Planetary Health Diet Adherence in Korean Adults: Association with the Korean Healthy Eating Index
Abstract
1. Introduction
2. Materials and Methods
2.1. Design and Data Collection
2.2. Methods and Variables
2.2.1. Socio-Demographic Factors
2.2.2. Assessment of Diet Intake
2.2.3. Assessment of Diet Quality
2.3. Statistical Analysis
3. Results
Socio-Demographic Factors According to Survey Period
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Willett, W.; Rockström, J.; Loken, B.; Springmann, M.; Lang, T.; Vermeulen, S.; Garnett, T.; Tilman, D.; Declerck, F.; Wood, A.; et al. Food in the Anthropocene: The EAT–Lancet Commission on healthy diets from sustainable food systems. Lancet 2019, 393, 447–492. [Google Scholar] [CrossRef]
- EAT-Lancet Commission. The EAT-Lancet Commission Summary Report; EAT Foundation: Stockholm, Sweden, 2019; pp. 1–32. [Google Scholar]
- Cacau, L.T.; De Carli, E.; De Carvalho, A.M.; Lotufo, P.A.; Moreno, L.A.; Bensenor, I.M.; Marchioni, D.M. Development and validation of an index based on EAT-Lancet recommendations: The Planetary Health Diet Index. Nutrients 2021, 13, 1698. [Google Scholar] [CrossRef]
- Parker, M.K.; Misyak, S.A.; Gohlke, J.M.; Hedrick, V.E. Cross-sectional measurement of adherence to a proposed sustainable and healthy dietary pattern among United States adults using the newly developed Planetary Health Diet Index for the United States. Am. J. Clin. Nutr. 2023, 118, 1113–1123. [Google Scholar] [CrossRef] [PubMed]
- Venegas Hargous, C.; Orellana, L.; Strugnell, C.; Corvalan, C.; Allender, S.; Bell, C. Adapting the Planetary Health Diet Index for children and adolescents. Int. J. Behav. Nutr. Phys. Act. 2023, 20, 76. [Google Scholar] [CrossRef] [PubMed]
- Llanaj, E.; Vincze, F.; Kósa, Z.; Bárdos, H.; Diószegi, J.; Sándor, J.; Ádány, R. Deteriorated dietary patterns with regards to health and environmental sustainability among Hungarian Roma are not differentiated from those of the general population. Nutrients 2021, 13, 721. [Google Scholar] [CrossRef] [PubMed]
- Ali, Z.; Scheelbeek, P.F.D.; Felix, J.; Jallow, B.; Palazzo, A.; Segnon, A.C.; Havlík, P.; Prentice, A.M.; Green, R. Adherence to EAT-Lancet dietary recommendations for health and sustainability in the Gambia. Environ. Res. Lett. 2022, 17, 115007. [Google Scholar] [CrossRef]
- Trijsburg, L.; Talsma, E.F.; Crispim, S.P.; Garrett, J.; Kennedy, G.; De Vries, J.H.M.; Brouwer, I.D. Method for the development of WISH, a globally applicable index for healthy diets from sustainable food systems. Nutrients 2021, 13, 93. [Google Scholar] [CrossRef]
- Hanley-Cook, G.T.; Argaw, A.A.; De Kok, B.P.; Vanslambrouck, K.W.; Toe, L.C.; Kolsteren, P.W.; Jones, A.D.; Lachat, C.K. EAT–Lancet diet score requires minimum intake values to predict higher micronutrient adequacy of diets in rural women of reproductive age from five low- and middle-income countries. Br. J. Nutr. 2021, 126, 92–100. [Google Scholar] [CrossRef]
- Ye, Y.; Geng, T.; Zhou, Y.; He, P.; Zhang, J.; Liu, G.; Willett, W.; Pan, A.; Koh, W. Adherence to a Planetary Health Diet, environmental impacts, and mortality in Chinese adults. JAMA Netw. Open 2023, 6, e2339468. [Google Scholar] [CrossRef]
- López, G.E.; Batis, C.; González, C.; Chávez, M.; Cortés-Valencia, A.; López-Ridaura, R.; Lajous, M.; Stern, D. EAT-Lancet Healthy Reference Diet score and diabetes incidence in a cohort of Mexican women. Eur. J. Clin. Nutr. 2023, 77, 348–356. [Google Scholar] [CrossRef]
- Mangone, L.; Sacerdote, C.; Laine, J.; Masala, G.; Bendinelli, B.; Panico, S.; Chiodini, P.; Grioni, S.; Pala, V.; Petiti, L.; et al. Food, health, and mitigation of climate change in Italy. Epidemiol. Prev. 2023, 47 (Suppl. S1), 32–38. [Google Scholar] [CrossRef] [PubMed]
- Yook, S.; Park, S.; Moon, H.; Kim, K.; Shim, J.E.; Hwang, J. Development of Korean Healthy Eating Index for adults using the Korea National Health and Nutrition Examination Survey data. J. Nutr. Health 2015, 48, 419–428. [Google Scholar] [CrossRef]
- National Institute of Fisheries Science. Composition Table of Marine Products in Korea, 8th ed. rev.; National Institute of Fisheries Science: Busan, Republic of Korea, 2018; p. 394. Available online: https://www.nifs.go.kr/portal/pcon0000203/systA/actionConts.do (accessed on 20 September 2025).
