Epidemiology and Health

Original Articles

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

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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

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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

The association of dietary patterns with incident chronic kidney disease and kidney function decline among middle-aged Korean adults: a cohort study: Jialei Fu, Sangah Shin; Epidemiol Health. 2023;45:e2023037. Published online March 21, 2023; DOI: https://doi.org/10.4178/epih.e2023037

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study assessed the association of dietary patterns with the incidence of chronic kidney disease (CKD) and kidney function decline among Korean adults.
METHODS
Data were collected from the records of 20,147 men and 39,857 women who participated in the Health Examinees study. Principal component analysis was used to identify 3 dietary patterns (prudent, flour-based food and meat, and white rice-based), and CKD risk was defined using the Epidemiology Collaboration equation for estimated glomerular filtration rate: (eGFR) <60 mL/min/1.73 m2. A kidney function decline was defined as a >25% decrease in eGFR from baseline.
RESULTS
During the 4.2-year follow-up, 978 participants developed CKD and 971 had a 25% decline in kidney function. After adjusting for potential impact variables, compared with the lowest quartile of the prudent dietary pattern, participants in the highest quartile had a 37% lower risk of kidney function decline among men (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.47 to 0.85); while higher adherence to the flour-based food and meat dietary pattern was associated with an increased risk of CKD in both men (HR, 1.63; 95% CI, 1.22 to 2.19) and women (HR, 1.47; 95% CI, 1.05 to 2.05) as well as a decline in kidney function in both men (HR, 1.49; 95% CI, 1.07 to 2.07) and women (HR, 1.77; 95% CI, 1.33 to 2.35).
CONCLUSIONS
Although a higher adherence to the prudent dietary pattern was inversely associated with the risk of kidney function decline in men, there was no association with CKD risk. In addition, a higher adherence to the flour-based food and meat dietary pattern increased the risk of CKD and kidney function decline. Further clinical trials are needed to confirm these associations.; Summary

Korean summary
건강한 식이패턴(prudent dietary pattern)은 한국 남성의 신장기능 저하 위험을 감소와 관련성이 있었다. 반면, 밀가루 음식과 육류 위주의 식이패턴(Flour-based food and meat dietary pattern)은 남성과 여성 모두에서 신장 기능 저하 위험뿐만 아니라, 만성신장질환(CKD) 위험의 증가와 관련이 있었다. 본 연구의 결과는 한국 성인에서 식사패턴이 신장 기능 및 만성 신장 질환의 발생에 미치는 영향을 확인하였다.

Key Message
1. Better adherence to the prudent dietary pattern may lower the risk of kidney function decline in Korean man. 2. A higher adherence to the flour-based food and meat dietary pattern may higher the risk of chronic kidney disease and kidney function decline.

Multimorbidity patterns by health-related quality of life status in older adults: an association rules and network analysis utilizing the Korea National Health and Nutrition Examination Survey: Thi-Ngoc Tran, Sanghee Lee, Chang-Mo Oh, Hyunsoon Cho; Epidemiol Health. 2022;44:e2022113. Published online November 29, 2022; DOI: https://doi.org/10.4178/epih.e2022113

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Improved life expectancy has increased the prevalence of older adults living with multimorbidity which likely deteriorates their health-related quality of life (HRQoL). However, relatively little is known about patterns and the relationships of multimorbidity by HRQoL status in older adults.

METHODS

Individuals aged 65 or older from the Korea National Health and Nutrition Examination Survey V-VII (2010-2018) were analyzed. HRQoL was assessed by the EuroQoL-5 dimensions questionnaire and categorized as poor, normal, or good. The impact of multimorbidity on HRQoL was evaluated using logistic regression. The patterns and inter-relationships between multimorbidity, stratified by HRQoL groups, were analyzed using the association rules and network analysis approach.

RESULTS

Multimorbidity was significantly associated with poor HRQoL (3 or more diseases vs. none; adjusted odds ratio, 2.70; 95% confidence interval, 2.10 to 3.46). Hypertension, arthritis, hyperlipidemia, and diabetes were the most prevalent diseases across all HRQoL groups. Complex interrelationships of morbidities, higher prevalence, and node strengths in all diseases were observed in the poor HRQoL group, particularly for arthritis, depression, and stroke, compared to other groups (1.5-3.0 times higher, p<0.05 for all). Apart from hypertension, arthritis and hyperlipidemia had a higher prevalence and stronger connections with other diseases in females, whereas this was the case for diabetes and stroke in males with poor HRQoL.

CONCLUSIONS

Multimorbidity patterns formed complicatedly inter-correlated disease networks in the poor HRQoL group with differences according to sex. These findings enhance the understanding of multimorbidity connections and provide information on the healthcare needs of older adults, especially those with poor HRQoL.

Summary

Korean summary
기대 수명의 증가에 따라 고령인구에서 건강관련 삶의 질을 저하시킬 수 있는 복합질환의 유병률도 함께 증가하고 있다. 본 연구에서는 국민건강영양조사 자료를 이용하여 65세 이상 우리나라 고령인구에서 건강관련 삶의 질 (HRQoL)에 따른 복합만성질환 패턴을 분석하였다. 복합만성질환은 건강관련 삶의 질 저하와 통계적으로 유의하게 연관되어 있으며, 연관성 및 네크워크 분석 결과 건강관련 삶의 질이 낮을수록 복합질환의 패턴이 복잡한 것으로 나타났다. 전체적으로 고혈압, 관절염, 고지혈증, 당뇨병이 가장 높은 발생률을 보였다. 건강관련 삶의 질이 낮은 그룹에서는 관절염, 우울증, 뇌졸중 등의 질병이 높은 발생률과 상호관련성을 보였으며, 이는 성별에 따라 차이가 있었다. 연구 결과는 고령자, 특히 건강관련 삶의 질이 낮은 노인의 의료 서비스 요구에 대해 정보를 제공해 줄 수 있을 것이다,

Key Message
Network analysis of older adults (65 or older) in Korea showed that hypertension, arthritis, hyperlipidemia, and diabetes were the most common multimorbidity regardless of HRQoL status. However, as HRQoL deteriorated, multimorbidity patterns formed complicatedly inter-correlated disease networks; the prevalence and the node strength of arthritis, depression, and stroke increased considerably and be diversified by sex.

