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COVID-19: Original Article
Changes in food sufficiency among Korean adults in urban and rural areas during the COVID-19 pandemic: an analysis of the 7th and 8th Korea National Health and Nutrition Examination Survey
Sarang Jeong, Jin-Young Jeong, Sohyun Park
Epidemiol Health. 2024;46:e2024045.   Published online April 16, 2024
DOI: https://doi.org/10.4178/epih.e2024045
  • 3,807 View
  • 119 Download
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Understanding changes in food sufficiency within various demographic groups during emergency situations, such as the global coronavirus disease 2019 (COVID-19) pandemic, is crucial in formulating public health policies for future preparedness. This study investigated potential differences between urban and rural residents in food sufficiency trends during the COVID-19 pandemic and examined how these changes varied according to socio-demographic factors.
METHODS
This cross-sectional study analyzed data from 19,724 adults aged 20 years and older, utilizing information from the 7th-8th Korea National Health and Nutrition Examination Survey (2018-2021).
RESULTS
In urban areas, across all subpopulations, food sufficiency improved significantly during the COVID-19 period relative to pre-pandemic levels (p<0.001). However, in rural regions, a significant increase in food sufficiency during the COVID-19 era was observed only among female, with an odds ratio of 1.42 (95% confidence interval, 1.06 to 1.89). Nevertheless, no significant interaction terms were found between region and various socio-demographic factors regarding changes in food sufficiency during the COVID-19 period.
CONCLUSIONS
During the COVID-19 pandemic, food sufficiency among urban residents improved compared to the pre-pandemic era, whereas their rural counterparts saw no such improvement. Additionally, no significant interaction was detected between urban versus rural areas and changes in food sufficiency during the COVID-19 period. These findings indicate the need for targeted food policies to prepare for potential future pandemics, particularly in rural areas, where food sufficiency did not improve.
Summary
Korean summary
- 본 연구는 COVID-19 팬데믹 동안 도시와 농촌 지역의 성인들 사이에서 식품 충분성의 변화를 조사하고, 이 변화를 사회인구학적 요인에 따라 분석하였다.
- 연구 결과, 코로나19 기간 동안 도시 지역의 다양한 인구통계학적 하위 그룹에서 식품 충분성이 크게 증가했으며, 농촌 지역에서는 여성들을 제외하고는 유의미한 변화가 나타나지 않았다.
- 본 연구는 향후 팬데믹 대비를 위한 식품 충분성 정책을 개발할 때 인구통계학적 요인과 지역적 차이를 고려하는 것이 중요하며, 특히 농촌 지역에서의 필요성을 강조한다.
Key Message
- This study examined changes in food sufficiency among adults in urban and rural areas during the COVID-19 pandemic, focusing on socio-demographic factors.
- Findings revealed that food sufficiency significantly increased in urban areas across various demographic subgroups during the COVID-19 period, while rural areas showed no significant overall change, except for an increase among women.
- The study highlights the importance of considering socio-demographic factors and regional differences, particularly the need for targeted food assistance programs in rural areas, for future pandemic preparedness.
