Abstract
This study aimed to investigate whether dietary quantity and/or quality differ according to food security levels in the Korean adult population. Dietary adequacy and quality were evaluated by the Korean Dietary Reference Intake and the Korean Healthy Eating Index (KHEI) for adults, respectively, according to three food security levels, i.e., food security, low food security, and very low food security. A total of 7144 Korean adults (aged 19 to 64 years) were selected from cross-sectional data from the 2013–2015 Korean National Health and Nutrition Examination Surveys. The risk of inadequate nutrient intakes of protein (p trend = 0.021) and phosphorus (p trend = 0.002) increased according to food insecurity levels after adjustment for putative risk factors. The total KHEI scores (p < 0.001) as well as scores of having breakfast (p < 0.001) were lowest in the very low food security group. Among KHEI components, adults with food insecurity were less likely to get full scores from intakes of mixed grains (p trend = 0.016), total fruit (p trend = 0.039), fresh fruit (p trend = 0.043), and breakfast (p trend < 0.001). In addition, food-insecure adults were more likely to get zero score from intakes of fresh fruit (p trend = 0.020), milk and dairy products (p trend = 0.049), breakfast (p trend < 0.001), % of energy from sweets and beverages (p trend = 0.002), and total energy (p trend = 0.033). In conclusion, food security levels were associated with how much they ate, as well what they ate, in adults in South Korea. These results implied that the diet adequacy as well as moderation and balance could be carefully treated with food assistance or nutrition intervention once nutritional adequacy has mostly been met. In addition, targeted intervention programs tailored to diverse contexts for improving food insecurity may prevent unintended consequences due to easy access to inexpensive obesogenic foods in adults with food insecurity.
Highlights
Dietary quality has recently become the focus of extensive research interest, given the increased number of diet-related diseases and mortality in developed countries
Socio-Demographic Characteristics According to Food Security Status
Our findings suggest that low food security may be an independent risk factor for nutritional inadequacy and lack of dietary quality in Korean adults
Summary
Dietary quality has recently become the focus of extensive research interest, given the increased number of diet-related diseases and mortality in developed countries. A prolonged consumption of nutritionally unbalanced meals, such as high intake of sodium and low intakes of whole grains as well as fruits, has been reported to increase the risk of mortality and disability-adjusted life years in many countries [1]. Food insecurity has been reported to be associated with eating habits and health behaviors [19,20], which affect physical and mental health [14,21,22,23] in Korea. Dietary inequality may exacerbate the impact of food insecurity
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