Citations

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Chronic Disease Patterns and Their Relationship With Health-Related Quality of Life in South Korean Older Adults With the 2021 Korean National Health and Nutrition Examination Survey: Latent Class Analysis
Mi-Sun Lee, Hooyeon Lee
JMIR Public Health and Surveillance.2024; 10: e49433. CrossRef
Health-promoting behavior to enhance perceived meaning and control of life in chronic disease patients with role limitations and depressive symptoms: a network approach
Je-Yeon Yun, Young Ho Yun
Scientific Reports.2023;[Epub] CrossRef

The association between fruit and vegetable consumption and metabolic syndrome in Korean adults: does multivitamin use matter?: Jihae Kim, Li-Juan Tan, Hyein Jung, Yumi Roh, Kyungjoon Lim, Sangah Shin; Epidemiol Health. 2022;44:e2022039. Published online April 19, 2022; DOI: https://doi.org/10.4178/epih.e2022039

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Metabolic syndrome (MetS) is closely associated with dietary intake; however, few studies have investigated whether the consumption of fruits and vegetables and multivitamin use affect MetS in the Korean population. This study aimed to examine these effects in Korean adults.

METHODS

This was a cross-sectional study of 89,548 participants aged between 40 years and 69 years selected from the baseline data of the Health Examinees study conducted in Korea. Fresh vegetable and fruit consumption was assessed using a validated 106-item food frequency questionnaire. MetS and its components were defined using the National Cholesterol Education Program, Adult Treatment Panel III criteria. Multivariate logistic regression analyses were conducted to identify associations of fresh vegetable, fruit, and fresh vegetable+fruit consumption and multivitamin use with the prevalence of MetS.

RESULTS

Female in the highest quartile of fresh vegetable, fruit, and fresh vegetable + fruit consumption exhibited a lower prevalence of MetS than those in the lowest quartile. An inverse association with the prevalence of MetS was observed among male with only fresh vegetable consumption. The interaction between the 3 categories and multivitamin intake on the prevalence of MetS was not significant (all pinteraction>0.05), regardless of sex.

CONCLUSIONS

Multivitamin use and consumption of fresh vegetables and fruits had no significant synergistic effects. Although fresh vegetable and fruit consumption showed an inverse association with the prevalence of MetS, this relationship was not altered by multivitamin use.

Summary

Korean summary
본 연구는 한국인 유전체역학조사사업의 도시코호트 조사에 참여한 40-69세 한국 성인 89 548명의 과일과 채소의 섭취와 종합비타민 섭취가 대사증후군에 미치는 영향을 분석하였다. 본 연구에서는 매일 다양한 과일과 채소를 섭취하면, 종합비타민의 섭취와 상관없이 대사증후군 유병 위험도를 낮추는 것을 확인하였다. 따라서, 대사증후군 예방을 위해서는 일상적인 식사에서 충분한 과일과 채소를 섭취하는 것이 권장된다.

Key Message
This study aimed to examine whether the consumption of fruits and vegetables and multivitamin use affect MetS among Korean middle-aged adults. Data was from the Health Examinees Study among 89 548 subjects. Results suggested that fruits and vegetables consumption was related with a decreased prevalence of MetS. However, there was no significant synergistic effect between the consumption of fruits and vegetables and multivitamin use in further reducing MetS prevalence.

Citations

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Association of serum water-soluble vitamin exposures with the risk of metabolic syndrome: results from NHANES 2003-2006
Xun Pei, Junjie Yao, Simiao Ran, Haifei Lu, Shuo Yang, Yini Zhang, Miyuan Wang, Heyuan Shi, Aihua Tan
Frontiers in Endocrinology.2023;[Epub] CrossRef

Association between levels of physical activity and low handgrip strength: Korea National Health and Nutrition Examination Survey 2014-2019: Hyungsoon Ahn, Hwa Young Choi, Moran Ki; Epidemiol Health. 2022;44:e2022027. Published online February 21, 2022; DOI: https://doi.org/10.4178/epih.e2022027

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aimed to investigate the association between levels of physical activity (PA) and low handgrip strength in Korean adults.

METHODS

Our cross-sectional study design included 24,109 Korean adults older than 19 years of age who participated in the Korea National Health and Nutrition Examination Survey 2014–2019. Low handgrip strength is described as hand strength less than the cut-off value of the 20th percentile of handgrip strength from a healthy population in each gender and age group. PA was categorized into three levels (inactive, active, and highly active) according to the World Health Organization’s global recommendations on PA for health. Multivariable logistic regression analysis was used to examine the association between levels of PA and low handgrip strength.

RESULTS

Odds ratios (ORs) for low handgrip strength were significantly higher in middle-aged women who were active (adjusted odds ratio [aOR], 1.40; 95% confidence interval [CI], 1.15 to 1.69) and inactive (aOR, 1.47; 95% CI, 1.23 to 1.76) than in those highly active in walking exercise. Most of older people had significantly higher ORs for low handgrip strength in active compared to highly active in the context of aerobic, muscle strengthening, and walking exercise.

