA–UPF score was 22.9 ± 8.3. A positive association was observed between the NOVA–UPF score and FFQbased UPF energy intake (Spearman’s ρ = 0.629, P < 0.001). Cross-classification showed that 51.9% were classified into the same tertile and 94.9% into the same or adjacent tertiles, with a weighted kappa coefficient of 0.279. Conclusion This NOVA-based scoring approach may serve as a preliminary tool for assessing UPF intake in Korean young adults. Further refinement and rigorous validation using quantitative dietary assessment methods and more diverse populations are required before broader application.

BACKGROUND/OBJECTIVES: This study examined factors associated with vegetarian orientation among adults in Seoul, with a focus on food literacy (FL) and sociodemographic characteristics. SUBJECTS/METHODS: A cross-sectional analysis was conducted using data from the 2023 Seoul Food Survey in Seoul, South Korea. The study included 3,592 adults aged ≥ 18 yrs, who were categorized into vegan, lacto-ovo vegetarian, pollo-pesco vegetarian, flexitarian, and omnivore groups. FL was assessed using a 33-item scale covering 3 domains: nutritional and safety, cultural and relational, and socioecological. Descriptive statistics, general linear models, and logistic regression analyses were performed. RESULTS: Among the participants, 16.0% followed a vegetarian-oriented diet, with flexitarians comprising the largest subgroup (10.9%). Vegetarian orientation was positively associated with being female (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.05–1.90), age of ≥ 65 yrs (OR, 2.51; 95% CI, 1.50–4.21) and having a college education (OR, 2.51;95% CI, 1.78–3.53). Negative associations were found for higher household income (≥ 5 million KRW/month) (OR, 0.63; 95% CI, 0.47–0.85) and low food security (OR, 0.33; 95% CI, 0.24–0.44). Vegetarian-oriented individuals had higher FL scores, particularly in the socioecological domain. In the multivariable models, higher FL scores remained significantly associated with vegetarian orientation. Health management (63.8%) was the most commonly reported motivation. CONCLUSION Gender, age, educational level and FL in the socioecological domain were significantly associated with vegetarian orientation. Our study findings underscore the need for policies and programs that promote sustainable diets tailored to specific sociodemographic groups with varying FL levels.

Background: With the aging population and advancements in medical care worldwide, the number of older patients with end-stage kidney disease continues to rise. This study aimed to identify factors associated with osteoporosis and osteopenia in older patients undergoing incident hemodialysis and assess their impact on mortality. Methods: We analyzed a large multicenter retrospective cohort of patients aged ≥70 years undergoing incident hemodialysis to identify factors associated with osteoporosis using logistic regression analysis and to assess the association of death with osteoporosis and osteopenia using Cox multivariable analysis. Results: Among 710 patients, 39.0% and 19.6% had osteoporosis and osteopenia, respectively. Osteoporosis was significantly associated with female sex, a history of fractures, and the absence of phosphate binder use. During a median follow-up of 36.8 months, 348 participants (58.8%) died. Mortality rates were the highest in the osteoporosis group (79.8%), followed by the osteopenia (77.2%) and normal bone mineral density (BMD) groups (35.2%). Cox regression analysis revealed that even after adjusting for covariates, the osteoporosis group was significantly associated with a higher mortality risk than the normal BMD group. Osteoporosis at the start of hemodialysis was significantly associated with higher mortality. Conclusion We should consider the importance of bone health in patients undergoing incident hemodialysis and pay attention to the use of phosphate binders and fracture prevention.

