Korea National Health And Nutrition Examination Survey Research Articles

Association between breastfeeding and periodontitis in Korean women using Korea National Health and Nutrition Examination Survey (KNHANES): a cross-sectional study

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.

Mediating Effects of Diet Quality between Meal Frequency and Cardiometabolic Risk among Korean Adults: Data from the 7th Korea National Health and Nutrition Examination Survey (KNHNES)

Purpose : The 2020 Dietary Guidelines Advisory Committee specifically noted that meal frequency is associated with risks for cardiovascular disease, type 2 diabetes, and all-cause mortality, although the current evidence on meal frequency is conflicting. As meal frequency itself is affected by various factors, the aim of the study was not only to examine its relationships with cardiometabolic risk but also to identify the mediating effects of dietary quality.Methods : This study used a descriptive correlational design. In all 8,141 healthy adults participated in the study. Measurements included meal frequency, cardiometabolic risk, and diet quality. Data were analyzed using descriptive statistics, Pearson’s correlation coefficient analysis, and process macro bootstrapping model 4.Results : The meal frequency was 3.52±0.61 times per day, the risk of cardiovascular metabolic diseases was 0.01±0.61 points, and the diet quality was 62.08±13.87 points. In mediation analysis, the effect of meal frequency on cardiometabolic risk score was completely mediated by diet quality.Conclusion : Improved diet quality in healthy adults should be considered when designing meal frequency interventions aimed at reducing their cardiometabolic risk, as the effect of meal frequency support on cardiometabolic risk was found to be mediated by diet quality.

The risk of obstructive sleep apnea is highly correlated with depressive symptoms among the Korean adults population: results from the 2020 Korea National Health and Nutrition Examination Survey

ObjectivesWe aimed to examine the association between Obstructive Sleep Apnea (OSA) risk, health behaviors, and depressive symptoms in a representative Korean sample.MethodsCross-sectional data from the 2020 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed. The sample included 4,352 adults aged 40 years and older. Multiple linear regression analysis was performed to examine the association between OSA risk, health behaviors, and depressive symptoms.ResultsIn total, 23.1% of the participants reported a high risk of OSA. Of the respondents, 39.8%, 19.0%, 27.2%, and 8.7% reported hypertension, snoring, tiredness, and observed apnea, respectively. The prevalence of moderate-severe depressive symptoms among adults with high-risk OSA was 7.5%. The significant associations between OSA risk and sex with PHQ-9 were shown in univariate linear regression. In the multiple linear regression analysis, the association between high risk of OSA and PHQ-9 showed in total (B = 1.58; P < 0.001), male (B = 1.21; P < 0.001), and female (B = 1.93; P < 0.001).ConclusionsA high risk of OSA was associated with an increased prevalence of depressive symptoms. Monitoring the risk factors of depressive symptoms, including OSA, or unhealthy behaviors may decrease the mental health issues of middle-aged and older adults.

279-LB: The Role of Body Composition Phenotypes on Insulin Resistance in Nondiabetic Asians—The Korea National Health and Nutrition Examination Survey (KNHANES) 2008–2011

It is increasingly recognized that obesity as defined by body fat distribution as well as body mass index (BMI) contributes to metabolic disturbances. The relationship between body fat percent (%BF) and insulin resistance in the Asian population remains uncertain. We investigated the association between insulin dynamics and the four body composition phenotypes using BMI and %BF; normal with normal-fat percent (NN), normal with high-fat percent (NH), obese (overweight/obesity) with normal-fat percent (ON), and obese with high-fat percent (OH). We performed a cross-sectional study with 16,578 adult participants aged between 19 and 80 in the fourth and fifth KNHANES with Dual Energy X-ray Absorptiometry (DEXA) data. The subjects with diabetes are excluded. The mean age was 42.72 (standard error (SE) 0.30) years old. The prevalence of impaired fasting glucose, hypertension, and dyslipidemia was higher depending on the body composition phenotypes (p for trend &amp;lt;0.001). Homeostatic model assessment of insulin resistance (HOMA-IR) increased and the quantitative insulin check index (QUICKI) decreased significantly according to the body composition phenotypes (p for trend &amp;lt;0.001). The OH group exhibited significantly the highest HOMA-IR (mean 2.69, SE 0.03) and the lowest QUICKI (mean 0.335, SE 0.001) values. The odds ratio (OR) for high HOMA-IR (men &amp;gt;2.5, women &amp;gt;2.0) and low QUICKI (men &amp;lt;0.347, women &amp;lt;0.343) was increased according to the body composition phenotypes. NH group showed significantly higher OR than ON group, compared to NN group (OR 1.25, 95%CI 1.02-1.53 vs OR 0.91, 95% CI 0.70-1.19, respectively). In conclusion, using body fat percent with BMI to categorize obesity is useful for estimating HOMA-IR and QUICKI. Although subjects have normal BMI, the amount of their fat mass plays an important role in insulin dynamics. The subjects with high-fat percent need to detect and intervene earlier for future prognosis. Disclosure A. Khang: None.