- Ministry of Food and Drug Safety. Manual for Determining Whether a Food is Processed, 2nd ed.; Ministry of Food and Drug Safety: Cheongju, Republic of Korea, 2023. Available online: https://mfds.go.kr/brd/m_227/view.do?seq=25104 (accessed on 29 July 2025).
- The Korean Nutrition Society. 2020 Dietary Reference Intakes for Koreans: Application; The Korean Nutrition Society: Seoul, Republic of Korea, 2022; Available online: https://www.kns.or.kr (accessed on 20 September 2025).
- Yun, S.; Park, S.; Yook, S.; Kim, K.; Shim, J.E.; Hwang, J.; Oh, K. Development of the Korean Healthy Eating Index for adults, based on the Korea National Health and Nutrition Examination Survey. Nutr. Res. Pract. 2022, 16, 233–245. [Google Scholar] [CrossRef]
- Kweon, S.; Park, J.Y.; Park, M.; Kim, Y.; Yeon, S.Y.; Yoon, L.; Yun, S.; Park, S.; Yang, J.E.; Kim, Y.; et al. Trends in food and nutrient intake over 20 years: Findings from the 1998–2018 Korea National Health and Nutrition Examination Survey. Epidemiol. Health 2021, 43, e2021027. [Google Scholar] [CrossRef]
- Jo, G.; Park, D.; Lee, J.; Kim, R.; Subramanian, S.V.; Oh, H.; Shin, M. Trends in diet quality and cardiometabolic risk factors among Korean adults, 2007–2018. JAMA Netw. Open 2022, 5, e2218297. [Google Scholar] [CrossRef]
- Song, S.; Lee, J.E.; Song, W.O.; Paik, H.; Song, Y. Carbohydrate intake and refined-grain consumption are associated with metabolic syndrome in the Korean adult population. J. Acad. Nutr. Diet. 2014, 114, 54–62. [Google Scholar] [CrossRef]
- Oh, S. Current status of nutrient intake in Korea: Focused on macronutrients. J. Korean Med. Assoc. 2022, 65, 801–808. [Google Scholar] [CrossRef]
- Shin, W.; Lee, H.; Shin, A.; Lee, J.; Lee, S.; Lee, J.E.; Kang, D. Multi-grain rice diet decreases risk of breast cancer in Korean women: Results from the Health Examinees Study. Nutrients 2020, 12, 2273. [Google Scholar] [CrossRef]
- Park, S.; Chung, S.; Kim, S.; Shin, S. The “fruit and whole-grain” pattern is associated with a low prevalence of hypertriglyceridemia among middle- and older-aged Korean adults: Using Korea National Health and Nutrition Examination Survey 2013–2018 data. Food Sci. Nutr. 2023, 11, 1201–1210. [Google Scholar] [CrossRef] [PubMed]
- Kim, J.; Jo, I.; Joung, H. A rice-based traditional dietary pattern is associated with obesity in Korean adults. J. Acad. Nutr. Diet. 2012, 112, 246–253. [Google Scholar] [CrossRef] [PubMed]
- Kang, J.W.; Lee, S.J.; Kim, S.A.; Hwang, J.Y. Behavioral intention toward planetary health diet among adult users of government worksite cafeterias in Seoul, South Korea: A mixed-methods study based on the theory of planned behavior and focus groups interviews. Korean J. Community Nutr. 2025, 30, 224–236. [Google Scholar] [CrossRef]
- Oh, H.; Jo, G.; Kim, O.Y.; Lim, H.; Song, S.; Choi, J.H.; Bae, J.H.; Jin, E.S.; Kim, R.; Lee, Y.; et al. Fact sheet: Nationwide trends in dietary intakes among Korean adults, 2013–2022. Korean J. Intern. Med. 2025, 40, 427–437. [Google Scholar] [CrossRef]
- Tian, Y.; Su, L.; Wang, J.; Duan, X.; Jiang, X. Fruit and vegetable consumption and risk of the metabolic syndrome: A meta-analysis. Public Health Nutr. 2018, 21, 756–765. [Google Scholar] [CrossRef]
- Sohn, C.; Sohn, C. Association of vegetable and fruit consumption with 10-year cardiovascular risk calculated using the pooled cohort equation: The 2010–2011 Korea National Health and Nutrition Examination Survey. Korean J. Health Educ. Promot. 2016, 25, 475–487. [Google Scholar] [CrossRef]
- Lee, Y. Fruit and vegetable intake and its association with metabolic diseases in Korean adults: The 2019–2021 Korea National Health and Nutrition Examination Surveys. East Asian Soc. Diet. Life 2024, 34, 272–283. [Google Scholar] [CrossRef]
- Statistics Korea. Consumer Price Trends in December and Year 2024; Statistics Korea: Daejeon, Republic of Korea, 2025. Available online: https://kostat.go.kr/board.es?mid=a10301010000&bid=213&act=view&list_no=434615 (accessed on 28 July 2025).
