BACKGROUND AND OBJECTIVES: Although dietary management is strongly recommended in patients with hypertension, little is known about how many manage their diet and follow the guidelines for hypertension. We investigated the prevalence of dietary management among adults with known hypertension and evaluated their compliance to the dietary guidelines.METHODS: Data from the Korea National Health and Nutrition Examination Survey 2013–2016 were used. Among 15,870 adults aged 30–79 years, 4,162 reported a physician-diagnosed hypertension. Diet management behavior was defined by self-report response. Actual dietary intake was assessed by a 24-hour dietary recall. Dietary quality was evaluated using the Korean Healthy Eating Index (KHEI).RESULTS: Among adults with hypertension, 28.0% reported that they were managing their diet. Those with hypertension consumed significantly less dietary sodium (p value<0.01), but also less potassium (p value<0.01), resulting in no difference of sodium-to-potassium ratio compared to those without hypertension (p value=0.66). Among those with hypertension, diet-managing adults had better KHEI score (66.9, p value<0.01) and consumed less sodium (3,354.3 mg, p value<0.01) than not-managing adults (63.6 score and 3,554.5 mg, respectively). However, total KHEI score was rather lower in those with hypertension (p value<0.01) than those without hypertension and their sodium intake was still over the recommended amount.CONCLUSIONS: More than two-thirds of Korean adults with hypertension did not manage their diet in daily life. More effective strategies are needed to increase the level of compliance with dietary recommendations for people with high blood pressure.
Adult ; Compliance ; Diet Therapy ; Diet ; Eating ; Humans ; Hypertension ; Korea ; Nutrition Policy ; Nutrition Surveys ; Potassium ; Prevalence ; Self Care ; Sodium ; Sodium, Dietary

PURPOSE: North Koreans could be at higher risk for their bone health because of previous periods of severe famine and the continuing low availability of food. This study determined the bone mineral density (BMD) status and its relationship with dietary behaviors and nutrient intake of North Korean refugees (NKR) in South Korea (SK). METHODS: This cross-sectional study analyzed 110 female NKR from a NORNS cohort of a non-probability sample of adult NKR in Seoul. BMD examined by DEXA was used to divide participants into the normal group (NG) and the non-normal group (NNG) according to the WHO guideline. A self-administered questionnaire included questions on age, the socioeconomic situation in North Korea (NK) and SK, the food security in NK and SK, and the health behaviors, dietary behaviors, and food frequency questionnaire administered in SK. A one-day 24-hr recall was conducted and the results were analyzed by using CanPro. SPSS was used to analyze whether BMD and related dietary behaviors and nutrient intakes differed according to the groups. RESULTS: NG (62.7%) was significantly younger and had a lower abdominal obesity score than NNG (p < 0.001). While 14.5% of NG reported experiencing menopause, all of NNG reported experiencing menopause. The NG more frequently consumed the dairy group of foods (9.6 times a week) than did the NNG (4.8 times a week) after the statistics were adjusted for age (p < 0.007). The NG consumed significantly more animal protein and animal calcium than did the NNG (p = 0.01, p = 0.009, respectively). Calcium intake was low with 49.3% of NG, and 78.0% of the NNG reported consuming calcium lower than the estimated average requirement. Only calcium showed an index of nutrient quality lower than one in both groups. CONCLUSION: These results showed that NKR women and possibly all North Korean women are at high risk for bone health and they consumed low levels of bone-related nutrients, and this should be considered for the nutrition policy for NKR and North Korea.
Adult ; Animals ; Bone Density ; Calcium ; Cohort Studies ; Cross-Sectional Studies ; Democratic People's Republic of Korea ; Diet ; Female ; Food Supply ; Health Behavior ; Humans ; Korea ; Menopause ; Nutrition Policy ; Nutritional Status ; Obesity, Abdominal ; Refugees ; Seoul ; Starvation