Association of maternal mental health and drinking/smoking with adolescents' mental health based on the Korea National Health and Nutrition Examination Survey.

Depression is one of the major concerns in adolescence, with a global prevalence of approximately 5%. Diverse environmental factors can affect the development of depression depending on the individual developmental stage. Using data from the Korea National Health and Nutrition Examination Survey (KNHANES), we aimed to investigate the association between socioeconomic factors and mental health in a population of non-clinically ill adolescents in Korea totaling 6,261 adolescents aged 12-18 years. Drinking, smoking, stress, depressed mood, suicidal ideation in adolescents, and stress, depressed mood, and suicidal ideation in mothers were identified as factors associated with adolescent depression. In addition to depressed mood and suicidal ideation, the higher perception of stress in mothers was related to higher stress perception, depressed mood, and suicidal ideation in adolescents. The association of adolescents' mental health with fathers' mental health was weaker than that with mothers' mental health. Additionally, increased smoking and drinking were commonly reported in adolescents with higher stress perception, depressed mood, and suicidal ideation. We conclude that close monitoring of mental health is required for adolescents with drinking and smoking habits and mothers with mental health problems.

Accelerometer-derived physical activity analysis of elderly osteoarthritis patients

BackgroundBecause disability in Osteoarthritis (OA) may change physical activity (PA), which might affect the disease progression, it is important to measure a patient's daily PA to study the relationship between a patient's PA and disease progression. ObjectiveThe objective of the present study was to investigate the relationship between PA and patients with OA and people without OA using data from the Korea National Health and Nutrition Examination Survey (KNHANES). MethodsDemographic study was conducted to obtain data of comorbidities of participants. PA was compared between the group with OA (OA group) and the group without OA (non-OA group). In addition, PAs of OA patients with comorbidities and those without comorbidities were compared. The cut-off of moderate to vigorous physical activity (MVPA) was obtained through a receiver operating characteristic (ROC) curve. ResultsIn the demographic study, there were significantly more educated participants in the OA group (p < .001). Actigraph data showed a significant decrease in MVPA (p < .001) but a significant increase in light activity (p = .002) in the OA group. In addition, the OA group showed significantly lower light PA but significantly higher MVPA in ≥10 min bout length. OA patients with comorbidities showed higher MVPA than OA patients without comorbidities (p = .044). The cut-off point of MVPA was 7.071 min/day when ROC curve was conducted. ConclusionsThe present study suggests that patients with OA and low activity need a certain level of physical activity and a cut-off point for MVPA is presented which accounts for comorbidities in OA patients.