- Food and Agriculture Organization of the United Nations (FAO). Carbon Footprint of the Banana Supply Chain. Available online: https://www.fao.org/world-banana-forum/projects/good-practices/carbon-footprint/en/ (accessed on 28 July 2025).
- Jung, D.; Yang, S.; Yang, S. The effects of local food on carbon emissions: The case of the Republic of Korea. Sustainability 2024, 16, 3614. [Google Scholar] [CrossRef]
- Hajihashemi, P.; Hassannejad, R.; Haghighatdoost, F.; Mohammadifard, N.; Sadeghi, M.; Roohafza, H.; Sajjadi, F.; Sarrafzadegan, N. The long-term association of different dietary protein sources with metabolic syndrome. Sci. Rep. 2021, 11, 19394. [Google Scholar] [CrossRef]
- Zeng, L.; Ruan, M.; Liu, J.; Wilde, P.; Naumova, E.N.; Mozaffarian, D.; Zhang, F.F. Trends in processed meat, unprocessed red meat, poultry, and fish consumption in the United States, 1999–2016. J. Acad. Nutr. Diet. 2019, 119, 1085–1098. [Google Scholar] [CrossRef]
- Kim, Y.; Je, Y. Meat consumption and risk of metabolic syndrome: Results from the Korean population and a meta-analysis of observational studies. Nutrients 2018, 10, 390. [Google Scholar] [CrossRef] [PubMed]
- Farchi, S.; De Sario, M.; Lapucci, E.; Davoli, M.; Michelozzi, P. Meat consumption reduction in Italian regions: Health co-benefits and decreases in GHG emissions. PLoS ONE 2017, 12, e0182960. [Google Scholar] [CrossRef]
- Lee, H.; Park, S.; Jung, J.; Choi, S. Association between egg consumption and metabolic disease. Korean J. Food Sci. Anim. Resour. 2018, 38, 209–223. [Google Scholar] [CrossRef]
- Lee, S.; Park, J.; Lee, M.A.; Park, E. Analysis of dietary identity questionnaire according to perception about soybean meat of Korean consumers. J. Nutr. Health 2022, 55, 492–503. [Google Scholar] [CrossRef]
- Kim, H.; Lee, K.; Rebholz, C.M.; Kim, J. Plant-based diets and incident metabolic syndrome: Results from a South Korean prospective cohort study. PLoS Med. 2020, 17, e1003371. [Google Scholar] [CrossRef]
- Nomura, M.; Yamaguchi, M.; Inada, Y.; Nishi, N. Current dietary intake of the Japanese population in reference to the planetary health diet—Preliminary assessment. Front. Nutr. 2023, 10, 1116105. [Google Scholar] [CrossRef]
- Uriza-Pinzón, J.P.; Verstraete, F.F.; Franco, O.H.; Artola Arita, V.; Nicolaou, M.; Van Der Schouw, Y.T. Planetary health diet compared to Dutch dietary guidelines: Nutritional content and adequacy. Nutrients 2024, 16, 2219. [Google Scholar] [CrossRef]
- Carvalho, C.; Correia, D.; Lopes, C.; Torres, D. Adherence to the EAT-Lancet planetary health diet in Portugal and its associations with socioeconomic and lifestyle factors. Eur. J. Nutr. 2025, 64, 221–233. [Google Scholar] [CrossRef] [PubMed]
- Hendrie, G.A.; Rebuli, M.A.; James-Martin, G.; Baird, D.L.; Bogard, J.R.; Lawrence, A.S.; Ridoutt, B. Towards healthier and more sustainable diets in the Australian context: Comparison of current diets with the Australian Dietary Guidelines and the EAT-Lancet Planetary Health Diet. BMC Public Health 2022, 22, 1939. [Google Scholar] [CrossRef] [PubMed]