CONCLUSIONS

Walking exercise was associated with a lower risk of sarcopenia in middle-aged women and older individuals. However, further studies are necessary to confirm the causal relationship between levels of PA and low handgrip strength.

Summary

Korean summary
본 연구는 국민건강영양조사 2014-2019년도 자료를 활용하여 한국인 만 19세 이상 건강한 성인을 대상으로 낮은 악력의 기준값을 성별 및 연령그룹별로 도출하고 유산소 운동, 근력 운동, 걷기 운동 수준과 낮은 악력의 연관성을 분석하였다. 분석 결과, 중년 여성과 노년층에서 걷기 운동이 근감소증 발생의 예방과 연관성이 있음을 알 수 있었다.

Key Message
The association between levels of physical activity and low handgrip strength was different by sex and age groups. For women, walking exercise was associated with low handgrip strength, but not for men. By age groups, muscle strengthening exercise could help prevent sarcopenia in the young population, aerobic exercise has the potential to prevent sarcopenia in middle-aged individuals, and walking exercise could reduce sarcopenia risk in older individuals.

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Examining factors contributing to the socioeconomic inequalities in handgrip strength among older adults in India: a decomposition analysis
Manacy Pai, T. Muhammad
Scientific Reports.2024;[Epub] CrossRef
Relationship between Handgrip Strength and Incident Diabetes in Korean Adults According to Gender: A Population-Based Prospective Cohort Study
Sung-Bum Lee, Min-Kyeung Jo, Ji-Eun Moon, Hui-Jeong Lee, Jong-Koo Kim
Journal of Clinical Medicine.2024; 13(2): 627. CrossRef
Association Between Dietary Fiber Intake and Low Muscle Strength Among Korean Adults
Sunhye Shin
Clinical Nutrition Research.2024; 13(1): 33. CrossRef
Association between composite dietary antioxidant index and handgrip strength in American adults: Data from National Health and Nutrition Examination Survey (NHANES, 2011-2014)
Dongzhe Wu, Hao Wang, Wendi Wang, Chang Qing, Weiqiang Zhang, Xiaolin Gao, Yongjin Shi, Yanbin Li, Zicheng Zheng
Frontiers in Nutrition.2023;[Epub] CrossRef
Assessment of dynapenia and undernutrition in primary care, a systematic screening study in community medicine
Marie Treuil, Meliha Mahmutovic, Paolo Di Patrizio, Phi-Linh Nguyen-Thi, Didier Quilliot
Clinical Nutrition ESPEN.2023; 57: 561. CrossRef
Water Intake and Handgrip Strength in US Adults: A Cross-Sectional Study Based on NHANES 2011–2014 Data
Dongzhe Wu, Chaoyi Qu, Peng Huang, Xue Geng, Jianhong Zhang, Yulin Shen, Zhijian Rao, Jiexiu Zhao
Nutrients.2023; 15(20): 4477. CrossRef
Hand Grip Strength, Osteoporosis, and Quality of Life in Middle-Aged and Older Adults
Hyo Jin Park, Byoungduck Han, So-youn Chang, Seung Ho Kang, Dae Wook Lee, Seok Kang
Medicina.2023; 59(12): 2148. CrossRef
Lower grip strength and insufficient physical activity can increase depressive symptoms among middle-aged and older European adults: a longitudinal study
Han Zheng, Qingwen He, Hongyan Xu, Xiaowei Zheng, Yanfang Gu
BMC Geriatrics.2022;[Epub] CrossRef

Secular trends and related factors in leisure-time sedentary behavior among Koreans: an analysis of data from the 2011-2017 Korea Community Health Survey: Hyun-Ju Seo, Min-Jung Choi, Soon-Ki Ahn; Epidemiol Health. 2022;44:e2022023. Published online February 14, 2022; DOI: https://doi.org/10.4178/epih.e2022023

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Abstract Summary PDF

Abstract

OBJECTIVES
Sedentary behavior has gradually increased and has become a public health problem. Therefore, this study investigated trends in weekday leisure-time sedentary behaviors, as well as characteristic socio-demographic and lifestyle correlates in Korean adults.

METHODS

We analyzed data from 914,946 adults aged ≥19 years who participated in the Korea Community Health Survey (2011, 2013, 2015, and 2017). Leisure-time sedentary behavior was categorized as a binary variable (<4 and ≥4 hr/day). Multivariable regression analysis was used to model the prevalence of sedentary behavior and estimate odds ratios.

RESULTS

The prevalence of leisure-time sedentary behavior decreased from 15.2% to 14.4% in men and from 16.6% to 16.0% in women between 2011 and 2017, respectively. However, a significant increase was observed in subjects with an education lower than high school in both genders (β coefficient=0.12 for men and 0.08 for women, p for trend <0.001). Women in the lowest household income level (β coefficient=0.08, p for trend=0.001) and with poor subjective health status (β coefficient=0.05, p for trend=0.013) showed an increasing trend. Other factors associated with sedentary behavior were age, education level, body mass index, household income, walking activity, perceived stress level, and subjective health status in both genders.

CONCLUSIONS

Identifying the secular trends and correlates of sedentary behavior by gender and associated factors will provide empirical evidence for developing public health campaigns and promotion programs to reduce sedentary behavior in Koreans.