#3784 DIETARY BEHAVIOR OF CKD PATIENTS BEFORE AND AFTER THE COVID-19 PANDEMIC PERIOD

Abstract Background and Aims As the COVID-19 infection went global pandemic in 2020, many governments around the world have carried out social lockdown policies. It resulted in changes in lifestyles such as diet, physical activity, and social interaction. This study aimed to investigate the changes of lifestyles focusing on diet, especially in patients with chronic kidney disease (CKD) during the COVID-19 pandemic period. Method We compared data from 2019 and 2020 of the Korea National Health and Nutrition Examination Survey (KNHANES) before and after COVID-19, because COVID-19 was first detected in January 2020 in South Korea. CKD was defined as albumin to creatinine ratio &amp;gt;30 mg/g or estimated glomerular filtration rate (eGFR) &amp;lt;60 mL/min/1.73 m2. CKD was categorized into two groups, CKD stage 1–2 and CKD 3–5; eGFR over 60 with albuminuria and eGFR below 60 mL/min/1.73 m2. We compared changes in diet behavior, nutrients, and food intake between 2019 and 2020 in normal, CKD stage 1–2, and CKD stage 3–5 groups. Results This analysis included a total of 5,084 and 4,338 participants from 2019 and 2020. When compared to normal group in the post-COVID-19, CKD group showed lower energy intake (p = 0.038), but the proportion of carbohydrates, proteins, and lipids did not differ. In the pre-COVID-19, CKD stage 3–5 group ate significantly lower sodium (1612.3 ± 62.1 mg/1000kcal) compared to normal (1809.1 ± 17.3 mg/1000kcal) and CKD stage 1–2 group (1856.3 ± 44.9 mg/1000kcal) (p = 0.007). However, post-COVID-19 period, sodium intake significantly increased only in CKD stage 3–5 group (1893.5 ± 109.2 mg/1000kcal, p = 0.015), and the urine Na/Cr ratio also increased (from 19.5 ± 1.4 to 26.0 ± 1.5, p = 0.001). The main source food of sodium was kimchi in every group, but the proportion changed in the post-COVID-19 period. In CKD stage 3–5 group, compared to the pre-COVID-19 period, the intake of noodles and Ramen increased 35% and 91%, respectively. Interestingly, the potassium intake increased from pre-COVID-19 to post-COVID-19 in all three groups. Conclusion The COVID-19 pandemic affects CKD patients' diets in terms of sodium intake. We need to pay attention to diet and nutritional education for CKD stage 3–5 patients.

#4666 ASSOCIATION BETWEEN URINARY ALBUMIN CREATININE RATIO AND CARDIOVASCULAR DISEASE

Abstract Background and Aims The association between microalbuminuria and cardiovascular disease (CVD) is accumulating in various patient populations. However, when stratified by sex, the relationship between microalbuminuria and CVD remains unclear. Method We obtained data from the 2011–2014 and 2019–2020 Korea National Health and Nutrition Examination Survey (KNHANES). Microalbuminuria was measured based on spot urine albumin-creatinine ratio (UACR). The Framingham risk score (FRS) model was implemented to evaluate the CVD risk. Linear and logistic regression models were used to identify the associations of microalbuminuria status with cardiometabolic predictors and CVD status determined by the FRS score. Results Among 19,340 representative Korean participants, the (UACR) in Korean women and men with history of CVD was higher than in those without history of CVD. Among patients without history of CVD, multivariate regression analysis showed that a high UACR was related to older age, lower high-density lipoprotein cholesterol level, higher total cholesterol level, higher systolic blood pressure, higher prevalence of current smoking, higher prevalence of diabetes, and higher anti-hypertensive medication use in both women and men. The UACR showed a positive linear correlation with the Framingham risk score in both women and men. Conclusion The presence of microalbuminuria was significantly associated with the cardiometabolic risk factors and the increased risk of CVD evaluated by FRS model in both women and men in a nationally representative sample of Korea.