Original Articles
Higher energy consumption in the evening is associated with increased odds of obesity and metabolic syndrome: findings from the 2016-2018 Korea National Health and Nutrition Examination Survey (7th KNHANES)
Sarang Jeong, Hajoung Lee, Sukyoung Jung, Jee Young Kim, Sohyun Park
Epidemiol Health. 2023;45:e2023087.   Published online September 19, 2023
DOI: https://doi.org/10.4178/epih.e2023087
  • 5,347 View
  • 186 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Chrono-nutrition emphasizes meal timing in preventing obesity and metabolic disorders. This study explores the impact of temporal dietary patterns (TDPs) on obesity and metabolic syndrome (MetS) in Korean adults aged 20 years to 65 years.
METHODS
We utilized dynamic time warping method and Kernel k-means clustering to investigate diet quality and the odds ratios (ORs) of obesity and MetS with different TDPs using data from the 7th Korea National Health and Nutrition Examination Survey.
RESULTS
Participants were divided into three groups based on relative energy intake over 24 hours. After adjusting for age and gender, Cluster 3 (with the highest proportion of energy intake in the evening) had the lowest Healthy Eating Index scores compared to other clusters. Following adjustment for key covariates, Cluster 3 showed the highest values for body mass index, waist circumference, blood pressure, total cholesterol, and triglycerides. Compared to Cluster 1 (with a lower proportion of energy intake in the evening), Cluster 2 and Cluster 3 had ORs for obesity of 1.12 (95% confidence interval [CI], 0.97 to 1.30) and 1.19 (95% CI, 1.03 to 1.37), respectively. For MetS, the ORs were 1.26 (95% CI, 1.08 to 1.48) and 1.37 (95% CI, 1.17 to 1.61) when comparing Cluster 2 and Cluster 3 to Cluster 1.
CONCLUSIONS
This study reveals that individuals with higher energy intake in the evening have increased odds of obesity and MetS, even after adjusting for major covariates, including age and total energy intake.
Summary
Korean summary
본 연구는 하루 중 주요 에너지 섭취 사간에 따른 인구사회학적 특징과 건강지표의 상관성을 분석하였다. 제 7기 국민건강영양조사의 20~65세의 한국 성인을 대상으로 Dynamic Time Warping 방법을 이용하여 군집을 나누어 분석한 결과, 하루 중 저녁시간에 에너지 섭취가 높은 그룹이 그렇지 않은 그룹에 비해 연령이 낮고, 흡연자, 음주자, 스트레스를 느끼는 대상자의 비율이 높았다. 또한, 저녁에 에너지 섭취 비율이 높은 그룹이 그렇지 않은 그룹에 비해 체질량지수, 허리둘레, 혈압, 총 콜레스테롤, 중성지방이 높았으며, 식생활 평가 지수가 가장 낮았다. 마지막으로 하루 섭취하는 총 에너지 양과 생활습관 변수를 보정하고도 저녁에 섭취하는 에너지가 많은 그룹은 그렇지 않은 그룹에 비해 비만 및 대사 증후군 유병이 더 높은 것으로 나타났다.
Key Message
• This study examined the relationship between sociodemographic characteristics and health indicators based on the timing of major energy intake during the day. • Using the Dynamic Time Warping method, the analysis revealed that the group with higher evening energy intake was younger and had a higher proportion of smokers, alcohol consumers, and individuals experiencing stress. • Additionally, the group with higher evening energy intake exhibited higher levels of obesity and metabolic syndrome, even after adjusting for total daily energy intake and lifestyle variables.

