Background/Objectives: Cardiometabolic risk factor clustering is common in older adults and is associated with substantially increased cardiometabolic morbidity and mortality. This study aimed to examine the association between serum 25-hydroxyvitamin D [25(OH)D] status and cardiometabolic risk factor clustering among rural community-dwelling older adults. Methods: This cross-sectional study analyzed data from the 2022 Korea National Health and Nutrition Examination Survey (KNHANES) for 432 adults aged ≥65 years residing in rural areas. Cardiometabolic risk factor clustering was defined as the presence of ≥2 of the following: abdominal obesity, hypertension, type 2 diabetes mellitus, and dyslipidemia. Multivariable logistic regression was performed adjusting for sociodemographic and behavioral factors. Results: Cardiometabolic risk factor clustering was more prevalent among participants with vitamin D deficiency (<15 ng/mL) than among those with sufficient levels (66.0% vs. 44.9%, p = 0.006). After adjustment, vitamin D sufficiency (≥15 ng/mL), compared with vitamin D deficiency (<15 ng/mL), was associated with lower odds of clustering (aOR = 0.422, 95% CI: 0.219–0.811, p = 0.010). Meeting the WHO physical activity guideline was also associated with lower odds of clustering (AOR = 0.450, 95% CI: 0.226–0.897, p = 0.023). Conclusions: Lower vitamin D status was associated with a higher prevalence of cardiometabolic risk factor clustering. These findings support the consideration of vitamin D assessment and lifestyle-focused strategies within community health nursing practice to reduce cardiometabolic risk in rural aging populations.

Objectives: We analyzed factors impacting health-related quality of life (HRQoL) among Korean older adults, as measured by the EuroQol 5 Dimensions (EQ-5D), and compared trends over time. Methods: Data were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES). Using data collected every four years from 2016 to 2024, we examined factors associated with older adults’ quality of life during each survey period. Participants were aged 65 years or older, with a sample size of 1,578 in 2016, 1,681 in 2020, and 1,951 in 2024. Complex sample logistic regression was used for statistical analyses. Results: Spanning the survey periods, sex and activity limitations consistently emerged as significant determinants of HRQoL. In 2016 and 2024, economic activity, stress, and unmet dental care were also significant factors, whereas in 2020, smoking and chewing discomfort were significant. Conclusions: HRQoL in older adults is influenced by interactions between structural factors (sex and activity limitations) and environmental and behavioral factors (economic activity, mental health, and oral health). Issues related to dental care access, such as unmet dental treatment needs, exert long-term impacts on quality of life, underscoring the need for integrated elderly health policies and early interventions to support health management.

PURPOSE: Type 2 diabetes is rapidly increasing in prevalence worldwide and, along with metabolic syndrome, serves as a major precursor to cardiovascular and cerebrovascular diseases. Physical inactivity is recognized as a significant contributing factor to both conditions. Therefore, an empirical review of the effectiveness of exercise interventions is essential. This study aimed to analyze the impact of aerobic physical activity and regular strength training on the prevalence of type 2 diabetes and metabolic syndrome risk factors, with the goal of providing evidence to guide the development of targeted exercise prescriptions and lifestyle improvement strategies tailored to the Korean adult population.METHODS: Using raw data from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES), we analyzed responses from 4,881 adults aged 19 years and older. Participants were categorized into four groups according to their engagement in aerobic physical activity and strength training. Key metabolic syndrome markers such as blood pressure, fasting glucose, triglycerides, and high-density lipoprotein cholesterol (HDL-C), along with the prevalence of type 2 diabetes, were examined. Statistical analyses included descriptive statistics, analysis of covariance (ANCOVA), and multivariate logistic regression. All analyses were adjusted for potential confounding variables, including age, sex, body mass index (BMI), smoking status, and alcohol consumption.RESULTS: After adjusting for confounding factors, individuals who participated in both aerobic physical activity and regular strength training had a 56% lower risk of type 2 diabetes compared to those who participated in neither activity (odds ratio [OR]: 0.44, 95% confidence interval [CI]: 0.28–0.70).CONCLUSIONS: Combining aerobic activity with strength training is more effective than either modality alone in reducing diabetes prevalence and improving metabolic syndrome risk factors. These findings underscore the need to develop integrated exercise guidelines and practical lifestyle modification programs, rather than broad public health policies, to optimize metabolic health and provide actionable recommendations for clinical and community settings.

