Search Results (491)

Background and Objectives: Sarcopenic obesity, or the coexistence of sarcopenia and obesity, carries an additional load of health risks, including functional decline and metabolic disorders. Despite its increasing importance, data on Korean adults’ prevalence and risk factors are poor. The objective of this study was to estimate the prevalence of sarcopenic obesity, sarcopenia, and obesity to identify factors associated with each condition using the most recent nationally representative data. Materials and Methods: This study analyzed data from 4332 adults aged ≥ 40 years who participated in the 2022–2023 Korea National Health and Nutrition Examination Survey (KNHANES). Sarcopenia was defined using the appendicular skeletal muscle index (SMI) via bioelectrical impedance analysis (BIA), and obesity by waist circumference per Korean criteria. Participants were categorized into four body composition groups. Complex sample logistic regression was used to identify factors independently associated with each condition. Results: The prevalence rates of sarcopenic obesity, sarcopenia-only, and obesity-only were 1.9%, 14.4%, and 35.5%, respectively. Sarcopenic obesity was significantly more common among older women with low education level, poor subjective health, diabetes, and low HDL-C. They were associated with older age, lower physical activity, lower education level, past smoking, and poor health condition. Obesity was associated with male sex, diabetes, hypertension, dyslipidemia, and moderate-to-poor perceived health. Conclusions: Sarcopenic obesity, while less prevalent, is relatively uncommon and represents a high-risk phenotype associated with metabolic and functional deficits. These results highlight the importance of identifying vulnerable subgroups and implementing targeted strategies that address both muscle loss and adiposity in aging Korean adults. Full article

Background: Metabolic syndrome (MetS) is a multifactorial condition involving central obesity, dyslipidemia, hypertension, and impaired glucose metabolism, significantly increasing the risk of type 2 diabetes and cardiovascular disease. Objectives: Given the clinical heterogeneity of MetS, this study aimed to identify distinct metabolic phenotypes, referred to as metabotypes, using validated biomarkers and to examine their association with MetS. Materials and Methods: A total of 1245 Korean adults aged 19–79 years were selected from the 2016–2023 Korea National Health and Nutrition Examination Survey. Metabotype risk clusters were derived using k-means clustering based on five biomarkers: body mass index (BMI), uric acid, fasting blood glucose (FBG), high-density lipoprotein cholesterol (HDLc), and non-HDL cholesterol (non-HDLc). Multivariable logistic regression was used to assess associations with MetS. Results: Three distinct metabotype risk clusters (low, intermediate, and high risk) were identified. The high-risk cluster exhibited significantly worse metabolic profiles, including elevated BMI, FBG, HbA1c, triglyceride, and reduced HDLc. The prevalence of MetS increased progressively across metabotype risk clusters (OR: 5.46, 95% CI: 2.89–10.30, p < 0.001). In sex-stratified analyses, the high-risk cluster was strongly associated with MetS in both men (OR: 9.22, 95% CI: 3.49–24.36, p < 0.001) and women (OR: 3.70, 95% CI: 1.56–8.75, p = 0.003), with notable sex-specific differences in lipid profiles, particularly in HDLc. Conclusion: These findings support the utility of metabotyping using routine biomarkers as a tool for early identification of high-risk individuals and the development of personalized prevention strategies in clinical and public health settings. Full article

Background/Objectives: Recent Japanese guidelines recommend using the average sodium-to-potassium (Na/K) ratio from casual urine samples to assess hypertension and cardiovascular risk, suggesting cutoffs of 2 (optimal) and 4 (feasible). We aimed to evaluate the proportion of Korean individuals who would be classified as having elevated Na/K ratios using these cutoffs, based on random urine Na/K measurements obtained from the nationally representative Korea National Health and Nutrition Examination Survey (KNHANES) dataset. Methods: We analyzed 50,440 participants from the KNHANES 2016–2023 with available random urine Na and K results. Annual urinary Na/K ratios were calculated, and the prevalence of ratios ≥2 and ≥4 was assessed by age and sex using sampling weights. Results: The weighted median Na/K ratios were consistently lower than the weighted means, indicating skewed distributions. From 2016 to 2023, the weighted median and mean values increased from 2.3 and 2.7 to 2.8 and 3.3, respectively. The prevalence of a Na/K ratio ≥2 increased from 60.5% to 72.0%, and that of a ratio ≥4 increased from 16.9% to 28.3%. A U-shaped trend in Na/K ≥4 prevalence was observed by age, highest among those <20 and ≥70 years. Males had a higher prevalence than females in all age groups except 20–29. Conclusions: A growing proportion of Koreans exceeded Na/K cutoffs of 2 and 4 over time. Age- and sex-specific variation suggests tailored interpretation may be necessary when applying these thresholds in population health monitoring. Full article