- Springmann, M.; Wiebe, K.; Mason-D’Croz, D.; Sulser, T.B.; Rayner, M.; Scarborough, P. Health and nutritional aspects of sustainable diet strategies and their association with environmental impacts: A global modelling analysis with country-level detail. Lancet Planet. Health 2018, 2, e451–e461. [Google Scholar] [CrossRef] [PubMed]
Characteristics | Total | Men | Women | p-Value |
---|---|---|---|---|
Total | 12,129 (100.0) | 5744 (47.4) | 6385 (52.6) | - |
Age (yr.) | <0.0001 | |||
19~39 y | 4350 (35.9) | 2040 (35.5) | 2310 (36.2) | |
40~64 y | 6406 (52.8) | 2843 (49.5) | 3563 (55.8) | |
≥65 y | 1373 (11.3) | 861 (15.0) | 512 (8.0) | |
Household income | 0.0092 | |||
Low | 1371 (11.3) | 708 (12.3) | 663 (10.4) | |
Low middle | 2942 (24.3) | 1386 (24.1) | 1556 (24.4) | |
Middle-high | 3841 (31.7) | 1794 (31.2) | 2047 (32.1) | |
High | 3975 (32.8) | 1856 (32.3) | 2119 (33.2) | |
Education level | 0.1854 | |||
Elementary school or less | 1115 (9.2) | 544 (9.5) | 571 (8.9) | |
Middle school | 908 (7.5) | 453 (7.9) | 455 (7.1) | |
High school | 4576 (37.7) | 2174 (37.9) | 2402 (37.6) | |
College or more | 5530 (45.6) | 2573 (44.8) | 2957 (46.3) |
Components | PHD (Possible Range) | Total | Men (n = 5744) | Women (n = 6385) | p-Value | |
---|---|---|---|---|---|---|
Whole grains | 232 | 11.45 ± 0.31 | 11.62 ± 0.44 | 11.24 ± 0.37 | 0.5046 | |
Total grains | - | 320.12 ± 1.95 | 322.41 ± 2.41 | 239.29 ± 1.92 | <0.0001 | |
Red meat (beef, pork, etc.) | 14 (0–28) | 80.76 ± 1.24 | 97.98 ± 1.91 | 59.50 ± 1.19 | <0.0001 | |
White meat (poultry) | 29 (0–58) | 30.34 ± 1.03 | 36.89 ± 1.67 | 22.25 ± 0.97 | <0.0001 | |
Fish and seafood | 28 (0–100) | 47.76 ± 0.85 | 54.57 ± 1.30 | 39.34 ± 0.92 | <0.0001 | |
Eggs | 13 (0–25) | 33.70 ± 0.57 | 35.56 ± 0.81 | 31.40 ± 0.68 | <0.0001 | |
Legumes (beans, soy) | 75 (0–100) | 37.34 ± 0.88 | 40.52 ± 1.35 | 33.41 ± 1.04 | <0.0001 | |
Nuts and seeds | 50 (0–75) | 6.14 ± 0.27 | 6.12 ± 0.35 | 6.17 ± 0.36 | 0.9340 | |
Protein sources | - | 236.03 ± 1.98 | 271.64 ± 2.93 | 192.07 ± 2.15 | <0.0001 | |
Vegetables | 300 (200–600) | 307.14 ± 2.41 | 329.18 ± 3.35 | 256.72 ± 2.81 | <0.0001 | |
Fruits | 200 (100–300) | 151.93 ± 2.80 | 137.41 ± 3.68 | 169.86 ± 3.70 | <0.0001 | |
Milk and dairy products | 250 (0–500) | 87.58 ± 1.69 | 81.63 ± 2.39 | 94.92 ± 2.27 | <0.0001 | |
Added fats/oils | Saturated fats | 6.8 (0–6.8) | 0.98 ± 0.04 | 1.08 ± 0.06 | 0.85 ± 0.05 | 0.0029 |
Unsaturated oils | 40 (20–80) | 6.64 ± 0.09 | 7.51 ± 0.14 | 5.57 ± 0.10 | <0.0001 | |
Added sugars (n = 8725) | 31 (0–31) | 37.48 ± 0.41 | 30.40 ± 0.54 | 23.22 ± 0.39 | <0.0001 |
Components | KDRIs | PHD | Total | Men (n = 5744) | Women (n = 6385) | p-Value | |||
---|---|---|---|---|---|---|---|---|---|
2000 | 2500 | 2000 | 2500 | ||||||
Whole grains | 3.5 | 4 | 2.5 | 3 | 0.13 ± 0.004 | 0.14 ± 0.005 | 0.13 ± 0.004 | <0.0001 | |
Total grains | 3.27 ± 0.018 | 3.55 ± 0.025 | 2.56 ± 0.019 | <0.0001 | |||||