Purpose: This study examined the associations between fasting blood glucose (FBG), glycated hemoglobin (HbA1c), fructosamine, and depression among adults with type 2 diabetes mellitus (T2DM) using nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES).Methods: A descriptive cross-sectional study was conducted using secondary data from the second year (2020) of the eighth KNHANES. Adults diagnosed with T2DM were included. Depression was assessed using the Patient Health Questionnaire-9. Complex-sample analyses were applied to account for the survey design, and hierarchical multivariable logistic regression analyses were performed to evaluate associations between glycemic indices reflecting different temporal windows and depression.Results: Depression was not significantly associated with FBG. In contrast, depression prevalence was significantly higher among participants with normal fructosamine levels, whereas it was significantly lower among those with normal HbA1c levels. Younger age and smoking were associated with higher odds of depression, while cohabitation and employment were associated with lower odds.Conclusion: Among adults with T2DM, glycemic indices representing different time frames demonstrated distinct associations with depression. Long-term glycemic control, as indicated by HbA1c, was associated with lower odds of depression, whereas intermediate-term glycemic control, reflected by fructosamine, showed an opposite association. These findings underscore the importance of considering the temporal characteristics of glycemic markers when interpreting their relationships with depression and highlight the need for longitudinal studies to clarify underlying mechanisms.

This study investigated whether serum 25-hydroxyvitamin D (25(OH)D) modifies the association between meeting WHO aerobic physical activity guidelines and cardiometabolic risk clustering among rural older adults in South Korea. This cross-sectional study analyzed 2023 Korea National Health and Nutrition Examination Survey (KNHANES) data for rural-dwelling adults aged ≥65 years with complete data (n = 441). Cardiometabolic risk clustering (CMRC) was defined as the presence of ≥3 of five risk factors (abdominal obesity, elevated blood pressure, low HDL-cholesterol, elevated triglycerides, and hyperglycemia). Exposures were continuous serum 25-hydroxyvitamin D (25(OH)D) and adherence to the WHO aerobic physical activity guidelines (yes/no). Multivariable logistic regression models tested the 25(OH)D × physical activity interaction, adjusting for sex, age (≥75 vs. <75 years), education, household income, smoking status, alcohol use, and obesity (BMI ≥ 25 kg/m2). Conditional effects of physical activity were estimated at the 16th, 50th, and 84th percentiles of 25(OH)D. A significant interaction between 25(OH)D and physical activity was observed (OR = 0.91, 95% CI: 0.85-0.97; p = 0.005). Physical activity was not associated with CMRC at low 25(OH)D (16th percentile, 17.08 ng/mL; OR = 1.64, 95% CI: 0.78-3.47), but it was associated with lower odds of CMRC at high 25(OH)D (84th percentile, 36.98 ng/mL; OR = 0.25, 95% CI: 0.10-0.62). Vitamin D status modified the association between aerobic physical activity and cardiometabolic risk clustering among rural older adults. Integrated prevention strategies addressing both physical activity and vitamin D insufficiency may be valuable in rural aging populations.

BackgroundGiven the limited evidence on the joint association of socioeconomic status and type 2 diabetes (T2DM) with influenza vaccination uptake, we examined this association among adults aged 65 years and older eligible for the National Immunization Program in the Republic of Korea.MethodsWe analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2019–2022, stratified by pre-COVID-19 (2019) and COVID-19 (2020–2022) periods including 5,525 adults aged 65 years and older. The participants were classified by T2DM status and SES indicators (income, education, and economic activity). Multivariable logistic regression estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for influenza vaccination, adjusting for demographic characteristics, health behaviors, health status measures, and healthcare access factors.ResultsAmong 5,525 adults aged ≥65 years in the 2019–2022 Korea National Health and Nutrition Examination Survey, the weighted influenza vaccination rate was 77.6% overall (78.2% pre–COVID-19; 77.1% during COVID-19). Compared with high-income adults without diabetes, low-income adults with T2DM had lower odds of vaccination (adjusted odds ratio [aOR] = 0.75; 95% CI, 0.57–0.99), and low-income adults without T2DM showed a similar trend (aOR = 0.82; 95% CI, 0.65–1.03). By education, low-education adults with T2DM had lower vaccination likelihood (aOR = 0.83; 95% CI, 0.61–1.15) compared with college-educated adults without T2DM. Economic activity was not significantly associated with vaccination (aOR = 0.91; 95% CI, 0.70–1.18). Findings were consistent across pre–COVID-19 and COVID-19 periods (P for interaction = 0.24).ConclusionsSocioeconomic disadvantage and T2DM may jointly contributed to lower influenza-vaccination uptake among Korean adults aged 65 years and older.