Objectives: This study aimed to investigate both the linear and non-linear associations between serum 25-hydroxyvitamin D [25(OH)D] levels and serum uric acid concentrations in Korean adults, with a particular focus on the vitamin D-insufficient range (<30 ng/mL), and to explore the potential metabolic implications of this relationship. Methods: Using data from the Korea National Health and Nutrition Examination Survey (KNHANES), we analyzed 10,864 adults aged 19 years and older. Serum vitamin D levels were categorized into quartiles (Q1–Q4), and their relationships with uric acid concentrations were examined using Pearson correlation, analysis of variance (ANOVA), and restricted cubic spline regression. Multivariate models were adjusted for potential confounders including age, sex, body mass index (BMI), kidney function, chronic disease status, and macronutrient intake. Results: In unadjusted analysis, a statistically significant but weak negative correlation was observed between serum 25(OH)D and uric acid levels (Pearson’s r = −0.092, p < 0.001). However, in multivariate regression adjusting for confounders, a weak positive association emerged. Restricted cubic spline analysis revealed significant positive associations in the lower quartiles (Q1–Q3), with the strongest association in Q3 (β = 0.769, 95% CI: 0.34–1.19, p < 0.001). No significant association was observed in the highest quartile (Q4). Conclusions: Serum vitamin D and uric acid concentrations show a non-linear relationship, with a significant positive association within the vitamin D-insufficient range (<30 ng/mL). These findings provide new insights into the potential metabolic role of vitamin D and highlight the need for longitudinal and interventional studies to clarify causality and clinical significance. Full article

Background: Cancer survivors may continue to experience health issues that affect their quality of life and raise the risk of other chronic diseases. Methods: This study aimed to assess adherence to general health check-ups, cancer-specific screenings, and chronic disease management among five-year cancer survivors using nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2013 and 2021. A total of 2597 cancer survivors and 2458 matched non-cancer controls were selected via 1:1 propensity score matching based on demographic and lifestyle characteristics. We analyzed health behaviors (smoking and alcohol use), participation in general and cancer-specific screenings, and medication adherence for hypertension, diabetes, and dyslipidemia. Results: Compared to controls, cancer survivors, especially those diagnosed more than five years ago, were significantly less likely to participate in recommended cancer screenings (adjusted OR: 0.82, p = 0.014) and had lower adherence to treatment for hypertension (adjusted OR: 1.84, p = 0.004) and dyslipidemia (adjusted OR: 1.42, p = 0.026). However, cancer survivors were less likely to smoke or consume alcohol. Conclusions: These findings underscore the need for comprehensive survivorship care policies that integrate both cancer surveillance and chronic disease management. Full article

Background/Objectives: This study aims to investigate the relationship between sleep duration, physical activity, and nutritional intake of calories and vitamins to determine the interconnections among sleep, physical activity, and dietary habits. Methods: Overall, 5491 participants (male = 2347, female = 3144) aged ≥ 18 years were recruited from the first survey of the 2023 9th Korea National Health and Nutrition Examination Survey (KNHANES). All participants were assessed for sleep duration, physical activity levels, and intake of vitamin D, carbohydrates, protein, and fat. Results: In both sexes, participants with ≥8 h of sleep per day had significantly higher levels of moderate-intensity physical activity (male: p = 0.026, female: p = 0.011), moderate-to-vigorous-intensity physical activity (male: p = 0.003, female: p = 0.004), vitamin D (male: p = 0.029, female: p = 0.008), protein (male: p < 0.001, female: p = 0.011), and fat (male: p = 0.007, female: p = 0.015) than those with < 8 h of sleep. In the unadjusted model, participants who did not meet the recommended protein intake were less likely to achieve sufficient levels of physical activity (OR = 1.59, 95% CI: 1.39–1.82) and adequate sleep duration (OR = 1.12, 95% CI: 1.10–1.16). Conclusions: Sleep duration, physical activity, and nutrient intake (particularly vitamin D and protein) appear to be interrelated. Therefore, increasing daily physical activity and ensuring adequate intake of protein and vitamin D is recommended to maintain healthy sleep duration. Full article

