1.The mediating effect of the Korean Healthy Eating Index on the relationship between lifestyle patterns and metabolic syndrome in middle-aged Koreans: data from the 2019–2021Korea National Health and Nutrition Examination Survey
Sori ON ; Woori NA ; Cheongmin SOHN
Nutrition Research and Practice 2025;19(1):96-106
BACKGROUND/OBJECTIVES:
Metabolic syndrome (MetS) is closely connected to dietary and lifestyle factors, with diet being one of the primary risk factors for MetS, acting as a key factor in both prevention and management. In this study, we analyzed the mediating effect of the Korean Healthy Eating Index (KHEI) on the relationship between lifestyle patterns and MetS in middle-aged Koreans using data from the 2019–2021 Korea National Health and Nutrition Examination Survey (KNHANES).
SUBJECTS/METHODS:
This study examined data from 5,196 adults aged 40–64 yrs who participated in the eighth KNHANES. Data on 5 lifestyle factors—smoking, alcohol consumption, physical activity, sleep duration, and stress perception—were analyzed. The latent class analysis (LCA) was performed using Mplus 8.11, and SPSS PROCESS Macro v4.2 was used for statistical analysis to analyze the mediating effect of the KHEI.
RESULTS:
The model categorized lifestyle factors into three into 3 clusters: ‘Low Activity Class,’ ‘Low Activity and Smoking Class,’ and ‘Multiple Risk Class.’ The KHEI mediation analysis showed significant effects: 0.0205 (95% confidence interval [CI], 0.0062–0.0363) in the ‘Low Activity and Smoke Class,’ and 0.0420 (95% CI, 0.0133–0.0726) in the ‘Multiple Risk Class.’ The mediating effect of the KHEI domain “adequacy” was significant in these groups, with effects of 0.0357 (95% CI, 0.0184–00563) and 0.0662 (95% CI, 0.0364–0.6491), for the respective groups. Balance of energy intake was significant in the group with ‘Multiple Risk Class’ (0.0189; 95% CI, 0.0044–0.0378).
CONCLUSION
The results suggest that a healthy diet improves health management and reduces risk factors for MetS. Nonetheless, better strategies for dietary improvement through a detailed analysis of KHEI components are warranted.
2.The mediating effect of the Korean Healthy Eating Index on the relationship between lifestyle patterns and metabolic syndrome in middle-aged Koreans: data from the 2019–2021Korea National Health and Nutrition Examination Survey
Sori ON ; Woori NA ; Cheongmin SOHN
Nutrition Research and Practice 2025;19(1):96-106
BACKGROUND/OBJECTIVES:
Metabolic syndrome (MetS) is closely connected to dietary and lifestyle factors, with diet being one of the primary risk factors for MetS, acting as a key factor in both prevention and management. In this study, we analyzed the mediating effect of the Korean Healthy Eating Index (KHEI) on the relationship between lifestyle patterns and MetS in middle-aged Koreans using data from the 2019–2021 Korea National Health and Nutrition Examination Survey (KNHANES).
SUBJECTS/METHODS:
This study examined data from 5,196 adults aged 40–64 yrs who participated in the eighth KNHANES. Data on 5 lifestyle factors—smoking, alcohol consumption, physical activity, sleep duration, and stress perception—were analyzed. The latent class analysis (LCA) was performed using Mplus 8.11, and SPSS PROCESS Macro v4.2 was used for statistical analysis to analyze the mediating effect of the KHEI.
RESULTS:
The model categorized lifestyle factors into three into 3 clusters: ‘Low Activity Class,’ ‘Low Activity and Smoking Class,’ and ‘Multiple Risk Class.’ The KHEI mediation analysis showed significant effects: 0.0205 (95% confidence interval [CI], 0.0062–0.0363) in the ‘Low Activity and Smoke Class,’ and 0.0420 (95% CI, 0.0133–0.0726) in the ‘Multiple Risk Class.’ The mediating effect of the KHEI domain “adequacy” was significant in these groups, with effects of 0.0357 (95% CI, 0.0184–00563) and 0.0662 (95% CI, 0.0364–0.6491), for the respective groups. Balance of energy intake was significant in the group with ‘Multiple Risk Class’ (0.0189; 95% CI, 0.0044–0.0378).