Background: Obesity is a well-known risk factor for chronic kidney disease and its progression. However, the impact of obesity on the renal function of the elderly population is uncertain. We investigated the association between obesity and renal outcomes in the elderly. Methods: We analyzed 130,504 participants from the Korean National Health Insurance Service-Senior cohort. Obesity was classified according to body mass index (BMI), sex-specific waist circumference (WC), and the presence of metabolic syndrome. The primary outcome was renal function decline, defined as a decline in the estimated glomerular filtration rate (eGFR) of at least 50% from baseline or new-onset end-stage renal disease. Results: During a follow-up period of 559,531.1 person-years (median, 4.3 years), 2,486 participants (19.0%; incidence rate of 4.44 per 1,000 person-years) showed renal function decline. A multivariate Cox proportional hazards model revealed that BMI/WC was not associated with renal function decline. However, the group with metabolic syndrome had a significantly increased risk of renal function decline compared to the group without metabolic syndrome (adjusted hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.13–1.36). Compared with the non-metabolic syndrome group, the adjusted HRs (95% CI) for participants with one through five components were 0.96 (0.84–1.11), 1.10 (0.96–1.27), 1.24 (1.06–1.45), 1.37 (1.12–1.66), and 1.99 (1.42–2.79), respectively (p for trend < 0.001). Conclusion In elderly Korean adults, metabolic syndrome and the number of its components were associated with a higher risk of renal function decline, but BMI or WC was not significant.

Early mortality following hemodialysis initiation hinders survival improvement in older patients. This study aimed to develop a clinical risk model for predicting 6-month mortality after dialysis initiation in older Korean hemodialysis patients. Methods: We analyzed data from incident hemodialysis patients aged >70 years from the Korean Society of Geriatric Nephrology (KSGN) database. A prediction model was developed using multivariate logistic regression analysis and externally validated with independent datasets. Results: Among 1,751 incident hemodialysis patients, the 6-month mortality rate was 15.5%. Using multivariate logistic analysis, we constructed the KSGN score as an independent risk factor for 6-month mortality, and its components and score are as follows: old age at dialysis initiation (≥85 years, score 2); hypertension and renovascular disease as a primary etiology of end-stage kidney disease (ESKD) (score 1); malignancy history (yes, score 1); low serum albumin (<3.5 g/dL, score 1); hypertension treatment (yes, score –1); prepared vascular access on maintenance dialysis (arteriovenous fistula/arteriovenous graft, score –3). In the development cohort, the area under the curve (AUC) for the KSGN score was significantly higher than the Alberta Wick’s score (0.707 vs. 0.683, p = 0.001). In the validation cohort, the KSGN score’s performance was comparable to existing models. Conclusion: The KSGN score may be a valuable tool for predicting early mortality after dialysis initiation in older patients with ESKD, aiding in decision-making and management regarding dialysis initiation.

The prevalence of dementia is 2- to 7-fold higher among patients with end-stage kidney disease (ESKD) than among the general population; however, its clinical implications in this population remain unclear. Therefore, this study aimed to determine whether comorbid dementia increases mortality among older patients with ESKD undergoing newly initiated hemodialysis. Methods: We analyzed data from the Korean Society of Geriatric Nephrology retrospective cohort, which included 2,736 older ESKD patients (≥70 years old) who started hemodialysis between 2010 and 2017. Kaplan-Meier survival and Cox regression analyses were used to examine all-cause mortality between the patients with and without dementia in this cohort. Results: Of the 2,406 included patients, 8.3% had dementia at the initiation of dialysis; these patients were older (79.6 ± 6.0 years) than patients without dementia (77.7 ± 5.5 years) and included more women (male:female, 89:111). Pre-ESKD diagnosis of dementia was associated with an increased risk of overall mortality (hazard ratio, 1.503; p < 0.001), and this association remained consistent after multivariate adjustment (hazard ratio, 1.268; p = 0.009). In subgroup analysis, prevalent dementia was associated with mortality following dialysis initiation in female patients, those aged <85 years, those with no history of cerebrovascular accidents or severe behavioral disorders, those not residing in nursing facilities, and those with no or short-term hospitalization. Conclusion: A pre-ESKD diagnosis of dementia is associated with mortality following dialysis initiation in older Korean population. In older patients with ESKD, cognitive assessment at dialysis initiation is necessary.

