Plan and operations of the 10th Korea National Health and Nutrition Examination Survey (2025-2027).

The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey that is conducted annually to assess the health and and health-related behaviors of Korean population. To utilize KNHANES data to studies of mortality risk factors, the Korea Disease Control and Prevention Agency (KDCA) constructed a database linking KNHANES data to cause-of-death statistics in Statistics Korea, made available to researchers since 2020. The KNHANES data were linked to the Cause of Death Statistics based on resident registration numbers for subjects aged 19 years or older who agreed to link the data. The linkage rate between 2007-2015 National Health and Nutrition Examination Survey and 2007-2019 Cause of Death Statistics was 97.1%. In the linked dataset, the total death rate was 6.6%, of which neoplasms accounted for the highest death rate (32.1%), followed by circulatory system disease (22.7%) and respiratory system disease (11.5%). The linked dataset was made available through the Research Data Center of the KDCA after a review of the research proposal, and will be made available after periodical updates.

Prevalence of chronic kidney disease and anemia among participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Cohort Study: Baseline results

Hepatitis C Virus Genotypes and Viral Concentrations in Participants of a General Population Survey in the United States

OBJECTIVESIn South Korea, there are two nationwide health surveys conducted by the Korea Centers for Disease Control and Prevention: the Korea Community Health Survey (KCHS) and Korea National Health and Nutrition Examination Survey (KNHANES). The two surveys are directly comparable, as they have the same target population with some common items, and because both surveys are used in various analyses, identifying the similarities and disparities between the two surveys would promote their appropriate use. Therefore, this study aimed to compare the estimates of six variables in KCHS and eight variables in KNHANES over a six-year period and compare time series stability of region-specific and sex- and age-specific subgroup estimates.METHODSData from adults aged 19 years or older in the 2010-2015 KCHS and KNHANES were examined to analyze the differences of estimates and 95% confidence interval for self-rated health, current smoking rate, monthly drinking rate, hypertension diagnosis rate, diabetes diagnosis rate, obesity prevalence, hypertension prevalence, and diabetes prevalence. The variables were then clustered into subgroups by city as well as sex and age to assess the time series stability of the estimates based on mean square error.RESULTSWith the exception of self-rated health, the estimates taken based on questionnaires, namely current smoking rate, monthly drinking rate, hypertension diagnosis rate, and diabetes diagnosis rate, only differed by less than 1.0%p for both KCHS and KNHANES. However, for KNHANES, estimates taken from physical examination data, namely obesity prevalence, hypertension prevalence, and diabetes prevalence, differed by 1.9-8.4%p, which was greater than the gap in the estimates taken from questionnaires. KCHS had a greater time series stability for subgroup estimates than KNHANES.CONCLUSIONSWhen using the data from KCHS and KNHANES, the data should be selected and used based on the purpose of analysis and policy and in consideration of the various differences between the two data.

BackgroundTo evaluate and analyse the factors associated with health-related quality of life (HR-QoL) in the Korean population aged 50 years and older.MethodsWe used data obtained from the fourth and fifth Korea National Health and Nutrition Examination Survey (KNHANES IV-V) 2007–2012, a national, cross-sectional health examination and survey, for which representative data on the health, nutritional status, and physical activities of the Korean general population are collected by the Korea Centres for Disease Control and Prevention (KCDC). The sampling protocol for the KNHANES was designed to involve a complex, stratified, multistage probability cluster survey of a representative sample of the noninstitutionalized civilian population in South Korea using a cross-sectional design. The association between HR-QoL and socio-economic factors and medical comorbidities in adults aged 50 years and older was investigated using data from the KNHANES IV-V from 2007 to 2012 (n = 17,937). The EuroQol 5-Dimension Questionnaire (EQ-5D) was used to evaluate HR-QoL, and the factors associated with HR-QoL were analysed after adjusting for socio-economic and demographic factors, anthropometric measurements and clinical comorbidities.ResultsHealth status declined with ageing, and low socio-economic status had negative associations with health status. Gender had no association with health status. Among chronic medical conditions, arthritis and depression had significant associations with health status in older people when stratified by age and gender (P < 0.05).ConclusionsThese findings suggest that older people may value the ability to perform daily activities, which may mean that it is necessary to pay more attention to the factors associated with musculoskeletal pain and emotional distress, as well as socio-economic status or chronic diseases.Trial registrationThe Korea National Health and Nutrition Examination Survey (KNHNES) is not a clinical trial registry, but the national health survey conducted by the Government of the Republic of Korea, to gather information on health and nutritional status of Korean population, to plan public health services and health education programs, and to do statistical studies of the efficiency of public health services required for setting up welfare and healthcare policies.

The Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based cross-sectional survey designed to assess the health related behavior, health condition, and nutritional state of Koreans (http://knhanes.cdc.go.kr/). It was conducted as a tri-annual survey for the first 3 cycles, implemented in 1998, 2001, and 2005. Beginning with the 4th cycle of 2007, it was converted to an annual survey. The 2011 data was recently opened to the public, and is free for all researchers who want to use it. The KNHANES provides a rich source of data which are easy to access and can be quickly obtained. Its ethical problems are minimal and there are no adverse effects in conducting the study. Using the KNHANES saves time, money, and personnel that would otherwise be spent collecting data, and provides a larger and higher-quality database beyond the capacity of any one individual researcher. Further, because the study participants are representative of the Korean population, the results have external validity. Therefore, this data is helpful to young investigators. In fact, the portion of submitted articles to the Korean Journal of Family Medicine (KJFM) using the KNHANES as the primary source of data is significant. Specifically, one article in 2007, three articles in 2008, four articles in 2009, three articles in 2010, five articles in 2011, and five articles in 2012 used the KNHANES data as their primary data source, totaling 21 articles (6.2%) among 338 original articles during the previous five years. However, there are several points investigators should keep in mind when using the KNHANES data. First, the KNHANES data are open to the public and there is no systematic process to control the research topic assignment. Many researchers might investigate the same topic simultaneously, especially popular topics like obesity and metabolic syndrome. Before deciding on the study topic, a thorough search of the database like Medline, EMBASE, and the abstracts of related conferences are needed. Once the topic is decided upon, the article should be submitted as soon as possible. Otherwise someone else may publish a similar study from the same dataset before you do. Second, investigators must be familiar with the huge and complex data structure and study design of the KNHANES. Non-response and multi-stage probability sampling should be taken into account by using survey statistics to estimate the data of the whole Korean population. Despite this, lots of studies submitted to KJFM using the KNHANES do not apply sampling weight in their analysis. In such a case the estimated association might be biased and revision is required. Third, the KNHANES is a secondary data source like the Korea Youth Risk Behavior Web-based Survey and the Community Health Survey, and has the same limitations that they have.1) The main purpose of the KNHANES is to produce national statistics, not to answer a specific research question. Therefore, the particular information the investigator wants may not be collected. For these reasons, the dataset should be examined carefully to confirm that it includes the necessary data. There also exists a potential for errors or mistakes in the data, even with its rigorous documents control system. Missing data is also a problem in the KNHANES.2)

IntroductionCholesterol is an irreplaceable nutrient in pulmonary metabolism; however, studies on high-density lipoprotein cholesterol (HDL-C) levels have shown conflicting results regarding lung function. Therefore, we investigated the association between lung...

Allergic sensitization is a key risk factor for but not synonymous with allergic disease

Anemia in the Elderly: How Should We Define It, When Does It Matter, and What Can Be Done?