Summary

Korean summary
본 연구는 지역사회건강조사에서 2011년부터 2017년까지 격년으로 수집된 성인의 좌식행동에 대한 시간적 추세와 관련 요인에 대해 분석한 시계열 단면연구이다. 분석결과, 주중 여가시간에 4시간 이상 앉아 있는 경우는 남성의 경우 15.2%에서 14.4%로, 여성의 경우 16.6%에서 16.0%로 감소되었다. 그러나, 남녀 모두에서 노인인 경우, 중졸 이하의 학력을 가진 경우, 소득수준이 월 100만원 미만인 경우, 주관적 건강상태가 부정적인 경우 좌식행동이 증가하였다. 따라서, 본 연구에서 나타난 좌식행동 관련 요인을 가진 대상자를 목표집단으로 한 건강증진 및 공중보건 캠페인이 개발 및 실행될 필요가 있다.

Key Message
This study is a serial cross-sectional study analyzing the temporal trend and related factors of sedentary behavior of adults using KCHS collected biennially from 2011 to 2017. The prevalence of leisure-time sedentary behavior decreased from 15.2% to 14.4% in men and from 16.6% to 16.0% in women, respectively. However, elderly, subjects with an education lower than high school, with the lowest household income level, and with poor subjective health status showed an increasing sedentary behavior trend. These findings suggest that health promotion and public health campaigns are need to reduce the prevalence of sedentary behavior in population with related factors.

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Association between long working hours and physical inactivity in middle-aged and older adults: a Korean longitudinal study (2006–2020)
Seong-Uk Baek, Won-Tae Lee, Min-Seok Kim, Myeong-Hun Lim, Jin-Ha Yoon, Jong-Uk Won
Journal of Epidemiology and Community Health.2023; 77(6): 355. CrossRef

Dairy product consumption and type 2 diabetes among Korean adults: a prospective cohort study based on the Health Examinees (HEXA) study: Jiaqi Zhang, Kyungjoon Lim, Sangah Shin; Epidemiol Health. 2022;44:e2022019. Published online February 4, 2022; DOI: https://doi.org/10.4178/epih.e2022019

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Abstract

OBJECTIVES
It has been suggested that the consumption of dairy products helps lower the prevalence of type 2 diabetes (T2D). We investigated the association between the consumption of dairy products and T2D events in middle-aged Korean adults.

METHODS

We followed up 53,288 participants (16,895 male and 36,393 female) in the Health Examinees (HEXA) study. The consumption of dairy products was assessed using the self-administered food frequency questionnaire, and T2D was defined according to the 2015 treatment guidelines of the Korean Diabetes Association. Hazard ratios (HRs) and 95% confidence intervals (CIs) between the consumption of dairy products and the risk of T2D were calculated using Cox proportional hazards models after adjusting for potential confounders. Spline regression was used to better represent the association between the consumption of dairy products and the risk of T2D.

RESULTS

Among male, those with higher consumption of dairy products had a significantly lower risk of T2D than those who consumed essentially no dairy products (HR, 0.73; 95% CI, 0.58 to 0.91). In particular, consumption of yogurt (HR, 0.75; 95% CI, 0.60 to 0.93; ptrend=0.035) and cheese (HR, 0.66; 95% CI, 0.49 to 0.89; ptrend=0.005) was negatively associated with the incidence of T2D in male. In female, daily consumption of 1 serving of yogurt decreased the risk of T2D by 11%.

CONCLUSIONS

The association between the consumption of dairy products and the risk of T2D differed by sex and dairy product type. Further prospective studies are needed to confirm these associations.

Summary

Korean summary
본 연구는 한국인유전체역학조사사업의 도시코호트 기반조사와 추적조사에 참여한 40-69세 한국 성인 53 288명의 유제품 섭취와 제2형 당뇨병 발생 위험도를 분석하였다. 요거트와 치즈를 포함한 유제품 섭취가 많을수록 남성의 제2형 당뇨병 위험도가 낮아졌다. 요거트 섭취량을 하루에 한번 증가하면 여성의 제2형 당뇨병 위험도가 감소하다. 유제품 소비와 제2형 당뇨병의 위험도의 연관성은 성별과 유제품에 따라 다르다. 이를 확인하기 위해서는 추가 연구가 필요하다.

Key Message
The study aimed to assess the association between the consumption of dairy products and type 2 diabetes events in Korean adults. Data was from the Health Examinees Study among 53 288 participants. Higher consumption of dairy products including yogurt and cheese was associated with a lower risk of developing type 2 diabetes in men. Increasing yogurt intake by one serving/day reduces the risk of type 2 diabetes in women. The association between the consumption of dairy products and the risk of type 2 diabetes differed by gender and dairy product type. Further studies are needed to confirm this.

