DOI QR코드

DOI QR Code

Evaluation of Diet Quality according to Self-Rated Health Status of Korean Middle-Aged Women -Based on 2008~2009 Korean National Health and Nutrition Examination Survey-

한국 중년 여성의 주관적 건강상태에 따른 식사의 질 평가 -2008~2009 국민건강영양조사 자료 활용-

  • Lee, Hye-Jin (Dept. Food and Nutrition, Changwon National University) ;
  • Lee, Kyung-Hea (Dept. Food and Nutrition, Changwon National University)
  • 이혜진 (창원대학교 식품영양학과) ;
  • 이경혜 (창원대학교 식품영양학과)
  • Received : 2013.05.16
  • Accepted : 2013.07.22
  • Published : 2013.09.30

Abstract

The purpose of this study was to evaluate the diet quality in Korean middle-aged women based on their self-rated health status (SRH) as well as to investigate the relationship between SRH and the diet quality. For the study, we obtained data for analysis from the combined 2008~2009 Korean National Health and Nutrition Examination Survey (KNHANES). The study subjects were divided into two groups-'Good' group (${\geq}3.06$, n=622) and 'Bad' group (<3.06, n=1,092)- on the basis of the average SRH value (3.06). The women in the 'Good' group had achieved a higher education level and had a significantly high monthly average income (P<0.05), whereas women in the 'Bad' group had a larger waist circumference (P<0.05). In addition, women in the 'Good' group engaged in more physical activities (P<0.01). In comparison with the women in 'Bad' group, women in the 'Good' group were found to have a superior nutritional status, with a nutrient adequacy ratio (NAR) of protein (P<0.05), calcium (P<0.05), iron (P<0.05), vitamin A (P<0.05), vitamin $B_2$ (P<0.05), and niacin (P<0.01). The mean adequacy ratio (MAR) of women in the 'Good' group was also significantly higher than that of the women in the 'Bad' group. The index of nutritional quality (INQ) of protein (P<0.05), iron (P<0.05), vitamin $B_1$ (P<0.05), and niacin (P<0.05) in women belonging to the 'Good' group were also significantly higher than that in the women assigned the 'Bad' group. The results of regression analysis on the relevance between the diet quality and SRH, MAR, and INQ showed a significantly positive relevance (P<0.001), even after adjusting for disturbance factors. The results of this study show that diet quality seems to be the important factor for improving SRH of women. Therefore, we suggest that developing dietary guidelines and educating women about the guidelines would improve health of middle-aged women in Korea.

본 연구에서는 2008~2009년도 국민건강영양조사 자료를 활용하여 45~60세 중년여성을 대상으로 주관적 건강상태에 따라 대상자를 분류하여 그룹 간에 생활습관, 건강특성, 영양소 섭취량 및 식사의 질에 차이가 있는지 비교하고, 주관적 건강상태와 식사의 질과의 관계를 살펴보았다. 조사대상자의 평균 나이는 $52.1{\pm}4.6$세였고, 교육수준과 월 평균 소득은 주관적 건강상태가 '좋음' 군에서 유의적으로 높았다(P<0.05). 주관적 건강상태가 '나쁨' 군의 허리둘레가 유의적으로 더 컸으며(P<0.05), 체지방률, 체질량지수는 주관적인 건강상태에 따라 유의적인 차이가 없었다. 신체활동에서도 주관적 건강상태가 '좋음' 군에서 일주일간 걷기 일 수와 신체활동 일 수 모두 유의적으로 많았다(P<0.01). 영양소 섭취량 분석 결과 주관적 건강상태가 '좋음' 군의 철(P<0.01), 인(P<0.05), 칼륨(P<0.05)과 비타민 A(P<0.05), 비타민 $B_1$(P<0.01), 비타민 $B_2$(P<0.05), 나이아신(P<0.01)의 섭취량이 유의적으로 높았다. NAR을 평가한 결과에서도 '좋음' 군의 단백질(P<0.05), 칼슘(P<0.05), 철분(P<0.05), 비타민 A(P<0.05), 비타민 $B_2$(P<0.05), 나이아신(P<0.01)의 NAR이 유의적으로 높았으며, MAR도 '좋음' 군에서 유의적으로 높았다. 단백질(P<0.05), 철(P<0.05), 비타민 $B_1$(P<0.05), 나이아신(P<0.05)의 INQ 또한 '좋음' 군에서 유의적으로 높았다. 식사의 질과 주관적 건강상태 관련성을 알아보기 위해 회귀분석을 실시한 결과 교란 인자를 보정한 후에도 MAR과 INQ는 주관적 건강상태와 유의적인 양의 관련성(P<0.001)을 보였다. 이상의 결과로 높은 식사의 질이 자기가 인식하는 주관적인 건강상태에 긍정적인 영향을 미칠 수 있으며, 중년여성의 식사의 질이 주관적 건강상태와 관련이 있는 만큼 이들 여성의 건강 증진을 위해 바람직한 식습관을 통한 식사의 질을 높일 수 있는 구체적인 식사 지침 및 식생활 교육이 마련되어야 할 것으로 사료되는 바이다.