OBJECTIVES The purpose of this study was to examine temporal trends in physical activity and metabolic syndrome (MetS) among Korean adults, and to evaluate secular trends in the association between physical activity and MetS from 2018 to 2023.METHODS This study utilized data from the Korea National Health and Nutrition Examination Survey (KNHANES) collected between 2018 and 2023. A total of 32,639 adults aged ≥ 19 years were included. Physical activity was dichotomized based on meeting the World Health Organization guidelines (≥ 150 minutes/week of moderate to vigorous physical activity). MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III criteria with Asian-specific waist circumference cutoffs, as the presence of ≥ 3 of 5 metabolic components based on measured component values. All analyses accounted for the complex sampling design of KNHANES by applying survey weights and primary sampling units and strata. Temporal trends were tested using orthogonal polynomial contrasts. Secular changes in the association between physical activity and MetS were evaluated using random-effects meta-regression.RESULTS Physical activity levels showed no significant temporal trends from 2018 to 2023. Among MetS components, waist circumference and HDL-C showed significant linear and quadratic trends, fasting plasma glucose demonstrated a significant quadratic pattern peaking in 2021, and both triglycerides and diastolic blood pressure showed significant negative linear trends, whereas systolic blood pressure showed no significant temporal trend. Pooled analyses revealed that meeting physical activity guidelines was associated with a 25% lower odds of MetS (pooled OR = 0.75, 95% CI = 0.70–0.80). Meta-regression indicated no significant secular change in this association across survey years.CONCLUSIONS Meeting physical activity guidelines was consistently associated with lower odds of MetS among Korean adults from 2018 to 2023, with no evidence of secular change in this association. Despite stable physical activity, several MetS components showed partially unfavorable temporal trends, underscoring the need for prevention strategies beyond physical activity alone.

Educational level is a key determinant of subjective health status. Drawing on conceptual hypotheses regarding how its relationship develops across the life course and differs across cohorts, this study examined long-term patterns in their association using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Integrated data from eight waves (2001-2023) comprising 94,717 adults were analyzed to assess trends in the association between two variables. Inverse probability weighting (IPW) was applied by multiplying the IPW weights with the complex survey design weights. After applying IPW, subjective health status among baby boomers with less than middle school group decreased by 0.28 per decade, while the decline was ≤0.1 among older cohorts. High school and college graduates reported 0.18 and 0.29 points higher subjective health, with slight downward trends over time. The findings support two hypotheses, confirming a persistent association between educational level and subjective health status across time.

Objective: This study aims to investigate the dietary assessment and trends of preschoolers aged 3 to 5 years in Korea from 2012 to 2021 and to provide basic data for early childhood dietary education and policy development. Methods: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2012 to 2021 were analyzed for 2510 children in the 3–5 age group. Dietary intake was assessed using a 24 h recall. Intakes of food groups, dishes, and nutrients were calculated, and trends across years were tested using generalized linear models adjusted for gender, age, household income, energy intake, mother’s age, and mother’s education. Results: Over the tenyear period, intakes of carbohydrates, phosphorus, iron, sodium, potassium, carotene, thiamine, niacin, and vitamin C, as well as the carbohydrate energy ratio, showed significant declines. Meanwhile, protein, fat, retinol, and riboflavin increased, as did the protein and fat energy ratios. Fruit intake decreased by approximately 42 g among food group intakes. Analysis of foods contributing to total food intake revealed that milk, white rice, apples, and eggs consistently accounted for a high proportion of total intake in all survey years. Average calcium intake was approximately 100 mg below the estimated average requirement. Conclusions: The results of this study showed that preschoolers exhibit insufficient intake of certain nutrients, such as calcium, and a decrease in fruit intake. Interventions are needed to establish regular meal patterns, promote plant food intake such as fruit, and improve calcium intake. These results provide valuable evidence for designing dietary education programs and dietary guidelines tailored to early childhood.