The Prevalence of Urinary Incontinence Among Community Dwelling Men: Results From the National Health and Nutrition Examination Survey

To improve the usefulness of the Korea National Health and Nutrition Examination Survey (KNHANES) and address emerging health issues, we propose a framework for a rotating survey for the KNHANES, aiming to satisfy the diversification of survey domains or items and minimize the response burden on survey participants simultaneously. To establish a rotating survey system for the health survey of the KNHANES, the research was conducted in the following 5 steps: 1) review and analysis of health survey for the 5th to 9th KNHANES, 2) first consultation with experts in each domain of health topics, 3) drafting a framework for the rotating system of the KNHANES, 4) second expert consultation, and 5) proposal of the final draft. Core items in all domains are surveyed annually. In the health behaviors domain, after classifying all topics into 5 groups in consideration of the interrelationships between topics, the 6-year survey cycle (rotating items) was established by assigning the survey cycle differently to 2 years (2 groups) or 3 years (3 groups). The annual average numbers of survey items for 6 years is 197 items (fixed items 179, rotating items 18). Health literacy, digital health, and infectious disease have been proposed as emerging new health issues to be included in the KNHANES. By implementing a rotating survey system, it is expected to reduce the response burden of the survey participants, to increase the efficiency of the survey, and to produce timely health statistics.

When Do The Milestones of Puberty Occur?: Wu T, Mendola P, Buck GM. Ethnic differences in the presence of secondary sex characteristics and menarche among U.S. girls: The third national health and nutrition examination survey, 1998\\N1994. Pediatrics 2002;110:752\\N7

ObjectivesThe effect of breastfeeding on periodontal disease in women remains unclear. This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey to explore the association between breastfeeding and periodontitis in Korean women using data from the Korean National Health and Nutrition Examination Survey (KNHANES VII).Materials and methodsCross-sectional data was analyzed from the KNHANES 2016–2018. The study population included 5,587 parous women aged ≥ 30 years. The outcome variable was the presence or absence of periodontitis. The explanatory variable, period of breastfeeding, was defined as “none”, “1–11 months”, and “more than 12 months”. Confounder variables (socio-educational, personal healthcare practice, and systemic medical characteristics) were adjusted for in the logistic regression analysis.ResultsApproximately 60% of the participants breastfed for ≥ 12 months. In all statistical models, the prevalence of periodontitis was approximately 60% greater in women that did not breastfeed compared to women that had breastfed for 12 months or longer. When adjusted for age, statistical significance was only present in the 50–59 years age group (adjusted odds ratio [aOR], 1.678; 95% confidence interval [CIs], 1.046–2.691).ConclusionOur study shows that women that breastfed for a relatively long duration had a lower risk of periodontitis. Therefore, breastfeeding may be beneficial for women’s periodontal health. These results are expected to be helpful in oral health education for pregnant women.

269. Is regular walking associated with a lower risk of low back pain? A cross-sectional study using the Korean National Health and Nutrition Examination surveys

The objective of this study was to develop a semi-quantitative food frequency questionnaire (FFQ) for an adult population for use in the Korea National Health and Nutrition Examination Survey (KNHANES). The 24-hour recall data for 2,939 subjects aged 19 years and over from the fourth KNHANES first year (2007) were used to extract the items included in the questionnaire. The FFQ items were developed by selection of major dishes based on the cumulative contribution rate, between-person variability based on the cumulative R 2 of energy and 14 nutrients (carbohydrate, protein, fat, crude fiber, calcium, phosphorous, iron, sodium, potassium, vitamin A, thiamin, riboflavin, niacin, and vitamin C ) and the number of consumers of each dish. In addition, the FFQ items were revised with analysis of 24-hour recall data of the fourth KNHANES second and third year (2008, 2009). Finally, 112 items were included in the FFQ and grouped as follows: rice (5 items), noodles and dumplings (6), breads and rice cakes (8), soups and stews (12), soybeans, eggs, meat and fish (23), vegetables, seaweed and potatoes (27), milk and dairy products (4), fruits (13), beverages (5), snacks (6) and alcoholic beverages (3). The food items of FFQ accounted for an average of 87.0% of energy and 14 nutrient intakes and also accounted for 81.7% of the between-person variability. The frequency range of the FFQ items was classified into nine categories (never or seldom, once per month, 2-3 times per month, once per week, 2-4 times per week, 5-6 times per week, once per day, twice per day and three times per day) and the portion size was divided into three categories (small, medium and large). We expect that this developed dish-based FFQ could be used in assessment of longterm dietary intakes of Korean adults. (Korean J Nutr 2013; 46(2): 186 ~ 196)