CONCLUSION
The results suggest that a healthy diet improves health management and reduces risk factors for MetS. Nonetheless, better strategies for dietary improvement through a detailed analysis of KHEI components are warranted.
3.The mediating effect of the Korean Healthy Eating Index on the relationship between lifestyle patterns and metabolic syndrome in middle-aged Koreans: data from the 2019–2021Korea National Health and Nutrition Examination Survey
Sori ON ; Woori NA ; Cheongmin SOHN
Nutrition Research and Practice 2025;19(1):96-106
BACKGROUND/OBJECTIVES:
Metabolic syndrome (MetS) is closely connected to dietary and lifestyle factors, with diet being one of the primary risk factors for MetS, acting as a key factor in both prevention and management. In this study, we analyzed the mediating effect of the Korean Healthy Eating Index (KHEI) on the relationship between lifestyle patterns and MetS in middle-aged Koreans using data from the 2019–2021 Korea National Health and Nutrition Examination Survey (KNHANES).
SUBJECTS/METHODS:
This study examined data from 5,196 adults aged 40–64 yrs who participated in the eighth KNHANES. Data on 5 lifestyle factors—smoking, alcohol consumption, physical activity, sleep duration, and stress perception—were analyzed. The latent class analysis (LCA) was performed using Mplus 8.11, and SPSS PROCESS Macro v4.2 was used for statistical analysis to analyze the mediating effect of the KHEI.
RESULTS:
The model categorized lifestyle factors into three into 3 clusters: ‘Low Activity Class,’ ‘Low Activity and Smoking Class,’ and ‘Multiple Risk Class.’ The KHEI mediation analysis showed significant effects: 0.0205 (95% confidence interval [CI], 0.0062–0.0363) in the ‘Low Activity and Smoke Class,’ and 0.0420 (95% CI, 0.0133–0.0726) in the ‘Multiple Risk Class.’ The mediating effect of the KHEI domain “adequacy” was significant in these groups, with effects of 0.0357 (95% CI, 0.0184–00563) and 0.0662 (95% CI, 0.0364–0.6491), for the respective groups. Balance of energy intake was significant in the group with ‘Multiple Risk Class’ (0.0189; 95% CI, 0.0044–0.0378).
CONCLUSION
The results suggest that a healthy diet improves health management and reduces risk factors for MetS. Nonetheless, better strategies for dietary improvement through a detailed analysis of KHEI components are warranted.
4.The Relationship between the Dietary Inflammatory Index (DII) and Cataract Prevalence in the Korean Elderly: Using Data from the 2019∼2021 Korea National Health and Nutrition Examination Survey
Woori NA ; Eunji LEE ; Cheongmin SOHN
Journal of the Korean Dietetic Association 2025;31(1):1-12
Cataract is a common eye disease in the elderly. It is affected by various factors including oxidative stress which cause inflammation and damage to the lens. In this study, we aimed to analyze the relationship between the dietary inflammatory index (DII), which indicates the contribution of various dietary components to inflammation, and cataract. The study was a cross-sectional study using data from the 2019∼2021 Korea National Health and Nutrition Examination Survey (KNHANES) and included 3,427 people aged 65 years and older. The DII was derived using a 24-hour recall method. To analyze the association between dietary inflammation and cataracts, we divided the DII into tertiles and performed logistic regression analysis. All analyses were performed using SPSS version 29.0. The results showed that 1,457 (42.5%) patients had cataracts.The DII was 1.56±0.1 in the cataract group and 1.18±0.1 in the non-cataract group (P<0.001). Logistic regression analysis with adjusted variables to analyze the association of DII with cataracts showed that the odds ratio (OR) of cataract incidence was lower from T1 to T3 (OR, 0.82; 95% CI, 0.68∼0.99, P for trend=0.040). This study shows that a lower DII score is associated with a lower OR of cataract development in the Korean elderly. This suggest that dietary strategies focusing on anti-inflammatory foods are needed to delay and effectively manage cataract development.