20-Year Trends in Metabolic Syndrome Among Korean Adults From 2001 to 2020

BackgroundThe number of people with metabolic syndrome (MetS) is increasing worldwide, and many socioeconomic and environmental factors contribute to this. ObjectivesThe authors investigated tangible trends in the prevalence of MetS using the 2001 to 2020 versions of the Korea National Health and Nutrition Examination Survey (KNHANES). MethodsIn these surveys, stratified multistage sampling designs were used to approximate the entire population. Blood pressure, waist circumference, and lifestyle variables were examined in a standardized fashion. Metabolic biomarkers were measured in a central laboratory operated by the Korean government. ResultsThe age-adjusted prevalence of MetS increased significantly from 27.1% in 2001 to 33.2% in 2020. It was more prevalent in men (25.8%→40.0%) but did not change in women (28.2%→26.2%). Among the 5 MetS components, the proportions of high glucose level and large waist circumference increased substantially by 17.9% and 12.2% over 20 years, while high-density lipoprotein cholesterol levels increased significantly, resulting in a decrease in low high-density lipoprotein cholesterol by 20.4%. Caloric intake derived from carbohydrates decreased from 68.1% to 61.3%, while fat consumption increased from 16.7% to 23.0%. Notably, sugar-sweetened beverage consumption showed an almost 4-fold increase from 2007 to 2020, while physical activity levels decreased by 12.2% from 2014 to 2020. ConclusionsGlycemic dysregulation and abdominal obesity were key features contributing to the increased prevalence of MetS observed in Korean men during the past 20 years. Rapid economic and socioenvironmental changes in this period may be involved in this phenomenon. Understanding these changes in MetS could be valuable for other countries undergoing such socioeconomic transformation.

Airflow obstruction and chronic obstructive pulmonary disease are common in pulmonary tuberculosis even without sequelae findings on chest X-ray

Purpose Pulmonary tuberculosis (TB) is a well-known risk factor for airflow obstruction and chronic obstructive pulmonary disease (COPD). The prognosis of TB without sequelae on chest X-ray (CXR) remains uncertain. Methods We used the 2008–2009 Korea National Health and Nutrition Examination Survey (KNHANES) data and 2007–2012 KNHANES-matched Health Insurance Review and Assessment Service cohort data. Airflow obstruction was assessed using a pulmonary function test. COPD was defined using diagnostic codes and the use of COPD medication for 3-year. We classified subjects into three groups based on TB history and sequelae on CXR. Results In 4911 subjects, the CXR(–) (no TB sequelae on CXR) post-TB group (n = 134) showed similar characteristics and normal lung function compared to that of the control group (n = 4,405), while the CXR(+) (TB sequelae on CXR) post-TB group (n = 372) showed different characteristics and reduced lung function. The prevalence of airflow obstruction was 9.3%, 13.4%, and 26.6% in control, CXR(-) post-TB, and CXR(+) post-TB groups, respectively. COPD was more common in the post-TB with CXR(+) (6.5%) or without CXR (–) (4.5%) groups, than in the control group (1.8%). Compared to the CXR(–) post-TB group, the control group showed a lower risk for airflow obstruction (OR, 0.774; p = .008). The CXR(+) post-TB group showed a higher risk for airflow obstruction (OR, 1.456; p = .011). The Control group also showed a lower risk for the development of COPD than the CXR(-) post-TB group (OR, 0.496; p = .011). Conclusions We need to educate TB patients that airway obstruction and COPD can easily develop, even if TB sequelae are not observed on CXR.

Association of dietary sodium intake with impaired fasting glucose in adult cancer survivors: A population-based cross-sectional study.

Dietary sodium intake is a crucial lifestyle factor that should be assessed in adult cancer survivors due to their increased risk of adverse health outcomes compared to the general population. However, its with impaired fasting glucose (IFG) in adult cancer survivors remains unclear. This study aimed to investigate the association of dietary sodium intake categorized by the American Heart Association (AHA) recommendation with IFG in the community-dwelling adult cancer survivors. A total of 1,052 adult cancer survivors without diabetes were identified from the sixth and seventh Korea National Health and Nutrition Examination Survey (KNHANES), 2013-2018. Data on dietary sodium intake was categorized as <1,500 mg/day, 1,500-2,999 mg/day, 2,300-3,999 mg/day, and ≥4,000 mg/day according to the AHA recommendation. A multiple logistic regression model adjusted for demographic, lifestyle, and health status was used to compute odds ratios (OR) and 95% confidence intervals (95% CI) for IFG according to dietary sodium intake categories. After adjusting for confounding variables identified in the KNHANES, the adjusted OR among the adult cancer survivors who consumed 1,500-2,999 mg/day, 2,300-3,999 mg/day, and ≥4,000 mg/day of dietary sodium were 1.16 (95% CI: 0.25-5.27), 1.93 (95% CI: 0.40-9.37), and 2.67 (95% CI: 0.59-12.18), respectively, as compared to those who consumed <1,500 mg/day (P value for trend = 0.036). Among community-dwelling adult cancer survivors, high dietary sodium intake was marginally associated with increased odds of IFG. Well-designed cohort studies or randomized clinical trials are needed to establish more epidemiologic evidence on this association in adult cancer survivors.