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Cheese consumption and multiple health outcomes: an umbrella review and updated meta-analysis of prospective studies
Mingjie Zhang, Xiaocong Dong, Zihui Huang, Xue Li, Yue Zhao, Yingyao Wang, Huilian Zhu, Aiping Fang, Edward L. Giovannucci
Advances in Nutrition.2023; 14(5): 1170. CrossRef
Effect of Milk and Cultured Milk Products on Type 2 Diabetes: A Global Systematic Review and Meta-analysis of Prospective Cohort Studies
Viswanathan Mohan, Kuzhandhaivelu Abirami, Valangaiman Sriram Manasa, Anandakumar Amutha, Balaji Bhavadharini, Rinky Rajput, Nagarajan Lakshmipriya, Chowdary Sruthi, Ranjit Mohan Anjana, Ranjit Unnikrishnan, Vasudevan Sudha, Kamala Krishnaswamy
Journal of the Indian Institute of Science.2023; 103(1): 167. CrossRef
Probiotic potential of fermented foods and their role in non-communicable diseases management: An understanding through recent clinical evidences
A. Nithya, Sourav Misra, Chirasmita Panigrahi, Chandrakant Genu Dalbhagat, Hari Niwas Mishra
Food Chemistry Advances.2023; 3: 100381. CrossRef
Dairy intake and risk of type 2 diabetes: results of a large prospective cohort
Shunming Zhang, Ge Meng, Qing Zhang, Li Liu, Hongmei Wu, Yeqing Gu, Xuena Wang, Juanjuan Zhang, Shaomei Sun, Xing Wang, Ming Zhou, Qiyu Jia, Kun Song, Yan Borné, Emily Sonestedt, Le Ma, Lu Qi, Kaijun Niu
Food & Function.2023; 14(21): 9695. CrossRef
Association of milk consumption with management and incidence of hypertension among South Korean adults: A prospective analysis of the health examinees study cohort
Hyein Jung, Geongu Lee, Kyungjoon Lim, Sangah Shin
Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(11): 2515. CrossRef
Association between dairy consumption and the risk of diabetes: A prospective cohort study from the China Health and Nutrition Survey
Yucheng Yang, Xiaona Na, Yuandi Xi, Menglu Xi, Haibing Yang, Zhihui Li, Ai Zhao
Frontiers in Nutrition.2022;[Epub] CrossRef
Association of dairy consumption patterns with the incidence of type 2 diabetes: Findings from Alberta's Tomorrow Project
Emad Yuzbashian, Mohammadreza Pakseresht, Jennifer Vena, Catherine B. Chan
Nutrition, Metabolism and Cardiovascular Diseases.2022; 32(12): 2760. CrossRef

Associations of physical activity at work and household income with obesity: a cross-sectional study among rural adults in Korea: Su Yeon Kye, Heeyoun Cho, Tran Thi Phuong Thao, Jin-Kyoung Oh, Min Kyung Lim; Epidemiol Health. 2021;43:e2021003. Published online December 29, 2020; DOI: https://doi.org/10.4178/epih.e2021003

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Abstract Summary PDF

Abstract

OBJECTIVES
This study was performed to identify the effect of physical activity at work on obesity and to analyze the contribution of socioeconomic factors and health behaviors to this association, which has been relatively little studied.

METHODS

From the Korean National Cancer Center Community Cohort, a total of 5,587 adults (2,125 men; 3,462 women) aged more than 30 years living in rural areas were enrolled. Information on socio-demographic factors, health behaviors, and body mass index was gathered using face-to-face interviews and measurements of height and weight.

RESULTS

Inverse associations were identified between vigorous-intensity physical activity at work and obesity in both men and women, while no association was found between vigorous-intensity physical activity during leisure time and obesity. High household income was independently associated with a lower risk of obesity among those who had low levels of vigorous-intensity physical activity at work. Vigorous physical activity at work showed an inverse association with obesity in rural areas where heavy manual labor is common.

CONCLUSIONS

Our findings indicate the necessity to account for various types of physical activity to improve the assessment and prevention of obesity.

Summary

Korean summary
신체활동의 종류에 따라 비만에 미치는 영향의 차이가 있는지를 보기 위하여 육체 노동이 많은 농촌지역 성인을 대상으로 직무신체활동과 비만과의 관련성을 다른 잠재요인을 보정하여 분석하였다. 남녀 모두에서 고강도 직무신체활동과 비만과의 역연관성이 확인된 반면 여가신체활동과 비만과의 연관성은 확인되지 않았다. 가구소득이 높은 경우 직무신체활동의 강도가 낮은 경우에도 비만과 역연관성을 보였다. 향후 비만 예방 및 중재 전략 수립 시 대상집단의 특성을 고려하여 다양한 종류의 신체활동에 대한 평가가 고려되어야 할 것이다.

Key Message
Regarding the inverse association of physical activity at work and household income with obesity identified in the study, various type of physical activity including physical activity at work and characteristics of target population might be concerned for assessment and prevention of obesity.

Citations

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The association between different types of physical activity and smoking behavior
Jipeng Zhang, Yiwen Cao, Hongfei Mo, Rui Feng
BMC Psychiatry.2023;[Epub] CrossRef
Efectividad de la actividad física en la prevención y tratamiento de la obesidad: una revisión de la literatura
Yudi Alexandra González, Diana Lucia Vega-Díaz
Revista digital: Actividad Física y Deporte.2023;[Epub] CrossRef
Factors affecting quality of life in low‐income overweight and obese women: The mediating effects of health‐promoting behaviors
Ju‐Hee Nho, Hye Young Kim, Eun Jin Kim
Worldviews on Evidence-Based Nursing.2022; 19(3): 201. CrossRef
Current status of health promotion in Korea
Soo Young Kim
Journal of the Korean Medical Association.2022; 65(12): 776. CrossRef

Relationship between smoking status and muscle strength in the United States older adults: R. Constance Wiener, Patricia A. Findley, Chan Shen, Nilanjana Dwibedi, Usha Sambamoorthi; Epidemiol Health. 2020;42:e2020055. Published online July 28, 2020; DOI: https://doi.org/10.4178/epih.e2020055

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Abstract PDF

Abstract

OBJECTIVES
Muscle strength in older adults is associated with greater physical ability. Identifying interventions to maintain muscle strength can therefore improve quality of life. The purpose of this study was to evaluate whether current or former smoking status is associated with a decrease in muscle strength in older adults.

METHODS

Data from the Health and Retirement Study from 2012-2014 were analyzed with regard to maximum dominant hand grip strength, maximum overall hand grip strength, and smoking status (current, former, or never). Unadjusted linear regression was conducted. Other factors known to be related to strength were included in the adjusted linear regression analyses.