BACKGROUND/OBJECTIVES: Happiness is an important factor in life, and food literacy (FL) has been emphasized as a core concept for a happy and healthy life. This study examined the level of happiness of Seoul citizens according to their sociodemographic factors and their association with FL. SUBJECTS/METHODS: This study used the data from the Seoul Food Survey, a cross-sectional study conducted on 4,039 Seoul citizens from September to October 2021. FL was measured using a validated questionnaire consisting of 33 items from 3 sub-domains: 14 items in the nutrition and safety domain, 8 items in the cultural and relational domain, and 11 items in the socio-ecological domain. Statistical analysis involved descriptive statistics and multivariate regression analysis. RESULTS: Various sociodemographic factors, such as household income, subjective health status, and food insecurity, were found to be associated with the level of happiness. The level of FL was also associated with the happiness scores. After adjusting for variables associated with happiness, the participants with the highest quartile FL scores were 7.32 times more likely to respond that they were happy than those with the lowest FL score. Three FL domains and total FL showed linear increases in overall happiness after controlling for subjective health status and sociodemographic factors (P < 0.001). CONCLUSIONS After adjusting for the related covariates, higher levels of FL were associated with higher scores in happiness. Based on this study, it would be meaningful to evaluate ways to intervene in FL to improve the level of happiness among the general population.

BACKGROUND/OBJECTIVES: The growing aging population has led to an increased utilization of senior daycare centers. This study was conducted to design a program to enhance the health of older adults in senior daycare centers in Chuncheon City, South Korea. SUBJECTS/METHODS: The study explored the health conditions and dietary patterns of older adults in senior daycare centers. Participants included staff and older adults from senior daycare centers in Chuncheon City. A mixed methods research design was used to obtain both qualitative and quantitative data. Qualitative insights were obtained through in-depth interviews with 26 staff members and older adults, coupled with observations made at 10 senior daycare centers. The quantitative component comprised structured questionnaires and physical measurements of 204 older adults at these centers. RESULTS: Many of the older adults relied on the meals provided by the center due to their limited cooking abilities. Dental health issues and dysphagia were common. Interviews highlighted the budgetary constraints of the centers in providing wholesome meals and the need for government support to alleviate meal expenses and enhance quality. A structured survey of older adults showed that the average age was 83.3 yrs, with an average of 2 chronic conditions per participant. Frailty analysis of the participants revealed that 56.2% were prefrail and 32.0% were frail. Almost half of the participants (47.0%) used dentures. Based on these findings, a preventive intervention program was proposed, addressing the specific needs and challenges of older adults while promoting overall well-being and preventing frailty. CONCLUSION Tailored health promotion strategies are crucial in senior daycare centers.Recommended interventions include staff nutrition education, improved dietary plans, and cost-effective strength training programs. These interventions aim to reduce frailty and enhance the quality of life of older adults in the community via interventions in daycare centers.

BACKGROUND/OBJECTIVES: Mukbang, a trend originating in South Korea and gaining global popularity, could influence children’s food choices and eating habits. This study analyzed the correlation between Mukbang viewing time in children and adolescents, their meal consumption frequency, nutrition quotient (NQ), and frequency of food intake. SUBJECTS/METHODS: From July to August 2022, this cross-sectional study investigated upper elementary students (ages 9–11 yrs) and adolescents (aged 12–18 yrs) using an online survey. The survey items included key demographic factors, Mukbang viewing frequency and duration, frequency of main meal consumption, commonly consumed foods, and the validated NQ, which was used to assess food intake quality. Multiple linear regression analysis was used to explore the link between Mukbang viewing and nutritional habits. RESULTS: Weekly Mukbang viewing time was significantly correlated with eating habits after adjusting for gender, age, physical activity frequency past week, household income, and primary caregiver’s level of education. Increased Mukbang viewing time correlated with reduced frequency of breakfast (P for trend < 0.001) and dinner (P for trend = 0.012), while the frequency of eating out (P for trend < 0.001) and late-night snacking (P for trend = 0.008) increased. Higher Mukbang viewing time notably decreased scores in the moderation domain (P for trend < 0.001), in the practice domain (P for trend = 0.031), and overall NQ (P for trend < 0.001). It also significantly elevated intake of sweets (P for trend = 0.001), Koreanstyle street food, Western-style fast food, instant noodles, sweetened beverages, caffeinated beverages, and fruit and vegetable juices (P for trend < 0.001). CONCLUSION This study identifies a negative correlation between Mukbang viewing and eating habits among Korean children and adolescents. The results indicate the importance of incorporating children and adolescents’ media usage and environmental factors on dietary education and the development of policy programs.