Red meat (beef, pork, etc.) | 0.2 | 0.3 | 1.86 ± 0.032 | 2.25 ± 0.050 | 1.39 ± 0.030 | <0.0001 | |||
White meat (poultry) | 0.5 | 0.6 | 0.50 ± 0.018 | 0.60 ± 0.030 | 0.36 ± 0.017 | <0.0001 | |||
Fish and seafood | 0.3 | 0.4 | 0.63 ± 0.011 | 0.72 ± 0.017 | 0.52 ± 0.011 | <0.0001 | |||
Eggs | 0.2 | 0.2 | 0.52 ± 0.009 | 0.55 ± 0.013 | 0.49 ± 0.011 | <0.0001 | |||
Legumes (beans, soy) | 2.3 | 2.8 | 0.43 ± 0.008 | 0.46 ± 0.012 | 0.38 ± 0.010 | <0.0001 | |||
Nuts and seeds | 2.3 | 2.9 | 0.21 ± 0.006 | 0.21 ± 0.009 | 0.21 ± 0.008 | 0.7418 | |||
Protein sources | 4 | 5 | 6 | 7.5 | 4.15 ± 0.039 | 4.80 ± 0.059 | 3.33 ± 0.038 | <0.0001 | |
Vegetables | 8 | 8 | 4 | 5 | 6.41 ± 0.047 | 7.15 ± 0.070 | 5.50 ± 0.055 | <0.0001 | |
Fruits | 2 | 4 | 2 | 2.5 | 1.54 ± 0.028 | 1.38 ± 0.035 | 1.74 ± 0.038 | <0.0001 | |
Milk and dairy products | 1 | 1 | 1 | 1 | 0.58 ± 0.011 | 0.54 ± 0.016 | 0.63 ± 0.015 | <0.0001 | |
Added fats/oils | Unsaturated oils | 4 | 7 | 10 | 13 | 1.35 ± 0.019 | 1.53 ± 0.028 | 1.13 ± 0.019 | <0.0001 |
Saturated fats | 0.12 ± 0.005 | 0.13 ± 0.007 | 0.10 ± 0.006 | 0.0426 | |||||
Added sugars (n = 8725) | 0.83 ± 0.009 | 0.94 ± 0.014 | 0.70 ± 0.010 | <0.0001 |
Components | KDRIs | PHD | Total | Men (n = 5744) | Women (n = 6385) | p-Value | ||
---|---|---|---|---|---|---|---|---|
2000 | 2500 | 2000 | 2500 | |||||
Red meat (beef, pork, etc.) | 0.2 | 0.3 | 1.48 ± 0.022 | 1.82 ± 0.035 | 1.07 ± 0.020 | <0.0001 | ||
White meat (poultry) | 0.5 | 0.6 | 0.69 ± 0.024 | 0.85 ± 0.039 | 0.51 ± 0.022 | <0.0001 | ||
Fish and seafood | 0.3 | 0.4 | 0.92 ± 0.016 | 1.05 ± 0.024 | 0.75 ± 0.016 | <0.0001 | ||
Eggs | 0.2 | 0.2 | 0.45 ± 0.008 | 0.47 ± 0.011 | 0.42 ± 0.009 | <0.0001 | ||
Legumes (beans, soy) | 2.3 | 2.8 | 0.35 ± 0.007 | 0.39 ± 0.010 | 0.32 ± 0.008 | <0.0001 | ||
Nuts and seeds | 2.3 | 2.9 | 0.07 ± 0.002 | 0.08 ± 0.004 | 0.07 ± 0.003 | 0.2751 | ||
Protein sources | 4 | 5 | 6 | 7.5 | 3.97 ± 0.035 | 4.65 ± 0.053 | 3.13 ± 0.034 | <0.0001 |
Components | PHD (Possible Range) | Men (n = 4500) | Women (n = 4924) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Q1 (n = 1252) | Q2 (n = 1168) | Q3 (n = 1136) | Q4 (n = 944) | p for Trend | Q1 (n = 1104) | Q2 (n = 1188) | Q3 (n = 1220) | Q4 (n = 1412) | p for Trend | |||
Whole grains | 232 | 4.82 ±0.60 | 8.97 ±0.76 | 16.04 ±1.11 | 24.62 ±1.57 | <0.0001 | 4.22 ±0.49 | 9.02 ±0.79 | 13.29 ±0.93 | 20.75 ±0.99 | <0.0001 | |
Total grains | - | 304.38 ±5.47 | 329.32 ±5.44 | 360.77 ±5.24 | 338.34 ±4.76 | <0.0001 | 221.17 ±4.68 | 244.85 ±4.57 | 260.91 ±4.10 | 264.00 ±3.62 | <0.0001 | |
Red meat (beef, pork, etc.) | 14 (0–28) | 115.24 ±4.60 | 92.56 ±3.71 | 87.35 ±3.58 | 78.76 ±2.88 | <0.0001 | 65.49 ±3.18 | 61.77 ±2.76 | 56.00 ±2.48 | 50.68 ±1.81 | 0.0140 | |
White meat (poultry) | 29 (0–58) | 40.02 ±3.90 | 33.63 ±3.74 | 34.86 ±3.33 | 38.26 ±3.84 | 0.4138 | 23.27 ±2.76 | 24.41 ±2.36 | 21.43 ±1.89 | 20.42 ±1.79 | 0.8582 | |