Health-related quality of life in older women with injuries: a nationwide study.

This study aims to describe the health-related quality of life (HRQoL) and influencing factors of older women who experienced injuries. This study is a secondary analysis of data from 4,217 women aged 65 years or older sampled from the Korea National Health and Nutrition Examination Survey (KNHANES) (2016-2020) database. Two-way analysis of variance was used to analyze the data. The mean HRQoL scores of older women with and without injuries were 0.81 ± 0.19 (n = 328) and 0.85 ± 0.17 (n = 3,889), respectively, which were significantly different (p < 0.001). The results of multiple regression analysis revealed that working, physical activity, BMI, osteoarthritis, stress, and subjective health status significantly affected the HRQoL of older women with injuries, and the explanatory power of the model was 29%. The results of this study on factors affecting HRQoL can contribute to the understanding of the experience of older women with injuries and can be used as a reference to develop health promotion programs.

Comparison of the Smoking Cessation of Heated Tobacco Product Users and Conventional Cigarette Smokers in Korea.

Since the introduction of heated tobacco products (HTPs) in Korea in 2017, their annual sales have increased. Several studies have investigated the perceptions of HTPs and smoking cessation behaviors. For the first time, In 2019, questions focused on HTP use were introduced in the Korea National Health and Nutrition Examination Survey (KNHNES). This study aimed to compare smoking cessation behaviors between HTP users and conventional cigarette smokers using KNHANES data. Data of 947 current adult smokers from the 8th KNHNES (2019) were analyzed. Current smokers were divided into conventional cigarette (CC)-only, HTP-only, and dual-use groups. The general characteristics of the three groups were investigated. Differences in current intention to quit smoking and past attempts to quit smoking among the three groups were analyzed using multivariate logistic regression analysis by IBM SPSS ver. 25.0. HTP-only users demonstrated fewer future smoking cessation plans (adjusted odds ratio [AOR], 0.398; 95% confidence interval [CI], 0.195-0.813; P=0.012) and fewer smoking cessation attempts in the past year (AOR, 0.533; 95% CI, 0.298-0.954; P=0.034) than CC-only smokers. However, there was no significant difference between dual-use (CC+HTP) and CC-only smokers. While dual-use and CC-only smokers showed similar smoking cessation behaviors, HTP-only users had fewer previous attempts to quit smoking and were less likely to be currently ready to quit smoking. These findings can be explained by a decrease in the need to quit smoking due to the convenience of HTP and the perception that HTPs are less harmful than CC.

Association of main meal frequency and skipping with metabolic syndrome in Korean adults: a cross-sectional study

BackgroundReduced meal frequency can increase the risk of metabolic syndrome (MetS). However, limited studies have examined the association between meal frequency and skipping meals with MetS. This study aims to analyze the association between main meal frequency and meal skipping with MetS in Korean adults aged ≥ 19 years.MethodsIn this study, we included data from 22,699 Korean adult participants from the 2016–2020 Korea National Health and Nutrition Examination Survey (KNHANES). The 24-h dietary recall method was used to classify the participants into three groups based on main meal frequency (one, two, or three meals per day) and seven groups based on the type of main meal they skipped. Multivariable logistic regression analysis was conducted to determine the association between main meal frequency and the types of main meals skipped with the odds of MetS and its associated components. Appropriate estimates were accounted for using sampling weights, stratification, and clustering.ResultsThe prevalence of MetS in the study population was 33.8%. The average age of the participants was 47.2 years with 42.6% being men, and 57.4% being women. Men who consumed two meals per day had higher odds of MetS than those who consumed three meals per day (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.01–1.33). Women who consumed two meals per day, and skipped breakfast had increased odds of having elevated fasting blood glucose levels (OR 1.18, 95% CI 1.02–1.35), and elevated triglycerides (OR 1.19, 95% CI 1.02–1.39). However, women who skipped dinner had reduced odds of having elevated fasting blood glucose levels (OR 0.74, 95% CI 0.58–0.94).ConclusionsOur findings suggest that meal frequency and the type of main meal skipped may be associated with MetS and emphasize the importance of consuming breakfast to prevent MetS.

