국민건강영양조사 신체활동 설문 문항: 현황, 제한점 및 향후 방향

김완수 ( Wan Soo Kim ) 대한보건협회 2012 대한보건연구 Vol.38 No.2

Objectives: This study was conducted to examine whether the Korea National Health and Nutrition Examination Survey(KNHANES) physical activity questions are appropriate to measure physical activity(PA) of Korean adults and propose the directions for future revision. Methods: After reviewing PA questions of KNHANES appropriate to make time series comparisons from 2005 to 2012, PA questions of KNHANES were compared to questionnaires internationally validated in PA measurement for adults. Results: This study found several limitations in KNHANES. 1) In the questions according to exercise intensity, activities associated with work and leisure-time were asked as one question. 2) There were no questions related to household chores. 3) There were no questions regarding walking in the section for moderate PA. 4) A question about travel walking was limited in domains and it could be confused with moderate-intensity walking. These limitations may not allow KNHANES to collect information with respect to the PA of adults accurately. In addition, PA of Korean adults is highly likely to be underestimated. Conclusion: PA questions of KNHANES should be revised, and this study proposes that 1) PA questions should be asked to according to domains such as work including household chores and leisure-time. 2) Walking must be included in moderate-intensity PA. 3) Questions about travel walking need to be asked in all domains. Furthermore, it is worthwhile to review the Global Physical Activity Questionnaire developed by World Health Organization to improve current KNHANES

우리 국민의 철 섭취량 평가: 식품별 영양성분 함량자료와 한국형 총식이조사 기반 추정량 비교

이지연,권성옥,여윤재,서민정,이계호,김초일 대한지역사회영양학회 2022 대한지역사회영양학회지 Vol.27 No.3

Objectives: This study was conducted to find out if the dietary iron intake of Koreans estimated by 2 different methods (iron content sources) using the food intake data from the Korea National Health and Nutrition Examination Survey (KNHANES) are comparable. One method was based on the KNHANES's Food & Nutrient Database (FND) derived mainly from the Korean Food Composition Table and the other used the iron content (IC) of food samples processed in the Korean Total Diet Study (KTDS). Methods: Dietary intake data from the 2013-2016 KNHANES was used to select representative foods (RFs) in KTDS for iron analysis. Selection of the RFs and cooking methods for each RF (RF × cooking method pair) was performed according to the ‘Guidebook for Korean Total Diet Studies’ and resulted in a total of 132 RFs and 224 ‘RF × cooking method’ pairs. RFs were collected in 9 metropolitan cities nationwide once or twice (for those with seasonality) in 2018 and made into 6 composites each, based on the origin and season prior to cooking. Then, the RF composites prepared to a ‘table ready’ state for KTDS were analyzed by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Dietary iron intake of the Korean population was estimated using only RFs’ intake data based on the 2 sources of iron content, namely FND-KNHANES and IC-KTDS. Results: RFs in KTDS covered 92.0% of total food intake of Koreans in the 2016-2018 KNHANES. Mean iron intake of Koreans was 7.77 mg/person/day by IC-KTDS vs 9.73 mg/person/day by FND-KNHANES. The major food groups contributing to iron intake were meats (21.7%), vegetables (20.5%), and grains & cereals (13.4%) as per IC-KTDS. On the other hand, the latter source (FND-KNHANES) resulted in a very different profile: grains & cereals (31.1%), vegetables (16.8%), and meats (15.3%). While the top iron source was beef, accounting for 8.6% in the former, it was polished rice (19.2%) in the latter. There was a 10-fold difference in the iron content of polished rice between 2 sources that iron intakes excluding the contribution by polished rice resulted in very similar values: 7.58 mg/person/day by IC-KTDS and 7.86 mg/person/day by FND- KNHANES. Conclusions: This study revealed that the dietary iron intake estimated by 2 different methods were quite comparable, excluding one RF, namely polished rice. KTDS was thus proven to be a useful tool in estimating a ‘closer-to-real’ dietary intake of nutrients for Koreans and further research on various nutrients is warranted.