Fish and seafood | 28 (0–100) | 40.06 ±2.45 | 56.59 ±3.30 | 66.19 ±3.02 | 69.83 ±2.96 | <0.0001 | 27.82 ±2.58 | 39.13 ±2.14 | 43.59 ±1.86 | 49.19 ±2.05 | <0.0001 | |
Eggs | 13 (0–25) | 29.17 ±1.73 | 31.34 ±1.64 | 37.04 ±1.71 | 43.64 ±2.07 | <0.0001 | 23.13 ±1.42 | 27.35 ±1.36 | 32.74 ±1.66 | 34.92 ±1.36 | <0.0001 | |
Legumes (beans, soy) | 75 (0–100) | 23.47 ±3.46 | 33.27 ±2.14 | 48.19 ±2.78 | 63.87 ±3.75 | <0.0001 | 18.28 ±1.51 | 28.07 ±2.51 | 32.47 ±2.72 | 46.68 ±2.38 | <0.0001 | |
Nuts and seeds | 50 (0–75) | 2.83 ±0.39 | 3.83 ±0.41 | 8.93 ±1.14 | 10.17 ±1.18 | <0.0001 | 2.91 ±0.44 | 4.23 ±0.54 | 7.72 ±0.90 | 10.40 ±1.24 | <0.0001 | |
Protein sources | - | 250.79 ±7.43 | 251.24 ±5.89 | 282.55 ±5.52 | 304.54 ±5.89 | <0.0001 | 160.89 ±5.34 | 184.97 ±4.85 | 193.95 ±4.67 | 212.28 ±3.71 | <0.0001 | |
Vegetables | 300 (200–600) | 255.06 ±5.87 | 336.39 ±7.06 | 382.07 ±7.57 | 401.76 ±7.87 | <0.0001 | 176.67 ±4.77 | 239.90 ±5.79 | 287.30 ±6.41 | 331.05 ±6.30 | <0.0001 | |
Fruits | 200 (100–300) | 53.31 ±4.46 | 109.53 ±8.74 | 176.20 ±8.68 | 289.67 ±10.92 | <0.0001 | 67.17 ±5.63 | 138.38 ±9.35 | 193.98 ±8.71 | 290.46 ±8.08 | <0.0001 | |
Milk and dairy products | 250 (0–500) | 49.24 ±4.38 | 74.15 ±5.13 | 79.16 ±5.26 | 137.51 ±6.05 | <0.0001 | 66.56 ±5.13 | 74.92 ±4.74 | 86.44 ±4.80 | 142.71 ±4.53 | <0.0001 | |
Added fats/oils | Saturated fats | 6.8 (0–6.8) | 1.52 ±0.18 | 1.00 ±0.13 | 1.29 ±0.14 | 1.06 ±0.12 | 0.0583 | 1.44 ±0.17 | 0.83 ±0.11 | 0.91 ±0.11 | 0.83 ±0.12 | 0.0694 |
Unsaturated oils | 40 (20–80) | 6.70 ±0.31 | 7.82 ±0.37 | 7.75 ±0.27 | 8.15 ±0.29 | <0.0001 | 4.63 ±0.24 | 5.27 ±0.20 | 5.93 ±0.22 | 6.63 ±0.23 | <0.0001 | |
Added sugars | 31 (0–31) | 36.19 ±1.33 | 28.37 ±1.10 | 23.86 ±0.97 | 20.69 ±1.01 | <0.0001 | 27.33 ±1.07 | 22.15 ±0.90 | 19.47 ±0.77 | 16.76 ±0.67 | <0.0001 |
Components | Men (n = 4500) | Women (n = 4924) | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Q1 (n = 1252) | Q2 (n = 1168) | Q3 (n = 1136) | Q4 (n = 944) | p for Trend | Q1 (n = 1104) | Q2 (n = 1188) | Q3 (n = 1220) | Q4 (n = 1412) | p for Trend | |
Total energy (kcal) | 2222.86 ±30.95 | 2254.78 ±27.23 | 2402.47 ±25.81 | 2404.15 ±22.84 | <0.0001 | 1519.83 ±23.87 | 1607.52 ±20.31 | 1735.23 ±18.74 | 1853.23 ±14.47 | <0.0001 |
Total carbohydrate (g) | 291.72 ±3.89 | 328.23 ±4.00 | 362.56 ±3.96 | 370.38 ±3.64 | <0.0001 | 211.60 ±3.30 | 244.02 ±3.31 | 273.75 ±3.13 | 296.58 ±2.66 | <0.0001 |
Dietary fiber (g) | 20.83 ±0.40 | 25.07 ±0.41 | 29.66 ±0.50 | 33.18 ±0.47 | <0.0001 | 15.45 ±0.29 | 19.69 ±0.35 | 23.70 ±0.38 | 28.22 ±0.35 | <0.0001 |
Total protein (g) | 77.15 ±1.38 | 81.51 ±1.30 | 88.75 ±1.23 | 93.18 ±1.28 | <0.0001 | 51.66 ±1.05 | 58.11 ±0.91 | 62.29 ±0.85 | 69.14 ±0.66 | <0.0001 |
Total fat (g) | 62.55 ±1.52 | 50.66 ±1.04 | 50.69 ±0.90 | 51.92 ±0.74 | <0.0001 | 43.99 ±1.18 | 39.53 ±0.84 | 39.79 ±0.76 | 41.43 ±0.52 | 0.0014 |
Saturated fatty acid (g) | 20.77 ±0.51 | 15.78 ±0.35 | 14.88 ±0.29 | 15.03 ±0.25 | <0.0001 | 15.11 ±0.45 | 12.53 ±0.31 | 11.98 ±0.26 | 12.21 ±0.17 | <0.0001 |