Background/Objectives: Metabolic syndrome (MetS) in adolescence increases chronic disease risk in adulthood. No study has explored the combined effects of skeletal muscle strength and dietary patterns in MetS. This study aimed to examine the individual and combined effects of dietary patterns and HGS on MetS and its components in Korean adolescents. Methods: Using the 2014–2019 Korea National Health and Nutrition Examination Survey data, a weighted sample of approximately 3.75 million adolescents was included. Dietary patterns were derived using principal component analysis. Relative handgrip strength (HGS) was calculated. Multivariable logistic regression and relative excess risk due to interaction (RERI) were used to assess dietary patterns, HGS, and MetS, stratified by sex and adjusted for age, smoking, alcohol consumption, economic status, residential area, and physical activity. Results: Low HGS was independently associated with a high odds of developing MetS in both men (OR, 1.108; 95% CI, 1.038–1.182) and women (OR, 1.128; 95% CI, 1.047–1.216). In contrast, dietary pattern alone was not significantly associated with MetS. Men with both low HGS and unhealthy dietary patterns (processed fat or Western diet) had higher odds of developing MetS, even though the interaction was sub-additive, as indicated by negative RERI values (processed fat: −0.22; Western diet: −0.11). Conclusions: Low HGS was a significant risk factor for MetS in Korean adolescents. Although no synergistic interaction was observed, low HGS remained a significant independent risk factor for MetS, underscoring the need to promote muscular strength in adolescents even in the absence of an unhealthy diet. Full article

Background/Objectives: Health behavior management plays a critical role in improving outcomes for cancer survivors. This study aims to examine differences in health behaviors based on survival status and time since diagnosis among individuals with gastric or colorectal cancer. Methods: Data were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES, 2014–2021). Among adults aged ≥40 years, 478 individuals diagnosed with gastric or colorectal cancer within the past 10 years were included. Participants were classified as current patients or survivors based on current disease status, and time since diagnosis was categorized as ≤3 years or >3 years. All analyses accounted for complex sample weights. Differences in health behaviors were evaluated using weighted t-tests and Rao–Scott chi-square tests, and weighted logistic regression was used to assess the association between time since diagnosis and current alcohol use. Results: Current alcohol consumption was significantly more prevalent in survivors (49.2%) than in current patients (29.9%) (p = 0.0002). Among current patients, those diagnosed more than three years earlier showed a higher drinking rate (40.9%) compared with those diagnosed within three years (25.4%) (p = 0.0411). In logistic regression analysis, time since diagnosis >3 years was associated with higher odds of alcohol consumption (OR = 2.32, 95% CI: 1.04–5.20), even after adjusting for age and sex. No significant differences were observed in smoking, aerobic activity, strength exercise, or walking. Conclusions: A longer time since diagnosis was associated with increased alcohol consumption in gastric and colorectal cancer patients, highlighting the need for sustained behavioral interventions during survivorship. Full article

Background/Objectives: This study examined differences in physical activity (PA) and sedentary behavior among Korean cancer survivors compared to cancer-free individuals from 2017 to 2021 and identified differences based on their cancer treatment status. Methods: We used data for 28,528 adults (1585 cancer survivors and 26,943 cancer-free individuals) from the 2017–2021 Korea National Health and Nutrition Examination Survey. PA and sedentary behavior were assessed using the Korean version of the Global Physical Activity Questionnaire. We examined adherence to aerobic and resistance training guidelines, domain-specific activity, and sedentary time. We also analyzed the descriptive statistics and conducted chi-square tests, the Mann–Whitney U test, and the non-parametric Kruskal–Wallis test, stratified by demographic and clinical subgroups. Results: Compared with cancer-free individuals, cancer survivors showed significantly lower adherence to aerobic PA guidelines in 2017 (p < 0.01), 2018 (p < 0.05), and 2021 (p < 0.01). Transportation-related activity accounted for the highest share of the total PA (mean: 59.1%). Sedentary time increased among survivors from 8.1 h/day (2017) to 9.0 h/day (2021). In 2021, resistance training adherence was higher among survivors (24.7%) than among non-cancer individuals (22.9%). In the subgroup analyses, male sex, younger age, recent diagnosis, higher income, and living with a spouse were associated with higher adherence. Conclusions: The findings underscore a clear need to address both PA and sedentary behavior in cancer survivors, irrespective of treatment phase. Full article