국민건강영양조사 자료를 이용한 가공식품 데이터베이스 구축

윤미옥(Yoon, Mi Ock),이현숙(Lee, Hyun Sook),김기랑(Kim, Kirang),심재은(Shim, Jae Eun),황지윤(Hwang, Ji-Yun) 한국영양학회 2017 Journal of Nutrition and Health Vol.50 No.5

본 연구는 가공식품의 섭취량이 증가하는 현실에서 국민건강영양조사 자료를 통한 정확한 영양소 섭취량 산출을 위해 국민건강영양조사의 원자료 중 최근 5년간 (2010~2014) 등장한 가공식품 4,858건에 대한 영양성분 DB를 구축하고, 이를 제6기 1차 년도 국민건강영양조사 (2013년) 자료에 적용하여 영양소 14종의 섭취량을 산출하여 구축한 DB에 대한 유용성을 검토하였다. 가공식품의 영양성분 DB구축을 위해 국내 국가기관에 신고된 가공식품 목록 8,785건, 반조리 식품 자료배합비, 국내 국립기관에서 발간된 식품성분표 1종, 제조사 및 인터넷 등을 통해 수집된 자료를 모아 가공식품에 대한 수준별 DB를 구축하였다. 매칭 식품과 유사 식품 DB를 모두 적용 후 가공식품 섭취량은 505.8 g (30.8%)로 추정되었으며 총섭취량에 대한 기여율은 각각 에너지 29.5%, 탄수화물 27.0%, 단백질 36.7%, 지방 26.5%, 식이섬유 16.1%로 나타났다. 또한 DB 적용 후 대부분의 영양소 섭취량이 유의한 차이를 보여 구축된 DB의 유용성을 보여준다고 사료된다. 나트륨의 경우 가공식품으로 부터의 섭취량이 DB 적용 전·후 2,527.6 mg에서 3,006.2 mg으로 증가하였다. 국민건강영양조사자료의 영양소 섭취량 추정에 필요한 에너지 및 영양소 14종에 대한국내 분석값 자료가 거의 없는 현실에서 본 연구는 DB 구축을 위한 계산값이나 대체값의 원칙을 세우고 문서화하여 가공식품 DB 구축을 위한 틀을 만들어 향후 DB 구축, 유지, 확대 등 식품영양 DB의 체계적 관리의 기초를 제공하였으며 국민건강영양조사자료를 이용하여 가공식품을 통한 영양소 섭취량 추정을 했다는 측면에서 의미가 있다고 사료된다. 향후 지속적이고 체계적인 가공식품 DB 구축과 관리가 필요하다. Purpose: The objective of this study was to develop a processed foods database (DB) for estimation of processed food intake in the Korean population using data from the Korea National Health and Nutrition Survey (KNHANES). Methods: Analytical values of processed foods were collected from food composition tables of national institutions (Development Institute, Rural Development Administration), the US Department of Agriculture, and previously reported scientific journals. Missing or unavailable values were substituted, calculated, or imputed. The nutrient data covered 14 nutrients, including energy, protein, carbohydrates, fat, calcium, phosphorus, iron, sodium, potassium, vitamin A, thiamin, riboflavin, niacin, and vitamin C. The processed food DB covered a total of 4,858 food items used in the KNHANES. Each analytical value per food item was selected systematically based on the priority criteria of data sources. Results: Level 0 DB was developed based on a list of 8,785 registered processed foods with recipes of ready-to-eat processed foods, one food composition table published by the national institution, and nutrition facts obtained directly from manufacturers or indirectly via web search. Level 1 DB included information of 14 nutrients, and missing or unavailable values were substituted, calculated, or imputed at level 2. Level 3 DB evaluated the newly constructed nutrient DB for processed foods using the 2013 KNHANES. Mean intakes of total food and processed food were 1,551.4 g (males 1,761.8 g, females 1,340.8 g) and 129.4 g (males 169.9 g, females 88.8 g), respectively. Processed foods contributed to nutrient intakes from 5.0% (fiber) to 12.3% (protein) in the Korean population. Conclusion: The newly developed nutrient DB for processed foods contributes to accurate estimation of nutrient intakes in the Korean population. Consistent and regular update and quality control of the DB is needed to obtain accurate estimation of usual intakes using data from the KNHANES.