Monounsaturated fatty acid (g) | 21.44 ±0.61 | 16.25 ±0.39 | 15.85 ±0.32 | 16.18 ±0.27 | <0.0001 | 14.36 ±0.44 | 12.67 ±0.29 | 12.53 ±0.27 | 12.88 ±0.18 | 0.0230 |
Polyunsaturated fatty acid (g) | 13.48 ±0.36 | 12.83 ±0.30 | 13.74 ±0.28 | 14.48 ±0.26 | <0.0001 | 9.56 ±0.27 | 9.65 ±0.23 | 10.63 ±0.24 | 11.35 ±0.20 | <0.0001 |
Cholesterol (g) | 281.01 ±8.10 | 280.12 ±7.70 | 306.56 ±7.96 | 337.02 ±8.93 | <0.0001 | 202.10 ±6.67 | 219.20 ±6.21 | 230.56 ±6.45 | 252.92 ±5.25 | <0.0001 |
Vitamin A (ug RAE) | 350.95 ±15.54 | 411.97 ±15.70 | 494.14 ±32.20 | 496.36 ±11.71 | <0.0001 | 282.78 ±10.65 | 331.05 ±10.36 | 386.07 ±14.20 | 448.89 ±10.82 | <0.0001 |
Vitamin C (mg) | 57.15 ±4.50 | 66.51 ±2.84 | 82.55 ±3.35 | 108.34 ±3.71 | <0.0001 | 44.78 ±2.07 | 59.87 ±2.51 | 82.60 ±3.58 | 110.20 ±3.91 | <0.0001 |
Vitamin B1 (mg) | 1.59 ±0.04 | 1.70 ±0.03 | 1.92 ±0.03 | 2.06 ±0.03 | <0.0001 | 1.04 ±0.03 | 1.22 ±0.02 | 1.38 ±0.02 | 1.61 ±0.03 | <0.0001 |
Vitamin B2 (mg) | 1.69 ±0.04 | 1.65 ±0.03 | 1.75 ±0.03 | 1.90 ±0.03 | <0.0001 | 1.17 ±0.02 | 1.28 ±0.02 | 1.37 ±0.02 | 1.55 ±0.02 | <0.0001 |
Niacin (mg) | 15.31 ±0.31 | 15.83 ±0.30 | 17.88 ±0.34 | 18.97 ±0.32 | <0.0001 | 10.27 ±0.24 | 11.89 ±0.21 | 12.79 ±0.19 | 14.42 ±0.18 | <0.0001 |
Calcium (mg) | 447.34 ±8.52 | 523.04 ±9.77 | 581.28 ±9.74 | 671.34 ±11.45 | <0.0001 | 355.35 ±7.79 | 414.91 ±9.01 | 462.39 ±7.09 | 568.19 ±8.32 | <0.0001 |
Sodium (mg) | 4064.28 ±73.27 | 4253.08 ±73.82 | 4429.20 ±77.39 | 4139.53 ±72.82 | 0.0024 | 2768.30 ±75.25 | 2959.15 ±55.22 | 3112.07 ±53.56 | 3099.68 ±46.96 | 0.0002 |
Potassium (mg) | 1055.69 ±16.33 | 1168.03 ±15.68 | 1315.46 ±15.51 | 1449.37 ±16.77 | <0.0001 | 749.50 ±12.55 | 870.29 ±12.52 | 967.01 ±11.02 | 1139.54 ±10.10 | <0.0001 |
Iron (mg) | 11.99 ±0.28 | 14.56 ±0.35 | 16.33 ±0.33 | 17.68 ±0.34 | <0.0001 | 8.24 ±0.19 | 10.66 ±0.23 | 12.12 ±0.21 | 14.31 ±0.22 | <0.0001 |
Components (Quartiles) | Total Fat (g) | SFA (g) | MUFA (g) | PUFA (g) | KHEI Score | KHEI Sub-Score: % Energy from SFA | |
---|---|---|---|---|---|---|---|
Fish Intakes | |||||||
Men | FQ1 (n = 1398) | 56.85 ± 1.23 | 18.52 ± 0.43 | 19.24 ± 0.49 | 12.95 ± 0.31 | 54.51 ± 0.49 | 6.15 ± 0.16 |
FQ2 (n = 1312) | 53.04 ± 1.05 | 16.90 ± 0.37 | 17.54 ± 0.42 | 12.45 ± 0.24 | 58.62 ± 0.46 | 7.05 ± 0.15 | |
FQ3 (n = 1370) | 53.48 ± 1.05 | 16.60 ± 0.36 | 17.39 ± 0.41 | 13.28 ± 0.27 | 61.80 ± 0.43 | 7.57 ± 0.13 | |
FQ4 (n = 1664) | 55.63 ± 0.88 | 16.27 ± 0.28 | 17.31 ± 0.32 | 15.74 ± 0.28 | 63.26 ± 0.38 | 8.16 ± 0.10 | |
p for trend | 0.6479 | <0.0001 | 0.0021 | <0.0001 | <0.0001 | <0.0001 | |
Women | FQ1 (n = 1634) | 43.16 ± 0.82 | 14.37 ± 0.31 | 14.13 ± 0.30 | 9.91 ± 0.21 | 57.96 ± 0.48 | 5.93 ± 0.15 |
FQ2 (n = 1720) | 40.04 ± 0.71 | 12.74 ± 0.27 | 12.96 ± 0.26 | 9.66 ± 0.17 | 61.89 ± 0.41 | 7.01 ± 0.14 | |
FQ3 (n = 1663) | 40.02 ± 0.68 | 12.37 ± 0.24 | 12.68 ± 0.24 | 10.38 ± 0.20 | 63.63 ± 0.42 | 7.37 ± 0.13 | |
FQ4 (n = 1368) | 43.98 ± 0.83 | 13.03 ± 0.29 | 13.47 ± 0.28 | 12.41 ± 0.26 | 65.73 ± 0.45 | 7.85 ± 0.13 | |