Citations

Citations to this article as recorded by  
  • Association of Dietary Fiber and Measures of Physical Fitness with High-Sensitivity C-Reactive Protein
    Ming-Zhen Su, Suyeon Lee, Dayeon Shin
    Nutrients.2024; 16(6): 888.     CrossRef
  • Advances in Gut Microbiota-Targeted Therapeutics for Metabolic Syndrome
    Yu Gao, Wujuan Li, Xiaoyu Huang, Yuhong Lyu, Changwu Yue
    Microorganisms.2024; 12(5): 851.     CrossRef
  • Dietary calcium intake in relation to metabolic syndrome in adults: A systematic review and dose–response meta‐analysis of epidemiological studies with GRADE assessment
    Roxana Nematbakhsh, Parisa Rouhani, Parvane Saneei
    Obesity Reviews.2024;[Epub]     CrossRef
Food literacy and its relationship with food intake: a comparison between adults and older adults using 2021 Seoul Food Survey data
Seulgi Lee, Sohyun Park, Kirang Kim
Epidemiol Health. 2023;45:e2023062.   Published online July 3, 2023
DOI: https://doi.org/10.4178/epih.e2023062
  • 6,163 View
  • 160 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study was conducted to examine the differences in food literacy between adults and older adults and the association of food literacy with food group intake.
METHODS
In total, 4,039 participants from the 2021 Survey for Food Consumption in Seoul were included in this study. The intake of whole grains, high-protein foods, total vegetables, vegetables excluding kimchi and pickles, fresh fruits, and milk and dairy products was assessed using a simple food frequency questionnaire. Food literacy was measured using a food literacy measurement questionnaire.
RESULTS
With the exception of milk and dairy, adults had a significantly higher proportion of insufficient food intake than older adults (p<0.001). Both adults and older adults with sufficient food group consumption had higher food literacy scores. Notably, the difference in food literacy scores by level of food intake was highest for fresh fruits (p<0.001). After adjusting for confounding factors affecting food literacy scores, a higher score was associated with a lower probability of having insufficient food intake in all food groups for both adults and older adults. Specifically, those in the highest food literacy score quartile were less likely to have insufficient intake of vegetables (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.28 to 0.43) and fresh fruits (OR, 0.32; 95% CI, 0.24 to 0.43), compared to the lowest quartile.
CONCLUSIONS
Improving food literacy is an important factor for promoting healthy food intake in older adults as well as adults. Therefore, it is necessary to develop intervention programs to work toward this goal.
Summary
Korean summary
건강정보 이해능력(health literacy)은 노인에서 만성질환이나 인지능력과의 관련성이 보고되고 있으나 영양정보 이해능력(food literacy)에 대한 연구는 미비하다. 급변하는 식이 환경에서 식사 및 영양과 관련된 정보를 올바르게 이해하고 판단할 수 있는 영양정보 이해능력은 노인성 질환 예방에 중요하다. 본 연구에서 영양정보 이해능력과 식품군 섭취와의 상관성을 분석한 결과 영양정보 이해능력이 높은 노인이 건강한 식품 섭취 부족 위험이 낮았다. 특히 과일 섭취 부족 위험은 영양정보 이해능력이 높은 노인에서 뚜렷하게 낮았다. 국내 영양정보 이해능력 연구는 초기 단계로 주로 성인 대상으로 연구가 이루어져서 본 연구에서의 결과는 그 의의가 크며, 영양정보 이해능력 향상은 성인과 마찬가지로 노인에서도 건강한 식품 섭취를 위한 중요한 요인으로서 이를 위한 프로그램 개발이 필요할 것으로 사료된다.
Key Message
The study on food literacy among older adults in Korea is significant as previous research has mostly focused on adults. The results showed that older adults with higher food literacy score had lower risk of insufficient food intake as compared with those with lower food literacy score. Specifically, the risk of insufficient fresh fruits intake was the lowest among older adults with higher food literacy score. Therefore, improving food literacy is an important factor for promoting healthy food consumption among older adults.

Citations

Citations to this article as recorded by  
  • Self-perceived food literacy in relation to the quality of overall diet and main meals: A cross-sectional study in Japanese adults
    Kentaro Murakami, Nana Shinozaki, Tsuyoshi Okuhara, Tracy A. McCaffrey, M. Barbara E. Livingstone
    Appetite.2024; 196: 107281.     CrossRef
  • Status of Food Literacy and Association with the Nutrition Quotient among Korean Adults
    Geum-Bi Ryu, Young-Ran Heo
    Human Ecology Research.2024; 62(3): 399.     CrossRef
Regional differences in the associations of diet quality, obesity, and possible sarcopenia using the seventh Korea National Health and Nutrition Examination Survey (2016-2018)
Hyeongyeong Lee, Sohyun Park
Epidemiol Health. 2023;45:e2023059.   Published online June 19, 2023
DOI: https://doi.org/10.4178/epih.e2023059
  • 6,820 View
  • 150 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Sarcopenic obesity is closely related to aging and the prevalence of various chronic diseases and frailty. The purpose of this study was to analyze whether diet quality is related to obesity, sarcopenia, and sarcopenic obesity, and if so, to explore the difference in that relationship between urban and rural settings.
METHODS
Using data from the Korea National Health and Nutrition Examination Survey of 2016-2018, a total of 7,151 participants aged 40 years or older were analyzed. Sarcopenia was diagnosed using handgrip strength. Diet quality was assessed using Korea Healthy Eating Index (KHEI) scores, and obesity was determined based on participants’ abdominal circumference. Multinomial logistic analysis was used for testing statistical significance.
RESULTS
Rural participants had significantly lower KHEI scores and a higher prevalence of sarcopenic obesity than urban participants. The study findings demonstrate that participants without obesity, sarcopenia, or sarcopenic obesity had significantly higher KHEI scores in both rural and urban settings. Multinomial regression analysis further revealed that a higher KHEI score was associated with a lower risk of sarcopenia and sarcopenic obesity among urban residents, while only the risk of obesity was lower with higher diet quality scores among rural residents.
CONCLUSIONS
Since diet quality and health status were lower in rural areas, it is important to address this regional disparity with appropriate policy measures. To mitigate urban health disparities, urban residents in poor health with few resources should also be supported.
Summary