한국 소아,청소년의 고열량 저영양 식품 섭취와 비만

허규진(Gyu Jin Heo),남소영(So Young Nam),이수경(Soo Kyung Lee),정상진(Sang Jin Chung),윤지현(Ji Hyun Yoon) 대한지역사회영양학회 2012 대한지역사회영양학회지 Vol.17 No.2

Consumption of foods with high energy and low nutrient values has been linked to various health issues including obesity and chronic diseases. This study investigated the high-energy/low-nutrient food consumption status and its relationship with obesity status and intake of energy and nutrients, using the Korea National Health and Nutrition Examination Survey (KNHANES) and the Korea Youth Risk Behavior Web-based Survey (KYRBWS). The prevalence of overweight and obesity among 2-18 year-olds was 8.4% and 10.8% in 2008 and 8.5% and 9.0% in 2009, respectively, in KNHANES. The prevalence of obesity among 12-18 year-olds was 13.9% in 2008 and 11.4% in 2009 in KNHANES, while it was 8.1% in 2008 and 8.2% in 2009 in KYRBWS. Consumption patterns of high-energy/low-nutrient foods were diverse depending on the particular food type. High-energy/low-nutrient foods such as cookies were most often consumed more frequently (2~3 times per week), but fast food type foods were generally consumed less frequently (once per week or less). No significant relationships between highenergy/ low-nutrient food consumption and level of energy and nutrient intakes were found in either datasets. Adolescents who were not obese more frequently consumed ramen (p < 0.001), cookies (p < 0.001) and fast food (p < 0.001) than those who were obese in KYRBWS, however, such relationships were not found in KNHANES. This direction of the relationship could be probably attributed to the cross-sectional nature of the datasets. This study was limited by the cross-sectional nature of the data, therefore, further longitudinal research using various study techniques would be necessary to understand the effects of high-energy/low-nutrient foods on child obesity. (Korean J Community Nutr 17(2) : 226~242, 2012)

경기 도시 지역 보건소 성인 방문자의 식생활과 건강 관련 라이프스타일 조사

권종숙(Jong Sook Kwon),김경민(Kyung Min Kim),서현창(Hyun Chang Seo),이윤나(Yoon Na Lee),임승건(Seung Geon Lim),최영숙(Young Sug Choi) 대한지역사회영양학회 2013 대한지역사회영양학회지 Vol.18 No.6

The purpose of this study was to investigate dietary behaviors and health-related lifestyles of adult visitors at a public health center in Gyeonggi urban area. A survey using questionnaire was conducted with 949 visitors at Seongnam public health centers from June to August, 2012. The data from 905 respondents were analyzed by gender, consisting of 322 males and 583 females, and age group, consisting of 243 low-age group (LA), 312 middle-age group (MA), 350 high-age group (HA), aged 20 to 30 years, 31 to 50 years, and 51 to 69 years, respectively. Average Body Mass Index was 23.0, which increased with age, and education level was high in LA. 59.0 percent of the subjects had various diseases, and the incidence of hypertension was the highest, followed by allergy, hyperlipidemia, diabetes mellitus, joint rheumatism. Incidence rates of chronic disease increased with age, which were lower than those from 2011 Korea National Health and Nutrition Examination Survey (KNHANES). Weekly drinking frequency rate and smoking rate decreased with age, and exercise performing rate was high at male and HA, which showed the same tendency as KNHANES. Female and HA showed more healthy dietary behaviors such as restricting salt, sugar, oily foods, foods containing food additives, calorie, caring for balanced diet, and referring to nutrition label. Subjects chose stress as the first factor, followed by diet, exercise, etc., among 13 suggested factors which strongly influence on human``s life-span. In general, public health center visitors, especially female and HA, showed better dietary behaviors and health-related lifestyles compared with KNHANES.