Background/Objectives: This cross-sectional study examined the association between diet quality, measured by the Korean Healthy Eating Index (KHEI), and medical expenditures among Korean adults. Methods: We used data from the Korea National Health and Nutrition Examination Survey (2016–2021). Adults aged ≥20 years with complete data on diet, sociodemographics, and healthcare use were included. Medical costs were estimated from self-reported service use and converted to USD. KHEI scores were categorized into quartiles. Multivariable linear regression was used to assess the association between KHEI quartiles and log-transformed costs. Subgroup analyses were conducted by age (<57 vs. ≥57 years), and sensitivity analyses treated KHEI as a continuous variable. A two-part model addressed skewed, zero-inflated cost data. Results: Compared to Q1, participants in Q4 had significantly lower inpatient (β = −0.080; 95% CI: −0.139 to −0.020) and total costs (β = −0.086; 95% CI: −0.144 to −0.027). In the younger group, Q4 was associated with lower total costs (β = −0.115; 95% CI: −0.198 to −0.031). Higher continuous KHEI scores were also linked to lower costs. In the two-part model, Q4 participants had a higher probability of incurring any cost but lower conditional costs (Q3 vs. Q1: β = −0.173; Q4 vs. Q1: β = −0.160; both p < 0.05). Conclusions: Higher diet quality was associated with reduced healthcare costs in Korean adults, especially among younger individuals. Promoting healthy eating may help lower economic burdens in aging societies. Full article

Background: This study aimed to evaluate the association between physical activity and suicidal ideation in adult women and to examine the moderating effect of self-rated health status. Methods: This study utilized raw data from the Korea National Health and Nutrition Examination Survey (KNHANES) from the 6th to the 8th cycle (2013–2021). Complex sample logistic regression analysis was performed to assess the association between physical activity and suicidal ideation, and stratified analysis was conducted to examine differences in effects according to self-rated health status. Results: The prevalence of suicidal ideation among participants was 5.5%. Stratified analysis revealed that the effect of physical activity on suicidal ideation varied by self-rated health status. Among women with good self-rated health, physical activity was associated with significantly reduced odds of suicidal ideation (OR = 2.116, 95% CI: 1.229–3.643). However, among those with fair or poor self-rated health, physical activity showed no significant protective effect (OR = 1.173, 95% CI: 0.902–1.525). Conclusions: This study demonstrates a significant association between physical activity and suicidal ideation, with self-rated health status playing a key moderating role. Suicide prevention strategies should incorporate interventions that promote physical activity while considering self-rated health status. Full article

Background/Objectives: This study aimed to examine the association between ultra-processed food (UPF) consumption and obesity in Korean adults. Methods: Data from the 2019 to 2021 Korea National Health and Nutrition Examination Survey were analyzed. Dietary intake and UPF consumption were assessed using the NOVA food classification based on 24 h recall data from 9662 participants (aged 19–64 years). The participants were divided into three groups based on the tertile of UPF intake. Obesity was defined as a body mass index of ≥25 kg/m². Multivariable logistic regression was used to estimate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) after controlling for potential confounders. Results: Of the participants, 50.2% were men and 49.8% were women. Men consumed more UPFs daily (401.3 g) than women (260.1 g; p < 0.0001). Among the various categories of ultra-processed foods, ‘soft drinks, fruit and vegetable drinks’ were the most frequently consumed by both men and women, with men showing a notably higher intake than women. Compared to the lowest quartile of UPF intake, the highest tertile was significantly associated with obesity in men (AOR: 1.28; 95% CI: 1.05–1.55; p for trend = 0.0003). Conclusions: This study suggests that a high intake of UPFs is associated with increased odds of obesity in men. Further research is needed to elucidate the specific negative health effects of UPFs in different populations, and targeted efforts should promote healthy diets for both men and women. Full article