노인의 우울 증상이 일반 및 암 건강검진 수검에 미치는 영향

Objective: In this study, we investigate the effect of depressive symptoms in elderly on general and cancer health screening participation using the large epidemiological study data in South Korea.&#x0D; Methods: This study was conducted on 1,977 people who responded to a health examination questionnaire among 2,360 adults aged 60 or older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) in 2020. Depressive symptoms were measured by the Patient Health Questionnaire-9 and classified as minimal (0-4), mild (5-9), and moderate and severe (10-27). To investigate the relationship between depressive symptoms and health screening participation, a multiple logistic regression model controlling covariates was used.&#x0D; Results: Compared to the group with minimal depressive symptoms, the mild group did not show a significant difference (odd ratio [OR]=0.71, 95% confidence interval [95% CI]=0.45-1.13), but the moderate to severe group showed a significant negative relationship with general health screening participation (OR=0.59, 95% CI=0.35-0.99). There was a significant negative relationship between depressive symptoms and cancer health screening participation (mild group OR=0.77, 95% CI=0.48-1.23; moderate to severe group OR=0.50, 95% CI=0.28-0.87).&#x0D; Conclusion: This study showed that people with depressive symptoms are less likely to get a general and cancer health screening. In order to promote health screening participation, policies that consider health behavior promotion programs and psychiatric interventions targeting moderate to severe depressive symptom groups are necessary

How Does the Frequency of Eating-Alone among Older People in Korea Affect Their Health and Dietary Behavior?

This study examined the relationship between general population characteristics and diet-related factors pertaining to eating alone for older adults (65 years and older) in Korea. This study used the Korea National Health and Nutrition Examination Survey (KNHANES), 2016–2020, and the target population was 7037 Koreans aged 65 years or older who participated in the nutritional survey and health interview. Eating alone variables were classified as follows. Eating together all day means “eating together”, eating only one meal a day means “1/day”, eating two meals a day alone means “2/day”, and “3/day” means eating three meals a day alone. The main results are as follows. The rate of moderate or severe food insecurity was 3.41% in the “eating together” group to 7.86% in the “3/day” group, which was 4.45% higher in the “3/day” group. Fruit + vegetable intake among food intake lowered by about 35 g from 301.2 g in the “eating together” group to 266.2 g in the “3 day” group. In addition, as a result of analyzing the prevalence of depression using the PHQ-9 score, the “3/day” group had a 1.775 to 2.464 times higher risk of depression than the “eating together” group. Finally, EQ-5D variables and quality of life scores were significantly lowered from the “eating together” group to the “3/day” group. Overall, higher frequency of eating alone was associated with food safety, essential food intake, and quality of life. Based on these results, it is thought that a dietary life support program such as the eating together program is necessary to improve the quality of life of the older people who eat alone.

What Is the Relationship between the Chewing Ability and Nutritional Status of the Elderly in Korea?

This study aims to determine the relationship between chewing ability and the nutritional status of the elderly in Korea. This study utilized the data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2013–2018 for persons who were ≥65 years of age. Of the 7835 subjects, 43.2% had chewing difficulty. Compared to the normal group, the chewing difficulty group had more stress, lower exercise frequency, less snack intake, a lower frequency of eating out, and a higher proportion of food insecurity. The chewing difficulty group had significantly lower food intake compared to the normal group, including various food groups such as cereals and grain, potatoes, fruits, meat, and milks and dairy products. The intake of fresh fruits was 24.5% lower and the intake of plant food (fresh fruits and nonstarchy vegetables) was 17.8% lower in the chewing difficulty group compared to the normal group. In addition, the intake of most nutrients (carbohydrates, fat, calcium, phosphorus, sodium, potassium, vitamin A, riboflavin, niacin, and vitamin C) was significantly lower in the chewing difficulty group than in the normal group. The chewing difficulty was significantly associated with undernutrition (OR = 1.63). In conclusion, chewing ability is closely related to food and nutrient intake among the elderly, which can decrease the quantity and quality of diet and is also related to undernutrition. Therefore, it is necessary to develop customized nutrition programs and aging-friendly food products that consider the chewing ability of the elderly.