국민건강영양조사(2013-2014년) 자료에 근거한 가구원수별 구성원의 영양상태 및 대사증후군 유병율 평가

이진영,최수경,서정숙 대한지역사회영양학회 2019 대한지역사회영양학회지 Vol.24 No.3

Objectives: This study evaluated the nutritional status and prevalence of metabolic syndrome of the people who participated in the KNHANES according to the number of household members. They were assessed by using information from the 2013∼2014 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: A total of 6,088 persons aged 19 years and over participated in 2013∼2014 KNHANES, and they were classified into three groups according to the number of household members (single-person, two-person, three-person & over). The dietary behavior, nutritional status, health-related factors and the prevalence of metabolic syndrome of the subjects were investigated with using information from the survey questionnaires of KNHANES. The nutrient intake data of the subjects were obtained by the 24-hour recall method and this was analyzed for evaluating the nutrition adequacy ratio and the index of nutritional quality. The prevalence of metabolic syndrome among the subjects, and according to the study groups, was estimated using the blood and physical measurement data of the subjects. Results: As for EQ-5D index available for all the health states generated by the EQ-5D descriptive system, the single-person household member was the lowest among all the household types. The index of nutrition quality for protein, crude fiber, calcium, phosphorus, potassium, riboflavin and vitamin C in the single-person household was lower than that of the two-person or the three-person and over households (p<0.001). The mean adequacy ratio of single-person households was significantly decreased compared with that of the other types of households (p<0.001). The prevalence of metabolic syndrome was higher in the single-person households than that in the multiple-person households (p<0.001). Conclusions: These results showed that dietary behaviors, nutrition status and health status might be influenced by the number of household members. The results from this study would be useful for improving Korean people’s dietary life and health status by implementing evidence-based, specialized intervention for the members of diverse types of households.

연구논문 : 백미밥의 섭취에 따른 영양과 식품 섭취 실태 및 대사증후군 위험수준: 1기(1998), 4기(2007~2009), 6기(2013) 국민건강영양조사 자료를 이용하여

송방방 ( Fang Fang Song ),장진아 ( Jin A Jang ),김양숙 ( Yang Suk Kim ),윤혜려 ( Hei Ryeo Yoon ),조미숙 ( Mi Sook Cho ) 한국식생활문화학회 2015 韓國食生活文化學會誌 Vol.30 No.5

The purpose of this research was to investigate the relationship between white rice consumption and dietary intake, the risk of metabolic syndrome in Korean based on 1st (1998), 4th (2007~2009), 6th (2013) KNHANES. This study included 25,799 subjects who were age 10 or over. Three groups(low, medium, high) were divided according to white rice consumption (per day). In the low group, the meat and oil intake were significantly higher than the high group. In the 1st survey year, the BMI, waist circumstances, hypertriglyceridemia and fasting blood glucose in the high group were higher than other groups, however the 4th and 6th survey year showed no significant results. In the 1st survey year the risk of waist circumstances was higher in the high white rice consumption group and also had high risk with hypertriglyceridemia. Since the lower white rice consumption in 4th than 1st survey year we found no significant results. But in the 6th survey year with the lowest white rice consumption the risk of high diastolic pressure was reduced in high group. Because continuously reduced white rice consumption meantime showed more intake of meat and oil, it can be concluded that defensive effects with the Korean health.

백미밥의 섭취에 따른 영양과 식품 섭취 실태 및 대사증후군 위험수준:1기(1998), 4기(2007~2009), 6기(2013) 국민건강영양조사 자료를 이용하여

송방방,장진아,김양숙,윤혜려,조미숙 한국식생활문화학회 2015 韓國食生活文化學會誌 Vol.30 No.5

The purpose of this research was to investigate the relationship between white rice consumption and dietary intake, the risk of metabolic syndrome in Korean based on 1st (1998), 4th (2007~2009), 6th (2013) KNHANES. This study included 25,799 subjects who were age 10 or over. Three groups(low, medium, high) were divided according to white rice consumption (per day). In the low group, the meat and oil intake were significantly higher than the high group. In the 1st survey year, the BMI, waist circumstances, hypertriglyceridemia and fasting blood glucose in the high group were higher than other groups, however the 4th and 6th survey year showed no significant results. In the 1st survey year the risk of waist circumstances was higher in the high white rice consumption group and also had high risk with hypertriglyceridemia. Since the lower white rice consumption in 4th than 1st survey year we found no significant results. But in the 6th survey year with the lowest white rice consumption the risk of high diastolic pressure was reduced in high group. Because continuously reduced white rice consumption meantime showed more intake of meat and oil, it can be concluded that defensive effects with the Korean health.