Keywords

References

  1. Kim SK, Sunwoo JG, Lee EJ. 2006. Relation of mineral nutrition status and climacteric symptoms in pre- and postmenopausal women. Korean J Nutr 39: 121-132.
  2. Lee HJ, Lee KH, Kim EK, Kim MJ, Hwang SM. 2012. The related factors influencing on self-rated health level of middle-aged women. Korean J Community Nutr 17: 290-301. https://doi.org/10.5720/kjcn.2012.17.3.290
  3. Song AR. 2005. Health factors related to management of menopause among climacteric women. Korean J Women Health Nutr 11: 12-19.
  4. Park CS. 1996. A model for health promoting behaviors in late-middle aged woman. J Korean Acad Womens Health Nurs 2: 257-284.
  5. Kim YT, Ahn SS, Chung JJ, Choi SW. 2008. Korean women's health conditions and policy agenda. Korean Women's Development Institute. Hanhakmunhwa, Seoul, Korea. p 1-248.
  6. Kim NS, Song HJ. 2004. Women's chronic diseases and policy implications in Korea. Health and Welfare Policy Forum 93: 39-46.
  7. Yang JH. 2003. A study on health behavior experience of middle-aged women in rural area. J Korean Acad Nurs 32:694-705.
  8. Kaplan GA, Camacho T. 1983. Perceived health and mortality: a nine year follow-up of the human population laboratory cohort. Am J Epidemiol 117: 292-304. https://doi.org/10.1093/oxfordjournals.aje.a113541
  9. Gold M, Franks P, Erickson P. 1996. Assessing the health of the nation. The predictive validity of a preference-based measure and self rated health. Med Care 34: 163-177. https://doi.org/10.1097/00005650-199602000-00008
  10. Menec VH, Chipperfield JG. 2001. A prospective analysis of the relation between self-rated health and health care use among elderly Canadians. Can J Aging 20: 293-306. https://doi.org/10.1017/S0714980800012794
  11. Ware JE. 1976. Scales for measuring general health perceptions. Health Serv Res 11: 396-415.
  12. Murray J, Dunn G, Tarnopolsky A. 1982. Self-assessment of health: an exploration of the effects of physical and psychological symptoms. Psychol Med 12: 371-378. https://doi.org/10.1017/S0033291700046705
  13. Bailis DS, Segall A, Chipperfield JG. 2003. Two views of self-rated general health status. Soc Sci Med 56: 203-217. https://doi.org/10.1016/S0277-9536(02)00020-5
  14. Bailis DS, Segall A, Mahon MJ, Chipperfield JG, Dunn EM. 2001. Perceived control in relation to socioeconomic and behavioral resources for health. Soc Sci Med 52: 1661-1676. https://doi.org/10.1016/S0277-9536(00)00280-X
  15. Garrity TF, Somes GW, Marx MB. 1978. Factors influencing self-assessment of health. Soc Sci Med 12: 77-81.
  16. Chang JY, Boo KC. 2007. Self-rated health status of Korean old people: an introduction for international comparative studies. Korean Journal of Population Studies 30: 45-69.
  17. Bobak M, Pikhart H, Hertzman C, Rose R, Marmot M. 1998. Socioeconomic factors perceived control and self-reported health in Russia. A cross-sectional survey. Soc Sci Med 47: 269-279. https://doi.org/10.1016/S0277-9536(98)00095-1
  18. Choi YJ, Park YS, Kim C, Chang YK. 2004. Evaluation of functional ability and nutritional risk according to self-rated health (SRH) of the elderly in Seoul and Kyunggi-do. Korean J Nutr 37: 223-235.
  19. Kanagae M, Abe Y, Honda S, Takamura N, Kusano Y, Takemoto T, Aoyagi K. 2006. Determinants of self-rated health among community-dwelling women aged 40 years and over in Japan. Tohuku J Exp Med 210: 11-19. https://doi.org/10.1620/tjem.210.11
  20. Lee OH, Kim JK, Lee HSY, Choue RW. 2012. Nutritional status, quality of diet and quality of life in postmenopausal women with mild climacteric symptoms based on food group intake patterns. Korean J Community Nutr 17: 69-80. https://doi.org/10.5720/kjcn.2012.17.1.69
  21. Lee HJ, Chung YJ, Kim HJ, Suh HS, Lee HS, Shim KW, Lee SH, Cho CY. 2002. Determinants of self-assessed health among elderly adults. J Korean Acad Fam Med 23: 1210-1218.