This study evaluated the relationship between vitamin D status and insulin resistance (IR) among Korean adolescents, focusing on the differences between normal-weight and overweight/obese groups using non-insulin-based IR indices. In this cross-sectional study, data from 3,838 adolescents (age: 12-18 years) who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2014 were included. Using this nationally representative dataset, serum 25-hydroxyvitamin D (25(OH)D) levels were measured, and the prevalence of vitamin D deficiency (25(OH)D < 20 ng/mL) was estimated at the population level. The subjects were divided into the normal-weight and overweight/obese groups. We used the triglyceride-glucose index (TyG), triglyceride-to-high-density lipoprotein cholesterol ratio(TG/HDL-C), TyG with body mass index (TyG-BMI), and metabolic score for IR (METS-IR) as non-insulin-based IR indices. To evaluate the mean differences between groups and the associations with vitamin D status, we used a survey-weighted generalized linear regression model, adjusting for age, sex, household income, and strength training. The prevalence of vitamin D deficiency among adolescents was 78.5%. In particular, the mean vitamin D levels were higher in boys, individuals who engaged in strength training, and individuals with waist circumferences below the 90th percentile. Vitamin D levels were significantly negatively associated with IR markers, particularly METS-IR in the normal-weight group and TyG-BMI and METS-IR in the overweight/obese group. The sensitivity analysis revealed that higher vitamin D levels were associated with a more substantial reduction in IR, especially in overweight/obese adolescents. Vitamin D deficiency is significantly associated with higher IR in adolescents, as measured by non-insulin-based indices. This association appears to be strong in overweight/obese individuals.

As breast cancer survival rates improve, attention is shifting toward long-term health outcomes, including oral health. This study evaluated the dental prosthesis needs of breast cancer survivors using a nationally representative sample and examined variations by menopausal status at diagnosis. This nationwide cross-sectional study analyzed data from 14,886 Korean women aged ≥ 19years who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) from 2016 to 2021. Among these, 214 participants reported a history of breast cancer. Multivariable logistic regression was used to compare prosthetic needs and dental care utilization between breast cancer survivors and non-cancer controls, with subgroup analyses stratified by menopausal status at diagnosis. Breast cancer survivors had significantly greater needs for fixed prostheses than the non-breast cancer controls (OR 1.102, 95% CI 1.018-1.194). Postmenopausal survivors were more likely to require fixed prostheses (OR 1.56, p < 0.001), while premenopausal survivors had greater partial denture needs (OR 5.549, p = 0.009) than the non-breast cancer controls. No significant differences in dental visit frequency or self-perceived oral health were observed between groups. Breast cancer diagnosis was significantly associated with higher prosthetic needs, though survivors did not perceive their oral health as worse and demonstrated dental care behaviors comparable to non-cancer individuals. These findings highlight a potential gap in survivor awareness and underscore the need for integrating oral health assessment into survivorship care planning. Targeted dental interventions and awareness programs may improve quality of life for breast cancer survivors.

We sought to investigate the association between allergen-specific immunoglobulin E (IgE) sensitization and open-angle glaucoma (OAG) using a nationally representative Korean population. This cross-sectional study used data from the 2010 Korea National Health and Nutrition Examination Survey (KNHANES). Among 8,958 participants, 1,334 subjects with complete ophthalmologic and allergen-specific IgE test results were included. Sensitization to indoor allergens (house dust mites, cockroaches, and dog dander) was assessed using ImmunoCAP assays. Multivariate logistic regression models were used to evaluate the association between allergen sensitization and OAG, adjusting for demographic, metabolic, and lifestyle factors. Among the 1,334 participants analyzed, 62 were diagnosed with OAG. Sensitization to cockroach allergens was associated with increased odds of OAG (adjusted OR = 1.19; 95% CI: 1.02-1.38), whereas sensitization to house dust mites was associated with lower odds (adjusted OR = 0.56; 95% CI: 0.31-1.00). No significant associations were found for total IgE levels or sensitization to dog allergens. Allergen sensitization is differentially associated with OAG, depending on the allergen type. Cockroach sensitization was associated with greater odds of glaucoma, while house dust mite sensitization demonstrated an inverse association. These findings provide epidemiological evidence for a differential association between specific allergen sensitizations and OAG. Also, it support the hypothesis of immune-mediated mechanisms in glaucoma pathogenesis and justify further investigation into these inflammatory pathways.

