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 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.
5.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.
6.Corrigendum: Functional bowel disorders among bariatric surgery candidates before and after surgery: A prospective cohort study
Sharif YASSIN ; Noa SORI ; Ophir GILAD ; Mati SHNELL ; Relly REICHER ; Nir BAR ; Yishai RON ; Nathaniel Aviv COHEN ; Subhi ABU-ABEID ; Danit DAYAN ; Shai Meron ELDAR ; Shira ZELBER-SAGI ; Sigal FISHMAN
International Journal of Gastrointestinal Intervention 2024;13(2):63-63
7.Functional bowel disorders among bariatric surgery candidates before and after surgery: A prospective cohort study
Sharif YASSIN ; Noa SORI ; Ophir GILAD ; Mati SHNELL ; Relly RICHER ; Nir BAR ; Yishai RON ; Nathaniel Aviv COHEN ; Subhi ABU-ABEID ; Danit DAYAN ; Shai Meron ELDAR ; Shira ZELBER-SAGI ; Sigal FISHMAN
International Journal of Gastrointestinal Intervention 2024;13(1):16-22
Background:
Functional bowel disorders (FBDs), including irritable bowel syndrome (IBS), are common worldwide. Recently, increasingly many bariatric surgical procedures have been performed in response to rising obesity rates. However, data on the association between FBDs and bariatric surgery are scarce. We examined the prevalence of FBDs among candidates for bariatric surgery and prospectively investigated the association between FBDs and bariatric surgery.
Methods:
This prospective cohort study included 112 bariatric surgery candidates at the Tel Aviv Medical Center from 2019 to 2020. Before and after surgery, patients completed the Rome III questionnaire. Data regarding demographics, socioeconomic status, and gastrointestinal symptoms were recorded. The rates of FBDs—IBS, functional constipation (FC), functional diarrhea (FDi), and unspecified functional bowel disorder (UFBD)—were then compared from before surgery to 6 months after the procedure.
Results:
Of 112 candidates with obesity at baseline, 68 underwent surgery and completed the postoperative questionnaire. Overall, the respective prevalence rates of FBDs, IBS, FC, FDi, and UFBD were 37.5%, 2.7%, 17.9%, 5.4%, and 11.6%. Female sex and single status were particularly common among patients with FBDs, whereas divorced status was more frequent in the group without FBDs. However, these factors were not independently associated with FBD presence upon multivariable analysis. IBS was more prevalent after surgery than before (8.8% vs. 1.5%, P = 0.06), but FBDs in general did not share this trend (44.1% vs. 36.8%, P = 0.44).
Conclusion
Bariatric surgery appears to increase the risk of developing IBS, while not impacting the overall risk of FBDs.
8.Corrigendum: Functional bowel disorders among bariatric surgery candidates before and after surgery: A prospective cohort study
Sharif YASSIN ; Noa SORI ; Ophir GILAD ; Mati SHNELL ; Relly REICHER ; Nir BAR ; Yishai RON ; Nathaniel Aviv COHEN ; Subhi ABU-ABEID ; Danit DAYAN ; Shai Meron ELDAR ; Shira ZELBER-SAGI ; Sigal FISHMAN
International Journal of Gastrointestinal Intervention 2024;13(2):63-63
9.Functional bowel disorders among bariatric surgery candidates before and after surgery: A prospective cohort study
Sharif YASSIN ; Noa SORI ; Ophir GILAD ; Mati SHNELL ; Relly RICHER ; Nir BAR ; Yishai RON ; Nathaniel Aviv COHEN ; Subhi ABU-ABEID ; Danit DAYAN ; Shai Meron ELDAR ; Shira ZELBER-SAGI ; Sigal FISHMAN
International Journal of Gastrointestinal Intervention 2024;13(1):16-22
Background:
Functional bowel disorders (FBDs), including irritable bowel syndrome (IBS), are common worldwide. Recently, increasingly many bariatric surgical procedures have been performed in response to rising obesity rates. However, data on the association between FBDs and bariatric surgery are scarce. We examined the prevalence of FBDs among candidates for bariatric surgery and prospectively investigated the association between FBDs and bariatric surgery.
Methods:
This prospective cohort study included 112 bariatric surgery candidates at the Tel Aviv Medical Center from 2019 to 2020. Before and after surgery, patients completed the Rome III questionnaire. Data regarding demographics, socioeconomic status, and gastrointestinal symptoms were recorded. The rates of FBDs—IBS, functional constipation (FC), functional diarrhea (FDi), and unspecified functional bowel disorder (UFBD)—were then compared from before surgery to 6 months after the procedure.
Results:
Of 112 candidates with obesity at baseline, 68 underwent surgery and completed the postoperative questionnaire. Overall, the respective prevalence rates of FBDs, IBS, FC, FDi, and UFBD were 37.5%, 2.7%, 17.9%, 5.4%, and 11.6%. Female sex and single status were particularly common among patients with FBDs, whereas divorced status was more frequent in the group without FBDs. However, these factors were not independently associated with FBD presence upon multivariable analysis. IBS was more prevalent after surgery than before (8.8% vs. 1.5%, P = 0.06), but FBDs in general did not share this trend (44.1% vs. 36.8%, P = 0.44).
Conclusion
Bariatric surgery appears to increase the risk of developing IBS, while not impacting the overall risk of FBDs.
10.Corrigendum: Functional bowel disorders among bariatric surgery candidates before and after surgery: A prospective cohort study
Sharif YASSIN ; Noa SORI ; Ophir GILAD ; Mati SHNELL ; Relly REICHER ; Nir BAR ; Yishai RON ; Nathaniel Aviv COHEN ; Subhi ABU-ABEID ; Danit DAYAN ; Shai Meron ELDAR ; Shira ZELBER-SAGI ; Sigal FISHMAN
International Journal of Gastrointestinal Intervention 2024;13(2):63-63

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