Citations

Citations to this article as recorded by  
  • Association of Dietary Protein Sources and Their Adequacy, Body Composition and Risk of Sarcopenic Obesity in South Korean Populations: A Cross-Sectional Study
    Jieun Kim, Kyoungsik Jeong, Sueun Lim, Siwoo Lee, Younghwa Baek
    Metabolites.2024; 14(2): 130.     CrossRef
  • Association of Combining Diet and Physical Activity on Sarcopenia and Obesity in Elderly Koreans with Diabetes
    Sohye Kim, Soojeong Kim, Kyung Hee Hong
    Nutrients.2024; 16(7): 964.     CrossRef
  • Longitudinal association between soft drink consumption and handgrip strength in adults: a prospective analysis from the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) cohort study
    Tongfeng Liu, Shengxin Quan, Ge Meng, Hongmei Wu, Yeqing Gu, Shunming Zhang, Xuena Wang, Juanjuan Zhang, Qing Zhang, Li Liu, Shaomei Sun, Xing Wang, Ming Zhou, Qiyu Jia, Kun Song, Zhongze Fang, Kaijun Niu
    British Journal of Nutrition.2024; 131(12): 1997.     CrossRef
  • Sex-Specific Effects of Dietary Factors on Sarcopenic Obesity in Korean Elderly: A Nationwide Cross-Sectional Study
    Soojeong Kim, Kyung Hee Hong
    Nutrients.2024; 16(8): 1175.     CrossRef
Positive association of unhealthy plant-based diets with the incidence of abdominal obesity in Korea: a comparison of baseline, most recent, and cumulative average diets
Sukyoung Jung, Sohyun Park
Epidemiol Health. 2022;44:e2022063.   Published online August 2, 2022
DOI: https://doi.org/10.4178/epih.e2022063
  • 8,487 View
  • 279 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Different approaches for analyzing repeated dietary measurements may yield differences in the magnitude and interpretation of findings. We aimed to compare 3 dietary measurements (baseline, most recent, and cumulative average) in terms of the association between plant-based diet indices (PDIs) and incident abdominal obesity in Korean adults aged 40-69 years.
METHODS
This study included 6,054 participants (54% women) free of abdominal obesity (defined as waist circumference ≥90 cm for men and ≥85 cm for women) at baseline. As exposures, baseline, most recent, and cumulative average measurements for PDI, healthy-PDI (hPDI), and unhealthy-PDI (uPDI) were created. A Cox proportional-hazard model was used to estimate the hazard ratios (HRs) for abdominal obesity.
RESULTS
During 45,818 person-years of follow-up (median, 9 years), we identified 1,778 incident cases of abdominal obesity. In the multivariable-adjusted analysis, a higher uPDI was associated with a higher risk of abdominal obesity in both total and stratified analyses. The findings were consistent across all approaches (Q5 vs. Q1: HRbaseline=1.70; 95% confidence interval [CI], 1.46 to 1.98; HRmost recent=1.52; 95% CI, 1.30 to 1.78; HRcumulative average=1.76; 95% CI, 1.51 to 2.06 in the total set). PDI showed no meaningful association with abdominal obesity risk in any analyses. hPDIaverage had a suggestive inverse association with abdominal obesity risk in men, and hPDIbaseline had a positive association with abdominal obesity risk in women.
CONCLUSIONS
Greater adherence to unhealthy plant-based diets may increase the risk of developing abdominal obesity in Korean adults. The findings were generally consistent across all approaches.
Summary
Korean summary
본 연구는 한국인 유전체역학조사사업의 안성안산코호트 조사에 참여한 40-69세 한국 성인 6,054명을 대상으로 식물성 기반의 식이 지수와 복부비만 간 연관성이 식이 노출 기간(기반, 최근, 누적 노출)에 따라 어떻게 다른지 비교 분석하였다. 건강하지 않은 식물성 기반의 식이 지수 점수가 높을수록 복부비만 발생 위험이 증가하였고, 식이 노출 기간에 관계없이 일관된 결과를 보였다. 식물성 기반의 식이가 반드시 건강에 유익한 것은 아니며, 정제된 곡물, 탄산음료, 사탕 등 간식류를 많이 먹는 식이 패턴은 식물성 기반 식이라 할지라도 복부비만 위험을 증가시킬 수 있으므로 주의가 필요하다.
Key Message
Unhealthy plant-based diets, including refined grains, sugar-sweetened beverages, sweets and desserts, and salty plant foods, can have a negative effect on abdominal obesity in Korean adults regardless of its exposure duration.