Background:With advances in cancer treatment, the number of cancer survivors has increased, bringing attention to long-term complications such as alterations in bone mineral density (BMD). Although survivors are at elevated risk for low BMD, prior studies have focused on specific cancer types and relied on traditional regression models, which are limited in capturing complex inter-variable relationships. This study aimed to examine the causal relationships among factors affecting BMD in cancer survivors and age-matched controls using causal Bayesian network (CBN) modeling.Methods:Data from the 2010-2011 Korea National Health and Nutrition Examination Survey (KNHANES) V were analyzed. We included 227 cancer survivors and 681 age- and sex-matched controls. Associations between BMD and variables such as age, sex, body composition, smoking, fracture history, and vitamin D were assessed using linear regression. A CBN model was then applied to evaluate probabilistic dependencies and potential causal relationships between variables and femoral neck BMD.Results:Among all participants, age, sex, smoking, fracture history, body fat percentage, muscle mass, and cancer history were significantly associated with femoral neck BMD. In cancer survivors, age (β = −0.032, P < .001) and sex (β = −0.680, P < .001) showed negative associations with BMD, whereas higher muscle mass (β = 0.073, P < .001) was a strong positive predictor. Smoking (β = −0.779, P = .005) and previous fractures (β = −0.507, P = .003) were also linked to lower BMD. The CBN model identified direct effects of age and muscle mass on BMD, with indirect effects from sex, smoking, and fracture history. Among women aged >60 years, greater muscle mass appeared particularly protective.Conclusion:Causal Bayesian network modeling identified muscle mass as a key modifiable factor influencing BMD among cancer survivors. These findings highlight the importance of muscle-preserving lifestyle interventions, including resistance exercise and adequate protein intake, in survivorship care. The CBN approach provides a framework for identifying individualized risk pathways and can support personalized bone-health management strategies in clinical practice.

Aims: Low-carbohydrate diets (LCDs) are associated with metabolic benefits, but their long-term effects remain uncertain, particularly in Asian populations with traditionally high carbohydrate intake. This study examined LCD patterns and their association with metabolic syndrome (MetS) in Korean adults using nationally representative data from the 2022-2023 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: Among 9617 adults aged ≥20 years with complete dietary and health data, LCD score was calculated from the percentage of energy derived from carbohydrates (reverse-scored), fats, and proteins, and participants were categorized into high-carbohydrate, moderate-carbohydrate, and low-carbohydrate groups. MetS was defined using an Adult Treatment Panel III and Korean criteria. Survey-weighted logistic regression was applied to assess associations between LCD score and MetS across sequentially adjusted models. Results: MetS prevalence differed significantly across LCD decile groups (LCD1: 9.6%, LCD2: 5.8%, LCD3: 9.7%; p < 0.001). In a minimally adjusted model, LCD decile 3 was associated with higher odds of MetS (OR, 1.14; 95% CI: 1.02-1.27). However, this association was attenuated and became non-significant after further adjustment for key metabolic risk factors. Obesity, blood pressure, fasting glucose, triglycerides, and high-density lipoprotein cholesterol were all strongly associated with MetS (all p < 0.001), and income-related disparities were evident, with lower-income groups showing higher carbohydrate and lower fat and protein intakes. Conclusions: These findings suggest that LCD patterns are not independently associated with MetS once underlying metabolic factors are considered. Public health strategies in Korea would be emphasized by improving nutrient quality, promoting balanced macronutrient intake, and reducing socioeconomic inequalities in diet to mitigate metabolic risk among adults.