  22. Kwak HK, Lee MY, Kim MJ. 2011. Comparisons of body image perception, health related lifestyle and dietary behavior based on the self-rated health of university students in Seoul. Korean J Community Nutr 16: 672-682. https://doi.org/10.5720/kjcn.2011.16.6.672
  23. Ahn BC, Joung HJ. 2006. Self-rated health and its indicators: a case of the 2001 Korean national health and nutrition examination survey. Korean J Community Nutr 8: 38-43.
  24. Korean Nutrition Society. 2010. Dietary reference intakes for Koreans. 1st revision. Korean Nutrition Society, Seoul, Korea.
  25. Koo JO, Park SY. 2012. Analysis of body composition, dietary behaviors and life style of 30-50 year old women living in Seoul. Korean J Community Nutr 17: 440-449. https://doi.org/10.5720/kjcn.2012.17.4.440
  26. Kim HS, Yoon KH, Lee MJ, Seo BH. 2005. Intake and awareness of the functional health food among housewives in Cheongju area. J Human Ecology 9: 179-196.
  27. Lee YW. 1988. A study on the relationship between health locus of control and health behavior of residents in Choong Nam province. J Nurs Acad Soc 18: 118-127. https://doi.org/10.4040/jnas.1988.18.2.118
  28. Kim BH, Koh SB, Hur HK, Park JK, Park SM. 2009. Women's cancer screening according to body mass index in a cohort of rural Korean women. J Korean Acad Nurs 39: 641-650. https://doi.org/10.4040/jkan.2009.39.5.641
  29. Nam SM, Ha EH, Suh YJ, Park HS, Chang MH, Seo JH, Kim BM. 2008. Effect of obesity and blood lipid profiles on hyperlipidemia in adults aged over 40 years. J Korean Soc Study Obes 17: 20-28.
  30. Kim YH, Kim YN. 2002. A study on body mass index and associated factors of the middle aged women in small city. Korean J Community Nutr 7: 506-515.
  31. Korean Society for the Study of Obesity. 2012. Obesity 2012. Korean Society for the Study of Obesity, Seoul, Korea. p 17-22.
  32. Baik IK, Shin C. 2010. Optimal waist circumference for the prevention of cardiovascular disease. Korean J Community Nutr 15: 275-283.
  33. Son YJ, Song JE, Youn HK. 2009. Cynical hostility, stress, and subjective health condition according to the body mass index in middle aged women. J Korean Soc Matern Child Health 13: 84-95. https://doi.org/10.21896/jksmch.2009.13.1.84
  34. Ramsey PW, Glenn LL. 2002. Obesity and health status in rural, urban, and suburban southern women. South Med J 95: 666-671. https://doi.org/10.1097/00007611-200207000-00003
  35. Reeves MJ, Rafferty AP. 2005. Healthy lifestyle characteristics among adults in the United States, 2000. Arch Intern Med 165: 854-857. https://doi.org/10.1001/archinte.165.8.854
  36. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. 2004. Actual causes of death in the United States, 2000. JAMA 291: 1238-1245. https://doi.org/10.1001/jama.291.10.1238
  37. Lee YR, Kim MJ. 2009. A transition of health habits and self-rated health status of women aged in early adulthood. Journal of Korean Academy of Public Health Nursing 23:199-206.
  38. Unden AL, Elofsson S. 2006. Do different factors explain self-rated health in men and women? Gend Med 3: 295-308. https://doi.org/10.1016/S1550-8579(06)80218-4
  39. Lee JE, Ahn YJ, Lee JY, Cha JH, Park C, Kim KC. 2004. Evaluation of nutrient intake quality over 40 year-old people living in rural and suburban areas. Korean J Community Nutr 9: 491-500.
  40. Park JC, Kweon HJ, Oh YK, Do HJ, Oh SW, Lym YL, Choi JK, Joh HK, Cho DY. 2010. Association of the metabolic syndrome and bone mineral density in postmenopausal women. Korean J Fam Med 31: 9-15. https://doi.org/10.4082/kjfm.2010.31.1.9
  41. Chung HK, Kang JH, Shin MJ. 2010. Assessment for nutrient intakes in Korean women according to obesity and metabolic syndrome. Korean J Community Nutr 15: 694-703.