국민건강영양조사를 이용한 성인의 혈중 중금속 농도와 생선 섭취 및 심혈관 질환과의 관련성-국민건강영양조사 (2008~2010년)

신지예,김지명,김유리 한국영양학회 2012 Journal of Nutrition and Health Vol.45 No.4

Limited studies are available concerning the effect of heavy metal exposure on cardiovascular diseases. As environmental pollution increases, food contamination, including heavy metal contamination of fish, also increases. However, researches based on the intake of heavy metals, cardiovascular disease, and fish intakes are inconclusive. We assessed an association of heavy metal exposure with cardiovascular disease and fish intake in a nationally representative group of general Korean adults. We used data from the combined 2008-2010 Korean National Health and Nutrition Examination Survey (KNHANES), and analyzed the data of 5,139 Koreans who participated in KNHANES. All participants were older than 20 years, and were diagnosed with stroke, ischemic heart disease, or hypertension. The mean blood cadmium, lead concentration, and mercury concentration of subjects were 1.07 ± 0.01 μg/L, 2.49 ± 0.02 μg/dL, and 5.19 ± 0.08 μg/L, respectively. We used the survey logistic regression model to account for the complex sample design of the cardiovascular disease risk in order to estimate the odds ratios (OR). After adjusting for age, education, income, alcohol, smoking, and BMI, the increase of serum cadmium in blood was associated with the increase in the prevalence of hypertension. Further, the increase in blood cadmium concentration was associated with the increase of both systolic blood pressure (SBP) and diastolic blood pressure (DBP). Although higher fish intakes were significantly associated with higher blood mercury concentration (p for trend < 0.0001), fish intakes did not affect either blood cadmium or lead concentration. Comparing the highest fish intake group with the lowest intake group, the OR of hypertension was 0.31 (95% CI: 0.19-0.59) in the crude model for total fish. However, these associations were no longer significant after the adjustment for potential confounding factors. In conclusion, cadmium in blood was associated with an increased risk of hypertension in the general Korean adult population. However, we found no evidence of a clear relationship between cardiovascular disease and frequency of fish consumption.

고혈압 위험 예측에 적용된 특징 선택 방법의 비교

dashdondov khongorzul,김미혜 한국정보처리학회 2022 정보처리학회논문지. 소프트웨어 및 데이터 공학 Vol.11 No.3

In this paper, we have enhanced the risk prediction of hypertension using the feature selection method in the Korean National Healthand Nutrition Examination Survey (KNHANES) database of the Korea Centers for Disease Control and Prevention. The study identifiedvarious risk factors correlated with chronic hypertension. The paper is divided into three parts. Initially, the data preprocessing stepof removes missing values, and performed z-transformation. The following is the feature selection (FS) step that used a factor analysis(FA) based on the feature selection method in the dataset, and feature importance (FI) and multicollinearity analysis (MC) were comparedbased on FS. Finally, in the predictive analysis stage, it was applied to detect and predict the risk of hypertension. In this study, wecompare the accuracy, f-score, area under the ROC curve (AUC), and mean standard error (MSE) for each model of classification. Asa result of the test, the proposed MC-FA-RF model achieved the highest accuracy of 80.12%, MSE of 0.106, f-score of 83.49%, and AUCof 85.96%, respectively. These results demonstrate that the proposed MC-FA-RF method for hypertension risk predictions is outperformedother methods. 본 논문에서는 질병관리청 국민건강영양조사(KNHANES: Korea National Health and Nutrition Examination Survey) 데이터베이스에서 특징선택 방법으로 고혈압을 감지 예측하는 방법을 개선했다. 또한 만성 고혈압과 관련된 다양한 위험 요인을 확인하였다. 본 논문은 3가지로 나누어,첫째 결측값을 제거하고 Z-변환을 하는 데이터 전처리 단계이다. 다음은 데이터 셋에서 특징선택법을 기반으로 하는 요인분석(FA)을 사용하는특징선택 단계이며, 특징선택을 기반으로 다중공선형 분석(MC)와 특징중요도(FI)을 비교했다. 마지막으로 예측분석단계에서 고혈압 위험을 감지하고예측하는데 적용했다. 본 연구에서는 각 분류 모델에 대해 ROC 곡선(AUC) 아래의 평균 표준 오차(MSE), F1 점수 및 면적을 비교한다. 테스트결과 제안한 MC-FA-RF모델은 80.12% 가장 높은 정확도를 보이고, MSE, f-score, AUC 모델의 경우 각각 0.106, 83.49%의, 85.96% 으로 나타났다. 이러한 결과는 고혈압위험 예측에 대한 제안된 MC-FA-RF 방법이 다른 방법에 비해 우수함을 보이고 있다.