OBJECTIVES: This study evaluated dietary intakes of total fat and fatty acids among the Korean adult population. METHODS: This cross-sectional study used the 2016–2017 Korea National Health and Nutrition Examination Survey data. A total of 10,772 subjects aged ≥19 y for which dietary data were available were selected. Data pertaining to energy and nutrient intakes were obtained by a 24-h recall method. Total fat and fatty acids intakes were evaluated based on the Acceptable Macronutrient Distribution Ranges (AMDR) of 2015 Dietary Reference Intakes for Koreans by sex and age groups. All statistical analyses accounted for the complex sampling design effect and sampling weights. RESULTS: The mean intakes of energy and total fat were 1,952 kcal (95% CI: 1928–1977) and 46.1 g (45.2–47.1), respectively, and about 21% of the energy was obtained from fat in this study population (21.7% in men and 20.2% in women). The mean percentages of energy from saturated, monounsaturated, and polyunsaturated fatty acids were 6.4%, 6.7%, and 5.2%, respectively. About 18% of adults exceeded the AMDR for fat (30% of energy), whereas 37.6% exceeded the AMDR for saturated fatty acids (7% of energy). The proportions of subjects who consumed more than the AMDR for fat and saturated fatty acids decreased across age groups in both sexes. Among young adults (19–29 y), about 63% of the subjects obtained ≥7% of their energy from saturated fatty acids. About 61% of older adults obtained less than 15% of their energy from total fat. CONCLUSIONS: Increased intake of fat energy was prominent in saturated fatty acids. Our findings suggest current information on total fat and fatty acids intakes in Korean adults and can be used to provide dietary guidelines for the improvement of public health.
Adult ; Cross-Sectional Studies ; Dietary Fats ; Fatty Acids ; Fatty Acids, Unsaturated ; Humans ; Korea ; Male ; Methods ; Nutrition Policy ; Nutrition Surveys ; Public Health ; Recommended Dietary Allowances ; Weights and Measures ; Young Adult

OBJECTIVES: This study examines the intake of food and nutrients of children according to the employment and working hours of their mothers. METHODS: The married women in the source data from the 6th National Health and Nutrition Survey were classified into full-time working mothers, part-time working mothers and housewives according to the working type and the data on their children from 3 to 18 years old were analyzed using SAS 9.4. RESULTS: The group from 3 to 5 years old was the smallest group with 682 children (20.2%), followed by the group from 6 to 11 years with 1,345 children (39.8%) and the group from 12 to 18 years old with 1,355 children (40.1%). The lowest rates for having no breakfast and dinner were observed in the group with housewives (p<0.05). The calcium and phosphorous intakes were the highest in the group with housewives at 61.9% and 126.8%, respectively, and the lowest in the group with full-time working mothers at 54.7% and 115.3%, respectively (p<0.05). The group with full-time working mothers had the highest rate in the calcium and iron intake less than the dietary reference intake at 74.9% and 30.0%, respectively. It indicated that the group with full-time working mothers did not have sufficient nutrients as compared to the other two groups. Moreover, the group with the part-time working mothers showed the high vitamin A intake ratio of 41.4% (p<0.05). CONCLUSIONS: This study found evidence of a negative association between mother's employment status and children's diet quality. The employment and economic activity of married women will continuously increase in the future. Therefore, a national nutrition policy is required to provide quality nutrition care for children in the households.
Breakfast ; Calcium ; Child ; Diet ; Eating ; Employment ; Family Characteristics ; Female ; Humans ; Iron ; Korea ; Meals ; Mothers ; Nutrition Policy ; Nutrition Surveys ; Nutritional Status ; Obesity ; Recommended Dietary Allowances ; Vitamin A

OBJECTIVES: This study examined the relationship between the presence of allergic rhinitis and the nutritional intake levels of Korean infants. METHODS: The study involved a total of 1,214 infant subjects aged 1~5 months from the 2013~2016 KNHNES (Korea National Health and Nutrition Examination Survey). The Subjects were classified into two groups based on the presence of allergic rhinitis: Non-allergic rhinitis infants (NARI, n=1,088) and allergic rhinitis infants (ARI, n=126). The general characteristics and family history of allergies, nutrient intake status, nutrient supplement intake, and breast milk and baby food start period data of the two groups were compared. All statistical analyses accounted for the complex sampling design effect and sampling weights. RESULTS: The mean age was 0.5 years old in the ARI group compared to the NARI group. In the residence, the rate of urban was higher in ARI. The family history revealed a significant difference between the two groups, particularly those of mothers rather than fathers. The nutrient intake levels were high in energy, phosphorus, sodium, potassium, iron, riboflavin, niacin, and polyunsaturated fatty acids. Breastfeeding was significantly higher in the ARI group than in the NARI group. The baby food start period was 0.3 months earlier in NARI group than in ARI group. The height, body weight, and birth weight were higher in ARI group than NARI group. The result of Odds ratio analysis showed that excess energy, protein, calcium, phosphorus, iron, riboflavin, and niacin intake increases the risk of allergic rhinitis. CONCLUSIONS: These results can be used as data to develop nutrition guidelines for allergic rhinitis infants.
Birth Weight ; Body Height ; Breast Feeding ; Calcium ; Fathers ; Fatty Acids, Unsaturated ; Humans ; Hypersensitivity ; Infant ; Iron ; Korea ; Milk, Human ; Mothers ; Niacin ; Nutrition Policy ; Nutrition Surveys ; Odds Ratio ; Phosphorus ; Potassium ; Rhinitis ; Rhinitis, Allergic ; Riboflavin ; Sodium ; Weights and Measures