RESULTS

For maximum grip strength, the regression coefficient was 4.91 for current smoking (standard error [SE], 0.58; p<0.001), 3.58 for former smoking (SE, 0.43; p<0.001), and 28.12 for never smoking (SE, 0.34). Fully adjusted linear regression on the relationship between dominant hand grip strength and smoking did not yield a significant result. The factors significantly associated with dominant hand grip strength were male sex, younger age, a race/ethnicity of non-Hispanic White or non-Hispanic Black, higher income, morbidity of ≤1 condition, no pain, and moderate or vigorous exercise more than once a week.

CONCLUSIONS

Muscle strength in older adults was not associated with smoking status in the adjusted analysis.

Summary

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Association between smoking status and handgrip strength in Korean male adults: based on Korea National Health and Nutrition Examination Survey 2016–2019
Eunbyul Cho, Hi Sun Soh, Jae-Ryun Lee, Jieun Yun, Woo Kyung Bae, Hyejin Lee
Frontiers in Medicine.2023;[Epub] CrossRef
Handgrip strength, dynapenia, and related factors in postmenopausal women
Pascual García-Alfaro, Sandra García, Ignacio Rodríguez, Faustino R. Pérez-López
Menopause.2022; 29(1): 16. CrossRef
Lower body muscle strength, dynapenic obesity and risk of type 2 diabetes –longitudinal results on the chair-stand test from the Survey of Health, Ageing and Retirement in Europe (SHARE)
Bernd Kowall
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Lifestyle-related predictors affecting prediabetes and diabetes in 20-30-year-old young Korean adults: Kyong Sil Park, Seon Young Hwang; Epidemiol Health. 2020;42:e2020014. Published online March 19, 2020; DOI: https://doi.org/10.4178/epih.e2020014

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
To investigate lifestyle-related predictors of prediabetes and diabetes in young adults aged 20–39 years using data from the 2014-2016 Korea National Health and Nutrition Examination Survey (KNHANES).

METHODS

This study is a cross-sectional, secondary analysis using the KNHANES data. Participants were classified into normal group (fasting plasma glucose [FPG] <100 mg/dL and/or hemoglobin A1c [HbA1c] <5.7%), prediabetes group (FPG 100-125 mg/dL and/or HbA1c 5.7-6.4%), and diabetes group (FPG ≥126 mg/dL and/or HbA1c ≥ 6.5%). The data were statistically analyzed using SPSS software.

RESULTS

Out of 4,190 participants, 27.7% of men and 16.3% of women were in the prediabetes group and 1.4% of men and 1.3% of women were in the diabetes group. Logistic regression confirmed that age and obesity are predictors of prediabetes and diabetes in both men and women. Additionally low physical activity and low education level are predictors of prediabetes in men and women, respectively (p<0.05).

CONCLUSIONS

This study has found that age and increased obesity are predictors of elevated blood glucose in young men and women in their 20s and 30s. A strategy to lower obesity by promoting physical activity in men in their 30s is essential to prevent metabolic syndrome and progression to prediabetes.

Summary

Korean summary
20-30대 젊은 성인 남성에서 당뇨전단계 27.7%, 당뇨 1.4%, 여성에서 당뇨전단계 16.4%, 당뇨 1.3%로 확인되었다. 당뇨전단계 및 당뇨의 이환을 예방하기 위해서 비만 관리가 필수적이며, 특히 교육수준이 낮은 젊은 여성과 신체활동이 낮은 30대의 남성에서 신체활동 증진을 통해 효율적으로 비만도를 낮추는 전략 마련이 필요함을 확인하였다.

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Effects of a Remote Physical Activity Improvement Program on Male Office Workers with Metabolic Syndrome in Their 30s and 40s with Sedentary Behavior: A Randomized Controlled Trial
Kyong Sil Park, Seon Young Hwang
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Yibo He, Hongyu Lu, Yihang Ling, Jin Liu, Sijia Yu, Ziyou Zhou, Tian Chang, Yong Liu, Shiqun Chen, Jiyan Chen
Cardiovascular Diabetology.2023;[Epub] CrossRef
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Yujin Lee, Jung-Hyun Kim
The Korean Journal of Community Living Science.2022; 33(1): 19. CrossRef
Sex differences in factors associated with prediabetes in Korean adults
Jin Suk Ra
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Anshul Sharma, Chen Lulu, Kee-Ho Song, Hae-Jeung Lee
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Physical activity level in Korean adults: the Korea National Health and Nutrition Examination Survey 2017: Ki-Yong An; Epidemiol Health. 2019;41:e2019047. Published online November 9, 2019; DOI: https://doi.org/10.4178/epih.e2019047

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study investigated physical activity (PA) participation based on demographic, physical, and psychological variables in Korean adults.

METHODS

Participants were divided into four groups (combined, aerobic only, resistance only, and neither) based on meeting the PA guidelines using moderate and vigorous PA time and resistance exercise frequency from the Korea National Health and Nutrition Examination Survey 2017. The association between meeting the PA guidelines and demographic, medical, fitness, lifestyle, and psychological variables were analyzed using complex samples crosstabs and a general linear model.

RESULTS

Of the 5,820 Korean adults, 66.0% did not meet any of the guidelines. Among demographic factors, sex, age, marital status, income, education level, occupation, and employment status were associated with meeting the PA guidelines. Chronic disease prevalence, weight, waist circumference, body mass index, diastolic blood pressure, glucose, high-density lipoprotein and triglyceride levels, hand-grip strength, resting heart rate, and family history of chronic disease in the medical and fitness variables; frequency of drinking and eating breakfast, total calorie, water, protein, and fat intake in the lifestyle variables; and perceived stress, depression, suicidal thoughts, and quality of life in the psychological variables were associated with meeting PA guidelines.