Background/Objectives: Research on oral dysfunctions as contributing factors to obstructive sleep apnea (OSA) is needed to prevent and treat OSA. This study aimed to explore the association of OSA with oral dysfunction and examine its impact on nutrient intake, physical activity, and handgrip strength. Methods: This cross-sectional study analyzed data from the Eighth cycle Korea National Health and Nutrition Examination Survey (KNHANES, 2019–2021). The OSA group included diagnosed individuals and those over 40 years with symptoms such as snoring, fatigue, or witnessed breathing pauses during sleep. The non-OSA group included individuals not meeting these criteria. Using 1:1 propensity score matching to control for confounders (sex, age, lifestyle factors), 7636 participants were included. Oral dysfunction was assessed based on chewing problems, complaints of chewing discomfort, and speech difficulties. Nutrient intake, physical activity, and handgrip strength were analyzed using the Rao–Scott χ² test, complex sample t-test, and complex sample logistic regression. Results: The OSA group demonstrated significantly more oral dysfunction elements than the non-OSA group (p < 0.001). Higher energy intake was observed in the OSA group, with no significant differences in macronutrient intake. Physical activity levels were similar between groups; however, OSA participants without oral problems had higher handgrip strength (p < 0.05). Regression analysis showed increased OSA risk correlated with greater oral dysfunction and lower protein intake. Conclusions: This study revealed a strong association between oral dysfunction and OSA risk. Focusing on the assessment and early intervention of oral dysfunctions that influence OSA risk factors may aid in the early detection and prevention of OSA. Full article

Background: Obstructive sleep apnea (OSA) and abnormal sleep duration are known risk factors for hypertension. However, evidence regarding their combined effect on hypertension is limited and inconsistent. This study aimed to examine the independent and interactive associations of OSA risk and sleep duration with hypertension in Korean adults. Methods: We analyzed data from 14,579 adults aged ≥40 years who participated in the 2019–2022 Korea National Health and Nutrition Examination Survey. OSA risk was assessed using the STOP-Bang questionnaire and classified as low (0–2), moderate (3–4), or high (5–8). Sleep duration was self-reported and categorized as <6, 6–<7, 7–<8, 8–<9, and ≥9 h. Hypertension was defined based on measured blood pressure and antihypertensive medication use. Multivariate logistic regression was conducted to evaluate the associations. Results: A dose–response association was observed between OSA risk and hypertension prevalence: adjusted ORs (95 CIs) were 9.69 (8.37–11.23) for moderate and 36.58 (29.35–45.59) for high OSA risk. Sleep duration alone was not significantly associated with hypertension. However, interaction models showed a U-shaped relationship, with the lowest hypertension prevalence in those sleeping 7–<8 h. Among participants with high OSA risk, both short (<7 h) and long (≥9 h) sleep durations were associated with significantly higher hypertension risk (OR 48.49, 95% CI 19.68–119.50 for ≥9 h). Conclusions: OSA risk and sleep duration jointly affect hypertension risk. Individuals with high OSA risk who are short or long sleepers may require targeted interventions to improve blood pressure control. Full article

Background/Objectives: The purpose of this study is to evaluate the dietary habits of older Korean adults according to their level of plant protein intake. Methods: To conduct this study, the daily plant protein intake of 4254 older adults aged 65 years and older who participated in the dietary survey (24-h recall method) of the 2016~2018 Korea National Health and Nutrition Examination Survey (KNHANES) was divided into quintiles. And the association among plant protein quintiles and general characteristics, health-related behaviors, dietary habits, nutrient intakes, and Korean Healthy Eating Index (KHEI) was examined. Results: For the energy contribution of protein, more than 90% of all groups from Q1 through Q5 were in the Acceptable Macronutrient Distribution Range (AMDR, 7–20%) for protein. In the case of food security, the proportion tended to increase by about 11 percentage points from Q1 (43.4%) to Q5 (54.4%) according to plant protein quintiles, and while food insecurity was above 50% from Q1 to Q3, the percentage tended to decrease as the plant protein quintile increased from Q4 (48.3%) to Q5 (45.3%). Overall, the low plant protein intake group, especially the Q1 to Q3 group, was found to have an inadequate intake of nutrients, including total protein, compared to the recommended intake. In addition, among the components of the KHEI score, the score for the item “consumption of multigrain rice” was found to be very low. Conclusions: Based on these findings, dietary education or guidelines are needed to increase individual awareness, as well as the development of dietary content at government level to support this. Full article