Citations

Citations to this article as recorded by  
  • Plant-based diets and the gut microbiome: findings from the Baltimore Longitudinal Study of Aging
    Xinyi Shen, Curtis Tilves, Hyunju Kim, Toshiko Tanaka, Adam P Spira, Chee W Chia, Sameera A. Talegawkar, Luigi Ferrucci, Noel T Mueller
    The American Journal of Clinical Nutrition.2024; 119(3): 628.     CrossRef
  • Association Between Plant-Based Diets and Risk of Metabolic Dysfunction-Associated Steatotic Liver Disease in Korean Adults: A Prospective Cohort Study
    Bayarmaa Nasan Ulzii, Kyungjoon Lim, Sangah Shin
    Nutrition.2024; : 112579.     CrossRef
  • Scoping review of the association of plant-based diet quality with health outcomes
    Richard M. Rosenfeld, Hailey M. Juszczak, Michele A. Wong
    Frontiers in Nutrition.2023;[Epub]     CrossRef
Trend of the Anthropometric Indices Among Adolescents in a Urban and a Rural Area Over the Period 1996~2005.
SoHyun Park, Minjung Ko, Shin Ah Kim, Mi Kyung Kim, Soo Hun Cho, Bo Youl Choi
Korean J Epidemiol. 2006;28(2):189-198.
  • 65,535 View
  • 22 Download
AbstractAbstract PDF
Abstract
This study investigated the secular trend of anthropometric parameters of 2,153 high school students in one urban and one rural area in Korea. The cross-sectional data was collected in 1996 and 2005 in Seoul and Gyung-gi province. As a result, the height of boys has increased by 2cm, whereas the weight has increased by 6.3kg from 1996 to 2005. By contrast, those parameters, including height or weight, did not change in girls. The prevalence of obesity has been more than doubled from 9.3% in 1996 to 20.5% in 2005 in boys; while that of girls was almost same for the same period (1998, 11.1%; 2005, 11.4%). In particular, the greater increase of obesity among boys was found in urban, which implicates the importance of environmental factor in determining weight gains among adolescents. This result emphasizes that the tailored intervention is strongly warranted, in particular among boys residing in urban area.
Summary

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