BACKGROUND/OBJECTIVES: The aim of this study was to analyze specific foods influencing absolute nutrient intake and between-person variations of nutrient intake among Korean preschoolers. SUBJECTS/METHODS: This study included 2,766 participants aged 1–5 years in the 2009–2013 Korea National Health and Nutrition Examination Surveys. Dietary data were obtained from a 24-h dietary recall method. Major food sources of absolute nutrient intake were evaluated based on percent contribution of each food. To assess the contribution of specific foods to between-person variations in nutrient intake, stepwise multiple regressions were performed and cumulative R2 was used. RESULTS: White rice and milk were main food sources of energy, protein, carbohydrate, phosphorus, iron, potassium, thiamin, riboflavin, and niacin. The percentage of fat contributed by milk was 21.3% which was the highest, followed by pork, soybean oil, and egg. White rice accounted for 25% and 40% of total variability in total energy and carbohydrate intakes, respectively. About 39% of variation in calcium intake was explained by milk while 40% of variation in phosphorous intake was explained by cheese. The top 10 foods contributing to between-person variations in nutrient intakes were similar with food items that mainly contributed to absolute nutrient intakes. The number of foods explaining 90% of absolute amounts of nutrient intakes varied from 28 for vitamin A to 80 for iron. CONCLUSIONS: This study identified specific foods that contributed to absolute nutrient intakes and between-person variations in nutrient intakes among Korean preschoolers. Our findings can be used to develop dietary assessment tools and establish food-based dietary guidelines for young children.
Calcium ; Cheese ; Child ; Diet ; Humans ; Iron ; Korea ; Methods ; Milk ; Niacin ; Nutrition Assessment ; Nutrition Policy ; Nutritional Status ; Ovum ; Phosphorus ; Potassium ; Red Meat ; Riboflavin ; Soybean Oil ; Vitamin A

BACKGROUND: This study aimed to investigate the food intake behavior of cancer survivors based on main sources of energy intake from different food groups in comparison with healthy individuals.METHODS: Baseline survey data from the Health Examinee cohort, which recruited participants from 2014 to 2013 were applied. A total of 5,269 cancer survivors and 5,219 healthy subjects without comorbidities who were matched by age, sex, and enrollment center were included in the analysis. The proportion of energy intake for 17 food groups was devided into lower median and median or upper. OR and 95% CIs were determined to measure the difference of energy intake proportion in cancer survivors, five major types of cancer survivors versus healthy individuals.RESULTS: Generally, the proportion of calories intake from sugars and sweets, meat and poultry, oils and fats, and beverage was lower in cancer survivors than in healthy individuals (OR = 0.83 [95% CI = 0.79–0.88], 0.75 [95% CI = 0.71–0.80], 0.84 [95% CI = 0.80–0.89], and 0.93 [95% CI = 0.88–0.99], respectively) with more prominently shown in breast, colon, and thyroid cancer individuals. In contrast, cancer survivors tended to intake calories from potatoes and starches, legume, seeds and nuts, vegetables, mushrooms, fruits, and seasonings more than healthy individuals (OR = 1.09 [95% CI = 1.03–1.16], 1.13 [95% CI = 1.06–1.19], 1.15 [95% CI = 1.09–1.22], 1.07 [95% CI = 1.01–1.13], 1.07 [95% CI = 1.02–1.14], 1.15 [95% CI = 1.08–1.21], and 1.17 [95% CI = 1.10–1.23], respectively) which were more prominent in gastric and breast cancer survivors.CONCLUSIONS: The dietary behavior measured by main sources of energy intake in cancer survivors was different from healthy individuals in terms of several food groups. Although there are nutrition guidelines for cancer survivors, because of the differences between Western population and Asian people in terms of food culture, the guidelines for balanced nutritious behavior should be established among Asian cancer survivors.
Agaricales ; Asian Continental Ancestry Group ; Beverages ; Breast ; Breast Neoplasms ; Carbohydrates ; Cohort Studies ; Colon ; Comorbidity ; Eating ; Energy Intake ; Fabaceae ; Fats ; Fruit ; Healthy Volunteers ; Humans ; Meat ; Nutrition Policy ; Nutritional Status ; Nuts ; Oils ; Poultry ; Seasons ; Solanum tuberosum ; Starch ; Surveys and Questionnaires ; Survivors ; Thyroid Neoplasms ; Vegetables