p for trend | 0.9989 | 0.0001 | 0.0183 | <0.0001 | <0.0001 | <0.0001 | |
Legumes Intakes | |||||||
Men | LQ1 (n = 1841) | 55.09 ± 0.97 | 18.12 ± 0.34 | 18.43 ± 0.37 | 12.32 ± 0.26 | 55.16 ± 0.39 | 6.45 ± 0.13 |
LQ2 (n = 816) | 55.05 ± 1.44 | 17.17 ± 0.50 | 17.98 ± 0.56 | 13.73 ± 0.36 | 58.30 ± 0.55 | 7.08 ± 0.18 | |
LQ3 (n = 1519) | 53.46 ± 1.04 | 16.51 ± 0.35 | 17.45 ± 0.39 | 13.25 ± 0.27 | 61.39 ± 0.44 | 7.55 ± 0.13 | |
LQ4 (n = 1568) | 55.75 ± 0.93 | 16.11 ± 0.31 | 17.48 ± 0.36 | 16.00 ± 0.27 | 65.07 ± 0.39 | 8.24 ± 0.11 | |
p for trend | 0.0112 | 0.0161 | 0.8524 | <0.0001 | <0.0001 | <0.0001 | |
Women | LQ1 (n = 2331) | 41.55 ± 0.64 | 13.74 ± 0.25 | 13.50 ± 0.23 | 9.50 ± 0.16 | 58.49 ± 0.36 | 6.40 ± 0.13 |
LQ2 (n = 1077) | 40.37 ± 0.88 | 12.99 ± 0.32 | 12.85 ± 0.30 | 9.90 ± 0.25 | 61.77 ± 0.50 | 7.01 ± 0.17 | |
LQ3 (n = 1513) | 40.71 ± 0.77 | 12.49 ± 0.27 | 13.13 ± 0.29 | 10.38 ± 0.21 | 64.34 ± 0.44 | 7.58 ± 0.13 | |
LQ4 (n = 1464) | 43.97 ± 0.84 | 12.85 ± 0.29 | 13.48 ± 0.29 | 12.84 ± 0.25 | 66.87 ± 0.46 | 7.51 ± 0.14 | |
p for trend | 0.0007 | 0.1706 | 0.1836 | <0.0001 | <0.0001 | <0.0001 | |
Nuts and Seed Intakes | |||||||
Men | NQ1 (n = 1417) | 51.76 ± 1.15 | 17.36 ± 0.43 | 17.06 ± 0.44 | 11.60 ± 0.27 | 54.81 ± 0.49 | 6.52 ± 0.15 |
NQ2 (n = 1386) | 49.85 ± 0.96 | 16.04 ± 0.33 | 16.19 ± 0.37 | 11.86 ± 0.24 | 59.37 ± 0.44 | 7.33 ± 0.13 | |
NQ3 (n = 1508) | 56.22 ± 0.97 | 17.24 ± 0.34 | 18.22 ± 0.38 | 14.28 ± 0.25 | 61.10 ± 0.41 | 7.63 ± 0.13 | |
NQ4 (n = 1433) | 61.63 ± 1.10 | 17.56 ± 0.35 | 20.04 ± 0.43 | 17.18 ± 0.35 | 63.97 ± 0.45 | 7.65 ± 0.13 | |
p for trend | <0.0001 | 0.0322 | <0.0001 | <0.0001 | <0.0001 | <0.0001 | |
Women | NQ1 (n = 1615) | 39.39 ± 0.81 | 13.42 ± 0.31 | 12.71 ± 0.30 | 8.79 ± 0.20 | 57.16 ± 0.43 | 6.21 ± 0.15 |
NQ2 (n = 1646) | 37.48 ± 0.64 | 12.14 ± 0.24 | 11.85 ± 0.22 | 9.12 ± 0.18 | 61.30 ± 0.44 | 7.17 ± 0.13 | |
NQ3 (n = 1525) | 43.28 ± 0.79 | 13.55 ± 0.30 | 13.67 ± 0.28 | 11.00 ± 0.21 | 63.45 ± 0.43 | 7.27 ± 0.13 | |
NQ4 (n = 1599) | 47.29 ± 0.77 | 13.49 ± 0.25 | 15.17 ± 0.27 | 13.42 ± 0.25 | 67.46 ± 0.42 | 7.48 ± 0.13 | |
p for trend | <0.0001 | 0.0137 | <0.0001 | <0.0001 | <0.0001 | <0.0001 |
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Lee, S.-J.; Hwang, J.-Y. Planetary Health Diet Adherence in Korean Adults: Association with the Korean Healthy Eating Index. Nutrients 2025, 17, 3060. https://doi.org/10.3390/nu17193060
Lee S-J, Hwang J-Y. Planetary Health Diet Adherence in Korean Adults: Association with the Korean Healthy Eating Index. Nutrients. 2025; 17(19):3060. https://doi.org/10.3390/nu17193060
Chicago/Turabian StyleLee, Su-Jin, and Ji-Yun Hwang. 2025. "Planetary Health Diet Adherence in Korean Adults: Association with the Korean Healthy Eating Index" Nutrients 17, no. 19: 3060. https://doi.org/10.3390/nu17193060
APA StyleLee, S.-J., & Hwang, J.-Y. (2025). Planetary Health Diet Adherence in Korean Adults: Association with the Korean Healthy Eating Index. Nutrients, 17(19), 3060. https://doi.org/10.3390/nu17193060