The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey mandated by Article 16 of the National Health Promotion Act to assess the health and nutritional status of the Korean population. Over the past 2 decades, the survey has continuously introduced timely survey components while strengthening its survey methodology and operational systems to enhance both the policy relevance and scientific utility of its findings. The 10th KNHANES (2025-2027) preserves the statistical representativeness of its sampling design while expanding the use of web-based self-administered questionnaires to improve participant convenience. In response to Korea's transition into a super-aged society, the 10th KNHANES incorporates enhanced older-adult health surveys, including osteoporosis assessment and older adults' life functioning, and newly introduces items addressing social support as part of the social determinants of health. In addition, a longitudinal follow-up survey system has been established to monitor long-term changes in population health. Collectively, these changes are expected to improve understanding of aging-related health issues, support evidence-based national health policy development, and expand the applicability of KNHANES data for academic research.

Background/AimsWe examined the association between diabetes duration and hyperuricemia in Korean subjects based on data from the Korea National Health and Nutrition Examination Survey (KNHANES).MethodsThis cross-sectional study included 4,575 subjects aged 30 years and older with type 2 diabetes mellitus based on data from the KNHANES from 2016 to 2021. Hyperuricemia was defined as a serum uric acid level ≥ 7.0 mg/dL. Univariable and multivariable logistic regression models were used calculate adjusted odds ratios (ORs) and their 95% confidence intervals (CIs).ResultsThe mean age of subjects was 61.0 years, 56.5% were male, and the mean body mass index (BMI) was 25.6 kg/m2. Compared to those with diabetes duration 5 to < 10 years, those with shorter or longer diabetes duration had higher serum uric acid levels and higher prevalence of hyperuricemia. In multivariable logistic regression models, a U-shaped association between diabetes duration and hyperuricemia was observed after adjusting for age, sex, income, smoking status, alcohol consumption, regular exercise, and presence of hypertension, dyslipidemia, or chronic kidney disease. Compared to those with new-onset diabetes mellitus, the adjusted OR (95% CI) for hyperuricemia was 0.55 (0.38–0.82) in those with diabetes duration 5 to < 10 years. The results were consistent in subgroup analysis according to age, sex, BMI, and chronic kidney disease.ConclusionsThe U-shaped association between diabetes duration and hyperuricemia was observed in a representative sample of Korean adults.

BackgroundA new diagnostic framework for clinical obesity, proposed by the Lancet Commission, defines obesity as excess adiposity with organ dysfunction, offering a more functional assessment than traditional body mass index (BMI)-based classification. However, it has not been applied to Asian populations, where obesity-related complications arise at lower BMI thresholds.MethodsWe analyzed 57,863 Korean adults aged ≥20 years from the 2014 to 2023 Korea National Health and Nutrition Examination Survey (KNHANES), a nationally representative, cross-sectional dataset. Clinical obesity was defined as excess adiposity with ≥1 obesity-related complication or functional limitation; preclinical obesity was defined as excess adiposity without complications. Age, sex, and temporal trends were examined and compared with BMI-based classifications using complex sampling weights and age-standardization.ResultsThe prevalence of clinical obesity and preclinical obesity was 31.2% and 8.1%, respectively. Among those with BMI-defined obesity (≥25.0 kg/m2), 20.1% had no complications, while 19.4% of overweight individuals (BMI 23.0–24.9 kg/m2) met clinical obesity criteria. Clinical obesity increased with age despite stable BMI, driven by metabolic and functional decline. Cancer prevalence was highest among individuals with clinical obesity (1.77%). Applying Western waist circumference cutoffs drastically reduced the estimated prevalence of clinical obesity to 13.1%. Longitudinal analyses showed a rising trend in clinical obesity over ime.ConclusionThis is the first large-scale study to apply the clinical obesity framework in an Asian population. The framework identifies high-risk individuals missed by BMI alone and supports a shift toward more functional, ethnically tailored obesity definitions for risk stratification and intervention.