BACKGROUND: This study aims to utilize Organization for Economic Cooperation and Development (OECD) data to identify macroscopic determinants of health at national level and to utilize it in health policy development through comparison and analysis with Korea. METHODS: The potential years of life lost (PYLL) were used as dependent variables and 19 indicators were selected as health determinants to be independent variables based on the results of previous studies. Data analysis was done using SAS ver. 9.4 package (SAS Institute Inc., Cary, NC, USA) and model used in technical statistics concerning PYLL by countries, multi-linearity test between independent variables and OECD economic studies were modified and used. RESULTS: From 1994 to 2012, the average PYLL for OECD countries was 4,262.9 years, the highest in Estonia and the lowest in Iceland. As a result of the analysis using the fixed effect model, the significant variables affecting PYLL were four variables: gross domestic product, nitric oxide, tobacco consumption, and number of doctors. The health determinants that had more influence on the PYLL of Korean people compared to other OECD countries were tobacco consumption, calorie consumption, fat intake and total health expenditure. CONCLUSION: In order to effectively reduce unnecessary deaths, we must continue to strengthen our smoking policy and nutrition policies such as calorie and fat intake. It is necessary to prevent the increase of total health expenditure due to the increase in the prevalence of chronic diseases and to strengthen the public health aspect.
Chronic Disease ; Estonia ; Gross Domestic Product ; Health Expenditures ; Health Policy ; Iceland ; Korea ; Nitric Oxide ; Nutrition Policy ; Organisation for Economic Co-Operation and Development ; Prevalence ; Public Health ; Smoke ; Smoking ; Statistics as Topic ; Tobacco Use

PURPOSE: The purpose of this study was to develop a valid instrument for measuring the dietary quality and behaviors of Korean elderly. METHODS: The development of the Nutrition Quotient for Elderly (NQ-E) was conducted in three steps: item generation, item reduction, and validation. The 41 items of the NQ-E checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Pearson's correlation was used to determine the level of agreement between the questionnaires and nutrient intake level, and 24 items were selected for a nationwide survey. A total of 1,000 nationwide elderly subjects completed the checklist questionnaire. The construct validity of the NQ-E was assessed using confirmatory factor analysis, LISREL. RESULTS: The nineteen checklist items were used as final items for NQ-E. Checklist items were composed of four-factors: food behavior (6 items), balance (4 items), diversity (6 items), and moderation (3 items). The standardized path coefficients were used as the weights of the items. The NQ-E and four-factor scores were calculated according to the obtained weights of the questionnaire items. CONCLUSION: NQ-E would be a useful tool for assessing the food behavior and dietary quality of the elderly.
Aged ; Checklist ; Humans ; Nutrition Policy ; Nutrition Surveys ; Weights and Measures

The purpose of this study was to examine the association between the symptoms of temporomandibular joint disorders and lumbar diseases in adults when the prevalence rate of osteoarthritis is increasing and to help develop health policies that can improve oral health and health in general. The study used representative data from the 5th Korea National Health and Nutrition Examination Survey phase 3 (2012). In total, we analyzed the data of 3,017 individuals aged over 50 years who participated in the health-related survey and underwent radiography of the lumbar joints. PASW statistics ver. 18.0 was used for analysis. This study revealed the following results: 16.1% experienced at least one symptom of temporomandibular joint disorders within the recent single year, 20.6% experienced lower back pain in the recent three months, and 30.6% had lumbar osteoarthritis revealed using radiography of the lumbar joints. Symptoms of temporomandibular joint disorders, lower back pain, and lumbar osteoarthritis were correlated with each other; the respondents who experienced symptoms of temporomandibular joint disorders had 1.70 times (95% confidence interval [CI], 1.30∼2.22) higher prevalence of lower back pain and 1.20 times (95% CI, 0.86∼1.68) higher prevalence of lumbar osteoarthritis than in those with no such difficulties. The results of this study confirmed that the symptoms of temporomandibular joint disorders affected lumbar diseases in adulthood. Therefore, adequate treatment and prevention of the symptoms of temporomandibular joint disorders in adults is expected to make crucial contributions to decreases in the prevalence rate of lumbar diseases and an improvement in the quality of life.
Adult* ; Health Policy ; Humans ; Joints ; Korea ; Low Back Pain ; Nutrition Surveys ; Oral Health ; Osteoarthritis ; Osteoarthritis, Spine ; Prevalence ; Quality of Life ; Radiography ; Surveys and Questionnaires ; Temporomandibular Joint Disorders* ; Temporomandibular Joint*