5.The Relationship between the Dietary Inflammatory Index (DII) and Cataract Prevalence in the Korean Elderly: Using Data from the 2019∼2021 Korea National Health and Nutrition Examination Survey
Woori NA ; Eunji LEE ; Cheongmin SOHN
Journal of the Korean Dietetic Association 2025;31(1):1-12
Cataract is a common eye disease in the elderly. It is affected by various factors including oxidative stress which cause inflammation and damage to the lens. In this study, we aimed to analyze the relationship between the dietary inflammatory index (DII), which indicates the contribution of various dietary components to inflammation, and cataract. The study was a cross-sectional study using data from the 2019∼2021 Korea National Health and Nutrition Examination Survey (KNHANES) and included 3,427 people aged 65 years and older. The DII was derived using a 24-hour recall method. To analyze the association between dietary inflammation and cataracts, we divided the DII into tertiles and performed logistic regression analysis. All analyses were performed using SPSS version 29.0. The results showed that 1,457 (42.5%) patients had cataracts.The DII was 1.56±0.1 in the cataract group and 1.18±0.1 in the non-cataract group (P<0.001). Logistic regression analysis with adjusted variables to analyze the association of DII with cataracts showed that the odds ratio (OR) of cataract incidence was lower from T1 to T3 (OR, 0.82; 95% CI, 0.68∼0.99, P for trend=0.040). This study shows that a lower DII score is associated with a lower OR of cataract development in the Korean elderly. This suggest that dietary strategies focusing on anti-inflammatory foods are needed to delay and effectively manage cataract development.
6.The mediating effect of the Korean Healthy Eating Index on the relationship between lifestyle patterns and metabolic syndrome in middle-aged Koreans: data from the 2019–2021Korea National Health and Nutrition Examination Survey
Sori ON ; Woori NA ; Cheongmin SOHN
Nutrition Research and Practice 2025;19(1):96-106
BACKGROUND/OBJECTIVES:
Metabolic syndrome (MetS) is closely connected to dietary and lifestyle factors, with diet being one of the primary risk factors for MetS, acting as a key factor in both prevention and management. In this study, we analyzed the mediating effect of the Korean Healthy Eating Index (KHEI) on the relationship between lifestyle patterns and MetS in middle-aged Koreans using data from the 2019–2021 Korea National Health and Nutrition Examination Survey (KNHANES).
SUBJECTS/METHODS:
This study examined data from 5,196 adults aged 40–64 yrs who participated in the eighth KNHANES. Data on 5 lifestyle factors—smoking, alcohol consumption, physical activity, sleep duration, and stress perception—were analyzed. The latent class analysis (LCA) was performed using Mplus 8.11, and SPSS PROCESS Macro v4.2 was used for statistical analysis to analyze the mediating effect of the KHEI.
RESULTS:
The model categorized lifestyle factors into three into 3 clusters: ‘Low Activity Class,’ ‘Low Activity and Smoking Class,’ and ‘Multiple Risk Class.’ The KHEI mediation analysis showed significant effects: 0.0205 (95% confidence interval [CI], 0.0062–0.0363) in the ‘Low Activity and Smoke Class,’ and 0.0420 (95% CI, 0.0133–0.0726) in the ‘Multiple Risk Class.’ The mediating effect of the KHEI domain “adequacy” was significant in these groups, with effects of 0.0357 (95% CI, 0.0184–00563) and 0.0662 (95% CI, 0.0364–0.6491), for the respective groups. Balance of energy intake was significant in the group with ‘Multiple Risk Class’ (0.0189; 95% CI, 0.0044–0.0378).