Dietary factors influence hyperuricemia; however, comprehensive evaluations integrating nutrient intake, dietary patterns, and overall diet quality remain limited. This study aimed to address this gap by assessing nutrient intake using the Korean Dietary Reference Intakes (KDRIs) and diet quality using the Korean Healthy Eating Index (KHEI). In this cross-sectional study using Korea National Health and Nutrition Examination Survey (KNHANES) data, 24,026 Korean adults were eligible prior to matching, stratified by sex, and then classified according to hyperuricemia status within each sex. After 1:1 propensity score matching based on age and body mass index, 10,268 participants were included in the final analysis. Dietary intake levels were assessed using a 24-h dietary recall, and nutrient intake and dietary quality were evaluated using the KDRIs and KHEI, respectively. The KDRI-based analysis showed that a lower proportion of individuals with hyperuricemia met or exceeded the recommended carbohydrate intake in both sexes (men: 39.1% vs. 34.0%, p < 0.001; women: 54.0% vs. 50.1%, p < 0.001), whereas a higher proportion of women with hyperuricemia had protein intake exceeding the recommended intake levels (10.6% vs. 8.1%, p = 0.003). In the hyperuricemia group, the proportion of participants meeting the KDRIs for fiber and minerals, such as magnesium and zinc, was significantly lower in both sexes. Among men, a lower proportion met the KDRI criteria for calcium, iron, potassium, folate, and vitamins B1, B2, and C intake. The mean KHEI score was significantly lower in the hyperuricemia group than in the control group, in both sexes. Among men, the proportion of individuals with component scores ≥7 for whole grains, total fruit, fresh fruit, total vegetables, and breakfast was significantly lower in the hyperuricemia group (all p < 0.01). Among women, the hyperuricemia group consumed a lower proportion of total vegetables (p = 0.003). This study highlights the importance of a comprehensive dietary approach in managing hyperuricemia. These findings support the implementation of individualized strategies focused on balanced macronutrient intake, quality and sources of macronutrients, increased consumption of fiber-rich plant-based foods, adequate micronutrient intake, and healthy eating practices.

BackgroundAlthough the mental health benefits of physical activity are well-established, they appear more pronounced when engaging in leisure activities rather than work-based efforts. This phenomenon is often referred to as the physical activity paradox. While leisure activity is often linked to reduced likelihood of depression, the influence of occupational physical activity remains less clearly understood, especially during periods of social disruption such as the COVID-19 pandemic.MethodsThis study analyzed data from 26,454 Korean adults aged 19 years and older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) in 2014, 2016, 2018, 2020, and 2022. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), and domain-specific physical activity was measured with the Global Physical Activity Questionnaire (GPAQ). Isotemporal substitution modeling examined associations between reallocating 30 minutes of activity among occupational, transport, and leisure domains and depressive symptoms. Subgroup analyses were conducted across three time periods: pre-pandemic (2014–2018), early pandemic (2020), and later pandemic (2022).ResultsIn the full sample, reallocating 30 min from occupational-type moderate-to-vigorous physical activity (MVPA) to leisure MVPA was associated with lower odds of depressive symptoms (odds ratio [OR]: 0.805, 95% confidence interval [CI:] 0.694–0.934), whereas the reverse substitution was linked to higher odds (OR: 1.242, 95% CI: 1.071–1.441). These associations were statistically significant during the pre-pandemic period but did not reach significance during the early or later pandemic phases.ConclusionsThe observed associations between physical activity and depressive symptoms appear to vary by activity type and the social context. The potential mental health benefits of leisure-based activity may be weaker during periods of societal disruption, such as the COVID-19 pandemic. These findings highlight the need for physical activity guidelines that consider both domain-specific patterns and the psychosocial environment in which activity takes place.

This study proposes a personalized diabetes prediction model by employing the AdaBoost classifier, a machine learningbased artificial intelligence (AI) algorithm, to integrate diverse health indicators. Using data from the 2022 Korea National Health and Nutrition Examination Survey (KNHANES), the model incorporates extended variables—including age, body mass index (BMI), urine sugar, hepatitis A antibody, and marital status—in addition to traditional physiological diagnostic indicators such as fasting blood glucose and glycated hemoglobin (HbA1c). The proposed model achieved 78% performance in accuracy, precision, recall, and F1-score under 5-fold cross-validation, which is meaningful as it was obtained through multivariate analysis with extended health attributes. Compared to conventional models centered on traditional indicators, the proposed approach demonstrated improved balance and stability in predictions, thereby contributing to the early identification of high-risk groups and the establishment of prevention-focused healthcare strategies.