Abstract

Changes in household dynamics in Korea, such as the transition from multi- to single-person households, have led to changes in individuals’ dietary behavior patterns and health status. Thus, this study aimed to compare dietary behaviors and determine the prevalence of metabolic syndrome (MetS) as well as explore factors associated with MetS according to household type among Korean adults. Using data from the Korea National Health and Nutrition Examination Survey 2014–2018, we included 21,944 Korean adults with available health examination and dietary recall data. Based on self-reported information, individuals were divided into two household types: single- and multi-person households. We used multivariable logistic regression to estimate the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for MetS and its components after adjusting for potential covariates. Among the study population, 9.19% and 90.81% lived in single-person and multi-person households, respectively. Individuals in single-person households had a higher energy intake overall and a greater percentage of energy from animal protein; total, saturated, and monounsaturated fats; and animal source foods and a lower percentage of energy from carbohydrates, plant protein, and plant source foods than those from multi-person households (all, p < 0.05). Individuals living in single-person rather than multi-person households were more likely to consume milk/dairy products, alcoholic and non-alcoholic beverages, oils/fats, and others but were less likely to consume vegetables/mushrooms, fruits, seaweeds, and fish/shellfish (all, p < 0.05). Living alone was associated with higher energy intake from main meals and foods prepared away from home but a lower dietary variety score and fewer total main meals consumed (all, p < 0.05). Skipping breakfast, frequent eating out, food insecurity, and MetS combination phenotypes significantly differed by household type. Individuals living alone had higher odds of MetS (AOR: 1.14, 95% CI: 1.02–1.29), abdominal obesity (AOR: 1.14, 95% CI: 1.01–1.28), elevated blood pressure (AOR: 1.28, 95% CI: 1.12–1.47), and elevated fasting blood glucose (AOR: 1.18, 95% CI: 1.05–1.33) than those living with others. Compared with those in multi-person households, individuals in single-person households tend to have health and dietary behaviors that increase vulnerability to MetS; therefore, establishing health care strategies and nutrition policies according to household type is necessary.

Highlights

  • According to a recent report from Statistics Korea, the number of single-person households nationwide in 2019 was approximately 5.99 million, accounting for 29.8% of all household types [1]

  • Individuals living in single-person households were more likely to have lower education and income levels and to reside in rural areas

  • KNHANES, Korea National Health and Nutrition Examination Survey; adjusted odds ratios (AORs), adjusted odds ratio; 95% confidence intervals (CIs), 95% confidence interval

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Summary

Introduction

According to a recent report from Statistics Korea, the number of single-person households nationwide in 2019 was approximately 5.99 million, accounting for 29.8% of all household types [1]. In a study of Korean elderly individuals aged ≥60 years, those living alone were approximately twice as likely to have a poor subjective health status than those living with family members [5]. Compared with those in multi-person households, those in single-person households experience loneliness, sadness, feelings of futility [6], and lower life satisfaction [7] more frequently and show an increased risk of suicidal ideation [8], indicating that single-person households are more vulnerable in terms of physical and mental health deterioration and require careful management. People living in single-person households are more likely to engage in unhealthy behaviors than those in multi-person households, showing higher rates of current smoking, drinking [9], and engaging in health-risk behaviors [10]

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