CONCLUSION
The results suggest that a healthy diet improves health management and reduces risk factors for MetS. Nonetheless, better strategies for dietary improvement through a detailed analysis of KHEI components are warranted.
7.The Relationship between the Dietary Inflammatory Index (DII) and Cataract Prevalence in the Korean Elderly: Using Data from the 2019∼2021 Korea National Health and Nutrition Examination Survey
Woori NA ; Eunji LEE ; Cheongmin SOHN
Journal of the Korean Dietetic Association 2025;31(1):1-12
Cataract is a common eye disease in the elderly. It is affected by various factors including oxidative stress which cause inflammation and damage to the lens. In this study, we aimed to analyze the relationship between the dietary inflammatory index (DII), which indicates the contribution of various dietary components to inflammation, and cataract. The study was a cross-sectional study using data from the 2019∼2021 Korea National Health and Nutrition Examination Survey (KNHANES) and included 3,427 people aged 65 years and older. The DII was derived using a 24-hour recall method. To analyze the association between dietary inflammation and cataracts, we divided the DII into tertiles and performed logistic regression analysis. All analyses were performed using SPSS version 29.0. The results showed that 1,457 (42.5%) patients had cataracts.The DII was 1.56±0.1 in the cataract group and 1.18±0.1 in the non-cataract group (P<0.001). Logistic regression analysis with adjusted variables to analyze the association of DII with cataracts showed that the odds ratio (OR) of cataract incidence was lower from T1 to T3 (OR, 0.82; 95% CI, 0.68∼0.99, P for trend=0.040). This study shows that a lower DII score is associated with a lower OR of cataract development in the Korean elderly. This suggest that dietary strategies focusing on anti-inflammatory foods are needed to delay and effectively manage cataract development.
8.The mediating effect of the Korean Healthy Eating Index on the relationship between lifestyle patterns and metabolic syndrome in middle-aged Koreans: data from the 2019–2021Korea National Health and Nutrition Examination Survey
Sori ON ; Woori NA ; Cheongmin SOHN
Nutrition Research and Practice 2025;19(1):96-106
BACKGROUND/OBJECTIVES:
Metabolic syndrome (MetS) is closely connected to dietary and lifestyle factors, with diet being one of the primary risk factors for MetS, acting as a key factor in both prevention and management. In this study, we analyzed the mediating effect of the Korean Healthy Eating Index (KHEI) on the relationship between lifestyle patterns and MetS in middle-aged Koreans using data from the 2019–2021 Korea National Health and Nutrition Examination Survey (KNHANES).
SUBJECTS/METHODS:
This study examined data from 5,196 adults aged 40–64 yrs who participated in the eighth KNHANES. Data on 5 lifestyle factors—smoking, alcohol consumption, physical activity, sleep duration, and stress perception—were analyzed. The latent class analysis (LCA) was performed using Mplus 8.11, and SPSS PROCESS Macro v4.2 was used for statistical analysis to analyze the mediating effect of the KHEI.
RESULTS:
The model categorized lifestyle factors into three into 3 clusters: ‘Low Activity Class,’ ‘Low Activity and Smoking Class,’ and ‘Multiple Risk Class.’ The KHEI mediation analysis showed significant effects: 0.0205 (95% confidence interval [CI], 0.0062–0.0363) in the ‘Low Activity and Smoke Class,’ and 0.0420 (95% CI, 0.0133–0.0726) in the ‘Multiple Risk Class.’ The mediating effect of the KHEI domain “adequacy” was significant in these groups, with effects of 0.0357 (95% CI, 0.0184–00563) and 0.0662 (95% CI, 0.0364–0.6491), for the respective groups. Balance of energy intake was significant in the group with ‘Multiple Risk Class’ (0.0189; 95% CI, 0.0044–0.0378).