  42. Seo KH, Lee HJ, Lim BD, Choi YJ, Oh HM, Yoon JS. 2009. Association of nutritional status with obesity by body mass index and waist circumference among hypertensive elderly patients. Korean J Community Nutr 14: 831-845.
  43. Manderbacka K, Lundberg O, Martikainen P. 1999. Do risk factors and health behaviors contribute to self-ratings of health? Soc Sci Med 48: 1713-1720. https://doi.org/10.1016/S0277-9536(99)00068-4
  44. Osler M, Heitmann BL, Hoidrup S, Jorgensen LM, Schroll M. 2001. Food intake patterns, self rated health and mortality in Danish men and women. A prospective observational study. J Epidemiol Community Health 55: 399-403. https://doi.org/10.1136/jech.55.6.399
  45. Kant AK, Schatzkin A, Ziegler RG. 1995. Dietary diversity and subsequent cause-specific mortality in the NHANES I epidemiologic follow-up study. J Am Coll Nutr 14: 233-238. https://doi.org/10.1080/07315724.1995.10718501
  46. Drewnowski A, Henderson SA, Shore AB. 1996. Diet quality and dietary diversity in France: implications for the French paradox. J Am Diet Assoc 96: 663-669. https://doi.org/10.1016/S0002-8223(96)00185-X
  47. Bae YJ. 2012. Evaluation of nutrient and food intake status, and dietary quality in Korean female adults according to obesity: based on 2007-2009 Korean National Health and Nutrition Examination Survey. Korean J Nutr 45: 140-149. https://doi.org/10.4163/kjn.2012.45.2.140
  48. Jovanovic GK, Zezelj SP, Malatestinic D, Sutic IM, Stefanac VN, Dorcic F. 2010. Diet quality of middle age and older women from Primorsko-Goranska County evaluated by healthy eating index and association with body mass index. Coll Antropol 34(Suppl 2): 155-160.
  49. Kim SH, Kim JY, Ryu KA, Sohn CM. 2007. Evaluation of the dietary diversity and nutrient intakes in obese adults. Korean J Community Nutr 12: 583-591.
  50. Clare E, Anne F, Allison H. 2008. Diet quality is associated with higher nutrient intake and self-rated health in mid-aged women. J Am Coll Nutr 27: 146-157. https://doi.org/10.1080/07315724.2008.10719686
  51. Carr MC. 2003. The emergence of the metabolic syndrome with menopause. J Clin Endocrinol Metab 88: 2404-2411. https://doi.org/10.1210/jc.2003-030242
  52. Kim SK, Sunwoo JG. 2007. The analysis of the dietary factors related to climacteric symptoms in middle-aged women. Korean J Community Nutr 12: 25-39.
  53. Teegarden D, White KM, Lyle RM, Zemel MB, Van Loan MD, Matkovic V, Craig BA, Schoeller DA. 2008. Calcium and dairy product modulation of lipid utilization and energy expenditure. Obesity 16: 1566-1572. https://doi.org/10.1038/oby.2008.232
  54. Jacobsen R, Lorenzen JK, Toubro S, Krog-Mikkelsen I, Astrup A. 2005. Effect of short-term high dietary calcium intake on 24-h energy expenditure, fat oxidation, and fecal fat excretion. Int J Obes 29: 292-301. https://doi.org/10.1038/sj.ijo.0802785
  55. Huang L, Xue J, He Y, Wang J, Sun C, Feng R, Teng J, He Y, Li Y. 2011. Dietary calcium but not elemental calcium from supplements is associated with body composition and obesity in Chinese women. PLoS One 6: 1-7.
  56. Park YS, Kang MI, Kim DY, Min YK, Park HM, Yoon HG, Lee DH, Lee EJ, Lee HH, Chung HY, Byun DW. 2009. Nutrient intake and osteoporosis: a case-control study in Korean postmenopausal women. Korean J Bone Metab 16:103-110.
  57. Heaney R, Recker R, Saville P. 1997. Calcium balance and calcium requirements in middle-aged women. Am J Clin Nutr 30: 1603-1611.
  58. Haveman-Nies A, de Groot L, Burema J, Cruz JA, Osler M, van Staveren WA. 2002. Dietary quality and lifestyle factors in relation to 10-year mortality in older Europeans: the SENECA study. Am J Epidemiol 156: 962-968. https://doi.org/10.1093/aje/kwf144
  59. Haveman-Nies A, de Groot LC, van Staveren WA. 2003. Dietary quality, lifestyle factors and healthy ageing in Europe: the SENECA study. Age Ageing 32: 427-434. https://doi.org/10.1093/ageing/32.4.427