CONCLUSIONS

Most Korean adults participate in insufficient PA. Moreover, individuals who are socially underprivileged, have low-income or poor physical and mental health conditions participated in relatively less PA. Our findings suggest that government and individual efforts are required to increase PA and resolve health inequality in Korean adults.

Summary

Korean summary
2017년 국민건강영양조사 자료를 분석한 결과, 한국 성인들의 신체활동 실천율은 매우 낮았으며, 특히, 사회적 약자나 저소득층, 신체적, 정신적 건강 위험요인이 높은 사람들에게 더 낮게 나타났다. 신체활동은 건강증진을 위한 가장 경제적이며 효율적인 방법으로써, 신체활동 참여를 늘리고 건강불평등을 해소하기 위한 정부, 의료기관, 교육기관은 물론 국민 개개인의 신체활동에 대한 인식개선과 적극적인 노력이 필요하다.

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우진 안, 채희 박
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Distribution and social determinants of overweight and obesity: a cross-sectional study of non-pregnant adult women from the Malawi Demographic and Health Survey (2015-2016): Leonard Mndala, Abhay Kudale; Epidemiol Health. 2019;41:e2019039. Published online September 27, 2019; DOI: https://doi.org/10.4178/epih.e2019039

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Abstract PDF

Abstract

OBJECTIVES
Hitherto regarded as a public health issue of well-heeled nations, overweight and obesity have emerged as a problem of concern in developing nations. Although social and demographic factors are equally important as proximal lifestyle factors affecting health, their role is neither well researched nor well understood. We conducted a novel study to determine the distribution, prevalence, and social and demographic determinants of overweight/obesity in Malawi.

METHODS

A population-based, quantitative cross-sectional study using data from the Malawi Demographic and Health Survey (2015-2016) was conducted among non-pregnant women aged 18-49 years. A total of 6,443 women were included in the analysis. Overweight/obesity, defined as a body mass index (BMI) ≥25.0 kg/m2 , was the main outcome variable. The analysis was done in SPSS version 20.0; after calculating descriptive statistics, bivariate and multivariate logistic regression was conducted to evaluate associations and determine odds.

RESULTS

In total, 16.8% and 6.3% of women were overweight and obese, respectively (p<0.001). Overweight and obesity were more prevalent in urban than in rural areas. The BMI distribution among women varied across different background characteristics. Women from the Ngoni ethnicity were more likely to be overweight/obese than others (adjusted odds ratio [aOR], 1.54; 95% confidence interval [CI], 1.14 to 2.08). Socioeconomic status (SES) and the age of the respondent were highly significant determinants that were strongly associated with being overweight/obese. The richest women were 3 times more likely to be overweight/obese than the poorest (aOR, 3.30; 95% CI, 2.46 to 4.43).

CONCLUSIONS

Overweight and obesity were highly prevalent and significantly associated with increasing SES, age, and being from the Ngoni ethnicity. Holistic interventions should also focus on improving social determinants in order to entirely curb the epidemic.

Summary

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The coverage rates for influenza vaccination and related factors in Korean adults aged 50 and older with chronic disease: based on 2016 Community Health Survey data: Kyeong Hyang Byeon, Jaiyong Kim, Boyoung Choi, Bo Youl Choi; Epidemiol Health. 2018;40:e2018034. Published online July 24, 2018; DOI: https://doi.org/10.4178/epih.e2018034

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aims to identify the coverage rates for influenza vaccination and related factors depending on chronic disease in Korean adults aged 50 and older.

METHODS

The 2016 Korea Community Health Survey was used for analysis. Chi-square test was performed to investigate the coverage rates for influenza vaccination depending on chronic disease, and a multiple logistic regression analysis was used to identify the factors associated with influenza vaccination, by chronic disease.

RESULTS

In men with ≥1 chronic disease, 39.8% of 50-64 years of age, and 86.8% of elderly (over 65 years of age) received influenza vaccination. In women with ≥1 chronic disease, 58.7% of 50-64 years of age, and 89.9% of elderly (over 65 years of age) received influenza vaccination (p<0.001). The chronic diseases associated with influenza vaccination were hypertension (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.19 to 1.37), diabetes (OR, 1.41; 95% CI, 1.28 to 1.55) in men aged 50-64, hypertension (OR, 1.34; 95% CI, 1.20 to 1.49), diabetes (OR, 1.17; 95% CI, 1.02 to 1.33), chronic cardiovascular disease (OR, 1.31; 95% CI, 1.07 to 1.60) in elderly (over 65 years of age). In women aged 50-64, hypertension (OR, 1.39; 95% CI, 1.30 to 1.49), diabetes (OR, 1.51; 95% CI, 1.35 to 1.68), chronic cardiovascular disease (OR, 1.31; 95% CI, 1.05 to 1.64), and hypertension (OR, 1.55; 95% CI, 1.40 to 1.71), diabetes (OR, 1.27; 95% CI, 1.12 to 1.43) in elderly (over 65 years of age).

CONCLUSIONS

Populations in aged 50-64 are recommendation subject for vaccination or classified as high-risk group in case with chronic disease. Though subject over 60 years old is age close to the elderly, the coverage rates for vaccination was low. It is necessary to devise strategies to raise the coverage rates for vaccination.