CONCLUSION
The results suggest that a healthy diet improves health management and reduces risk factors for MetS. Nonetheless, better strategies for dietary improvement through a detailed analysis of KHEI components are warranted.
9.Effect of web-based personalized nutrition management on gut microbiota in Korean patients with irritable bowel syndrome aged between 20 and 30 years
Woori NA ; Dayoung OH ; Seohyeon HWANG ; Cheongmin SOHN
Journal of Nutrition and Health 2024;57(1):75-87
Purpose:
Dietary habits are strongly related to the symptoms of people with irritable bowel syndrome (IBS). Therefore, personalized nutrition management can help reduce symptoms and improve the quality of life of people with IBS. This study assessed the effectiveness of a personalized web-based nutrition management based on the types of food that trigger IBS symptoms.
Methods:
Sixty Korean adults with IBS according to Rome IV criteria in their 20s and 30s were enrolled in this study. The data from the final 49 patients who completed a three-month personalized nutrition intervention were analyzed. The general information, anthropometry, dietary intake survey, and gut microbiota were examined pre and post-intervention. The gut microbiota analysis included the relative abundance and the Shannon index. The food intake was recorded for two days for personalized nutrition education, followed by three months of personalized nutrition intervention. Statistical analysis was performed using the Wilcoxon signed-rank test in SPSS 26.0, with the significance set to p < 0.05.
Results:
The relative abundance of the gut microbiota changed after personalized nutrition management, with a significant decrease in the presence of Veillonella (p = 0.048). Furthermore, when the gut microbiota was analyzed according to the type of food that triggers symptoms, the diversity was increased significantly in the high fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) type (p = 0.031) and FODMAPs-containing gluten-type personalized nutrition intervention types (p < 0.001).
Conclusions
Gut microbial diversity and gut microbiota distribution changed after using web-based personalized nutrition management. Hence, personalized nutrition management that considers trigger foods may improve IBS symptoms.
10.Effectiveness of a mobile health intervention on weight loss and dietary behavior changes among employees with overweight and obesity: a 12-week intervention study investigating the role of engagement
Imhuei SON ; Jiyoun HONG ; Young-Hee HAN ; Bo Jeong GONG ; Meng Yuan ZHANG ; Woori NA ; Cheongmin SOHN ; Taisun HYUN
Korean Journal of Community Nutrition 2023;28(2):141-159
Objectives:
This study aimed to determine whether a mobile health (mhealth) intervention is effective in reducing weight and changing dietary behavior among employees with overweight and obesity. The study also investigated whether engagement with the intervention affected its effectiveness.
Methods:
The intervention involved the use of a dietary coaching app, a wearable device for monitoring physical activity and body composition, and a messenger app for communicating with participants and an intervention manager. A total of 235 employees were recruited for a 12-week intervention from eight workplaces in Korea. Questionnaire surveys, anthropometric measurements, and 24-h dietary recalls were conducted at baseline and after the intervention.
Results:
After the intervention, significant decreases in the mean body weight, body mass index, body fat percentage, and waist circumference were observed. Furthermore, the consumption frequencies of multigrain rice and legumes significantly increased, whereas those of pork belly, instant noodles, processed meat, carbonated beverages, and fast food significantly decreased compared with those at baseline. The mean dietary intake of energy and most nutrients also decreased after the intervention. When the participants were categorized into three groups according to their engagement level, significant differences in anthropometric data, dietary behaviors, and energy intake were observed following the intervention, although there were no differences at baseline, indicating that higher engagement level led to greater improvements in weight loss and dietary behavior.
Conclusions
The intervention had positive effects on weight loss and dietary behavior changes, particularly among employees with higher engagement levels. These results indicate the importance of increasing the level of engagement in the intervention to enhance its effectiveness. The mhealth intervention is a promising model for health promotion for busy workers with limited time.

Result Analysis
Print
Save
E-mail