Cited by

  1. Dietary Habits, Dietary Behaviors, Depression and Stress according to Self-Rated Health of University Students in Kyungnam Province vol.22, pp.4, 2016, https://doi.org/10.14373/JKDA.2016.22.4.272
  2. Analysis of Dietary Inflammatory Index of Metabolic Syndrome in Korean : Data from the Health Examinee Cohort (2012-2014) vol.25, pp.6, 2016, https://doi.org/10.5934/kjhe.2016.25.6.823
  3. Effects of Using Prop for Con vergence Pilates Met Exercise on the Immunoglobulin in Middle-aged Women vol.6, pp.5, 2015, https://doi.org/10.15207/JKCS.2015.6.5.329
  4. Comparison of Nutrient Intake and Health Indices by the Intake of Noodles vol.31, pp.4, 2016, https://doi.org/10.7318/KJFC/2016.31.4.373
  5. 가정배달급식 수혜 노인의 영양위험도와 영양위험도에 미치는 요인 vol.24, pp.3, 2013, https://doi.org/10.5720/kjcn.2019.24.3.197
  6. Concept Analysis of Health Promotion Activities in the Middle-aged Women vol.32, pp.5, 2013, https://doi.org/10.13000/jfmse.2020.10.32.5.1242
  7. Comparison of Nutrient Intake and Diet Assessment according to the Subjective Health Perception and Disease Existence : The Korea National Health and Nutrition Examination Survey Data(2013~2017) Analy vol.32, pp.3, 2013, https://doi.org/10.7856/kjcls.2021.32.3.395