Summary

Korean summary
매년 인플루엔자 환자수는 증가하는 추세이며 인플루엔자로 인한 의료이용의 질병부담은 커질 것으로 생각된다. 국내에서는 우선접종 권장대상자들에게 예방접종을 받도록 권고하고 있으며, 예방접종은 인플루엔자를 예방할 수 있는 비용 효과적인 방법이다. 65세 이상 대상자는 국가 무료 예방접종 사업 대상으로 인해 예방접종률이 높은 것으로 확인되었다. 50-64세 인구는 예방접종 권고 대상자임에도 불구하고 낮은 것으로 나타났고, 50-64세 연령에서 만성질환을 동반할 경우 고위험군이지만 여전히 낮은 예방접종률을 보였다. 또한 50-64세 연령에서 1개 이상 만성질환을 동반할 경우 대도시, 중소도시에 거주하는 것보다 군지역에 거주할 경우 높은 예방접종률을 확인함으로써 대도시 및 중소도시에 거주하는 50-64세 연령에 대해 예방접종률을 올릴 수 있는 적극적인 예방접종 홍보가 필요할 것으로 생각한다.

Citations

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Heeseon Jang, Jaelim Cho, Seong-Kyung Cho, Donghan Lee, Sung-il Cho, Sang-Baek Koh, Dong-Chun Shin, Changsoo Kim
Journal of Korean Medical Science.2023;[Epub] CrossRef
Cost-Effectiveness of Influenza Vaccination Strategies in Adults: Older Adults Aged ≥65 Years, Adults Aged 50–64 Years, and At-Risk Adults Aged 19–64 Years
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Determinants of health-related quality of life in Iranian adults: evidence from a cross-sectional study: Satar Rezaei, Mohammad Hajizadeh, Ali Kazemi, Masoud Khosravipour, Farid Khosravi, Shahab Rezaeian; Epidemiol Health. 2017;39:e2017038. Published online August 15, 2017; DOI: https://doi.org/10.4178/epih.e2017038

13,740 View
224 Download
15 Web of Science
11 Crossref

Abstract PDF

Abstract

OBJECTIVES
This study aimed to measure the level and determinants of health-related quality of life (HRQoL) in adults in Kermanshah, a city in the western region of Iran.

METHODS

Convenience sampling was employed to obtain a sample of 998 adults aged 18 years and older (646 males and 352 females) in the city of Kermanshah. A 2-part self-administered questionnaire was used to collect data over the period between March 1 and May 30, 2017. The first part was designed to collect information on socio-demographic characteristics, socioeconomic status, and lifestyle factors (10 items). The second part consisted of the EuroQoL 5-dimensions (EQ-5D) EuroQoL-3-level and the EuroQoL visual analog scale (EQ-VAS) questions. A multiple linear regression model was used to determine the factors associated with the EQ-5D index and EQ-VAS score among study participants.

RESULTS

The mean values for the EQ-5D index and the EQ-VAS score were 0.74 (standard deviation [SD], 0.19) and 80.9 (SD, 16.5), respectively. The highest percentage of self-reported problems (‘some’ and ‘severe’ problems) across the 5 dimensions of the EQ-5D index were associated with the dimensions of anxiety/depression (35.3%) and pain/discomfort (32.9%). The percentage of self-reported problems for the dimensions of usual activities, mobility, and self-care were 19.0, 12.8, and 8.9%, respectively. Our regression analyses indicated that there were statistically significant positive associations between being physically active, monthly household income per capita, and post-secondary education and the EQ-5D index and EQ-VAS score. In contrast, negative associations were found between older age, being married, having a chronic disease, and smoking and the EQ-5D index and EQ-VAS score. A negative association was also found between being uninsured and the EQ-5D index.

CONCLUSIONS

Our findings suggest that interventions aiming to improve physical activity, to prevent chronic diseases, and to reduce the smoking rate among adults living in the city of Kermanshah may improve their HRQoL.

Summary

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Associations between a health-promoting lifestyle and quality of life among adults with beta-thalassemia major: Aghbabak Maheri, Roya Sadeghi, Davoud Shojaeizadeh, Azar Tol, Mehdi Yaseri, Mojtaba Ebrahimi; Epidemiol Health. 2016;38:e2016050. Published online November 15, 2016; DOI: https://doi.org/10.4178/epih.e2016050

15,998 View
325 Download
16 Web of Science
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Abstract PDF

Abstract

OBJECTIVES
A health-promoting lifestyle (HPL) is a factor that affects the quality of life (QoL) in patients with beta-thalassemia (β-thalassemia). Due to the lack of studies of this issue, this study aimed to determine the association between HPL and QoL among adults with β-thalassemia.

METHODS

This cross-sectional (descriptive-analytic) study was conducted among 389 adult patients with β-thalassemia in Tehran, Iran. The research instrument included a questionnaire consisting of three parts: demographic items, the Short-Form Health Survey and the Health-Promoting Lifestyle Profile. The data were analyzed using SPSS version 23.0. The results were considered significant at the conventional p<0.05 level.

RESULTS

The mean age of the participants was 30.2±8.3 years. The mean score of the HPL dimensions was 127.28±21.53, and the mean score of the QoL domains was 61.44±23.38. The highest and the lowest mean scores of the HPL dimensions were found for spiritual growth (23.96±5.74) and physical activity (11.32±3.95), respectively. The QoL scores in all three domains (total, physical component summary score, and mental component summary score) were moderate. Health responsibility, physical activity, spiritual growth, and interpersonal relations were significant predictive factors of QoL in adults with β-thalassemia; these four dimensions explained 37.9% of the variance in QoL.

CONCLUSIONS

QoL and HPL were not at acceptable levels among patients with thalassemia. Therefore, educational interventions emphasizing spiritual growth, physical activity, and interpersonal relations are necessary for patients with thalassemia.

Summary

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