Interaction between blood cadmium and lead concentration and physical activity on hypertension from the Korean national health and nutrition examination survey in 2008–2013

BackgroundPrevious studies have suggested that blood Cd, Pb exposure, and physical activity levels may influence the development of hypertension. This study aimed to investigate the relationship between blood Cd, Pb levels, and hypertension by the level of physical activity in Korean adults using The Korea National Health and Nutrition Examination Survey (KNHANES).MethodsWe used data from the KNHANES (2008–2013), a nationally representative, cross-sectional, population-based study. We included 8,510 participants who had records of blood Cd, Pb and, blood pressure measurements. Multiple logistic regression was used to examine the association between blood Cd and Pb exposure and the development of hypertension, as well as the modifying effects of physical activity levels. Additive interaction was estimated using relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S).ResultsFollowing covariates adjustments, we found significant associations of blood Cd and Pb with higher hypertension prevalence. This association was more apparent in low physical activity while blood Cd and Pb concentrations were not significantly associated with hypertension in participants with more activity. Additionally, there was a significant interaction between blood Cd and physical activity on hypertension risk (RERI = 0.17, 95% CI: -0.36–0.7; AP = 0.12, 95% CI: -0.28–0.52; S = 1.75, 95% CI:1.36–2.14).ConclusionsOur results suggest that low physical activity may substantially amplify the adverse effects of blood Pb and Cd exposure on hypertension risk. However, interactions were only found for Cd. Further studies are needed to confirm these findings.

A Predictive Model of Ischemic Heart Disease in Middle-Aged and Older Women Using Data Mining Technique.

This study was conducted to identify ischemic heart disease-related factors and vulnerable groups in Korean middle-aged and older women using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Among the 24,229 people who participated in the 2017-2019 survey, 7249 middle-aged women aged 40 and over were included in the final analysis. The data were analyzed using IBM SPSS and SAS Enterprise Miner by chi-squared analysis, logistic regression analysis, and decision tree analysis. The prevalence of ischemic heart disease in the study results was 2.77%, including those diagnosed with myocardial infarction or angina. The factors associated with ischemic heart disease in middle-aged and older women were identified as age, family history, hypertension, dyslipidemia, stroke, arthritis, and depression. The group most vulnerable to ischemic heart disease included women who had hypertension, a family history of ischemic heart disease, and were menopausal. Based on these results, effective management should be achieved by applying customized medical services and health management services for each relevant factor in consideration of the characteristics of the groups with potential risks. This study can be used as basic data that can be helpful in national policy decision making for the management of chronic diseases.

Association between breakfast frequency and insulin resistance in Korean adults with prediabetes: A nationwide population-based cross-sectional study

AimsThis study aimed to investigate the association between breakfast frequency and insulin resistance using the triglyceride and glucose (TyG) index in Korean adults with prediabetes. MethodsThis study used data from the 2016–2018 Korea National Health and Nutrition Examination Survey (KNHANES). A total of 16,925 participants were included in this study. Breakfast frequency was classified as 0 times, 1−4 times, and 5−7 times per week. High insulin resistance was defined as a TyG index of ≥8.5. A multivariate logistic regression analysis was performed. ResultsCompared with the group whose breakfast frequency was 5–7 times per week, the odds ratio for high insulin resistance was 1.39 times (95% confidence interval (CI), 1.21−1.59) and 1.17 times (95% CI, 1.04–1.32) higher in the group whose breakfast frequency was 0 times and 1−4 times per week, respectively. ConclusionsThis study revealed that a lower frequency of breakfast consumption was significantly associated with a higher risk of insulin resistance in Korean adults with prediabetes. In the future, a large-scale prospective longitudinal study is required to establish the causal relationship between breakfast frequency and insulin resistance.