A Study on the Relationship between Food Security and the Number of Remaining Teeth in Korean Adults: The Korea National Health and Nutrition Examination Survey (KNHANES VII), 2016-2018

Food security is important for human health and quality of life. This study investigated the association between food security and the number of remaining teeth in Korean adults. Raw data from the Korea National Health and Nutrition Examination Survey (KNHANES) VII (2016-2018) were analyzed, including data from 13,199 adults aged 19 years or older. The associations between food security and number of teeth were assessed using multiple multinomial logistic regression models after adjusting for demographic and health factors as covariates. In the model adjusted for all socioeconomic, medical, and behavior variables, the odds ratio of tooth loss (16-20 teeth) was 3.80 (95% confidence interval [CI] 1.56-9.21) in the group of people that reported often feeling insecurity regarding various food groups compared to those who reported feeling food security. The results of this study demonstrated an association between food security and the number of remaining teeth in Korean adults. Therefore, food security is essential for improving lifelong oral health.

Development of a Frailty Detection Model Using Machine Learning with the Korean Frailty and Aging Cohort Study Data

OBJECTIVES

This paper aimed to use machine learning to identify a new group of factors predicting frailty in the elderly population by utilizing the existing frailty criteria as a basis, as well as to validate the obtained results.

METHODS

This study was conducted using data from the Korean Frailty and Aging Cohort Study (KFACS). The KFACS participants were classified as robust or frail based on Fried's frailty phenotype and excluded if they did not properly answer the questions, resulting in 1,066 robust and 165 frail participants. We then selected influential features through feature selection and trained the model using support vector machine, random forest, and gradient boosting algorithms with the prepared dataset. Due to the imbalanced distribution in the dataset with a low sample size, holdout was applied with stratified 10-fold and cross-validation for estimating the model performance. The reliability of the constructed model was validated using an unseen test set. The model was then trained with hyperparameter optimization.

RESULTS

During the feature selection process, 27 features were identified as meaningful factors for frailty. The model was trained based on the selected features, and the weighted average F1-score reached 95.30% with the random forest algorithm.

CONCLUSIONS

The results of the study demonstrated the possibility of adopting machine learning to strengthen existing frailty criteria. As the method analyzes questionnaire responses in a short time, it can support higher volumes of data on participants' health conditions and alert them regarding potential risks in advance.

Household Food Insecurity: Comparison between Families with and without Members with Disabilities

Although the high rate of food insecurity among people with disabilities and their households has emerged as an important concern in public health and nutrition policy, the available data on these issues are still too limited to fully understand this phenomenon. This study aimed to compare the prevalence of food insecurity between households with and without persons with disabilities and to explore which sociodemographic and disability characteristics are associated with household food insecurity among households with members with disabilities. The data of 2690 households with and without members with disabilities from the 2013 Korea National Health and Nutrition Examination Survey were analyzed. Household food insecurity was more prevalent among households including persons with disabilities than among those without such members. The likelihood of experiencing food insecurity was especially high in households having a female head with a disability (odds ratio (OR) = 1.98); working-age adults with disabilities (OR = 1.70); members with disabilities who were not economically active (OR = 1.53); and members with mental disabilities (OR = 2.81), disabilities involving internal organs (OR = 4.38), or severe (grades 1–3) disabilities (OR = 1.73). The findings indicate that the disability status and sociodemographic characteristics of disabled family members are closely associated with household food security status.

Combined effects of disease management and food insecurity on physical and mental health in Korean adults

OBJECTIVE

The present study aimed to examine the combined effects of disease management and food insecurity on physical and mental health in a representative Korean population.

DESIGN

A cross-sectional study.

SETTING

Data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2012-2015.

PARTICIPANTS

Adults aged ≥30 years (n 17 934) who participated in the KNHANES.

RESULTS

Among health-care factors, unmet health-care needs and mental health counselling were different by food insecurity status, with a higher prevalence in adults with food insecurity. The prevalence of underweight was higher in men with food insecurity (5·9 %), whereas the prevalence of obesity was higher in women with food insecurity (37·4 %), than that in men and women with food security. Food insecurity was associated with a high risk of all mental health outcomes. For the combined effects of disease management and food insecurity, unmet health-care needs was related to increased risk of obesity for food-insecure men (Pinteraction = 0·029) and lack of participation in nutrition education or counselling was related to increased risk of obesity for food-insecure women (Pinteraction = 0·010). In addition, higher unmet health-care needs in adults with food insecurity was related to higher risk of mental health outcomes.

CONCLUSIONS

Unmet health-care needs may exacerbate obesity for food-insecure men and mental health problems for both food-insecure men and women. In addition, lack of participation in nutrition education or counselling may exacerbate the obesity for food-insecure women.

Objective and perceived food environment and household economic resources related to food insecurity in older adults living alone in rural areas

Background

Limited attention has been paid to an association between food environment and household economic resources related to food expenditure in food-insecure seniors. The aim of the study was to investigate the relationship between factors of economic resource, food environment, and food insecurity in single seniors residing in rural areas of South Korea.

Methods

A cross-sectional study was conducted in 170 single senior households aged 65 years or over residing in rural areas. Face-to-face interviews were performed to collect data on demographic characteristics, household economic resources/expenditure, food environmental factors, and food insecurity.

Results

Among economic resources, generally limited food expenditures due to housing fees and heating costs during the winter were positively related to food insecurity. Among food environmental factors, food accessibility at community level such as food stores located far from home and inconvenient bus routes was related to food insecurity. The most explainable economic and food environment factors related to food insecurity by stepwise logistic regression analysis were the percentage of total expenditure on housing fee (OR = 1.021, 95% CI: 1.008–1.034), foods purchasing at super supermarket (OR = 0.398, 95% CI: 0.166–0.951), having difficulties in food purchasing due to food stores being located far from home (OR = 14.487, 95% CI: 5.139–40.842) and inconvenient bus routes (OR = 0.083, 95% CI: 0.015–0.460).

Conclusion

Inadequate community food environment as well as limited household food resources were an important risk factor for food insecurity in Korean single rural seniors. Findings of this study could help us better understand how characteristics of household food resources and community food environment can serve as barriers or facilitators of food security among single older adults residing in rural areas.

Association between Household Food Insecurity and Asthma in Korean Adults

Household food insecurity has been associated with noncommunicable diseases. The aim of this study was to investigate the association between household food insecurity and asthma in Korean adults. Household food security statuses were classified into three groups: Food-secure household, food-insecure household without hunger, and food-insecure household with hunger. The odds ratios and 95% confidence intervals for the presence of asthma according to household food security status were calculated using multiple logistic regression analyses after adjusting for confounding factors. A total of 14,770 participants were included in the analysis. The prevalence of asthma was 2.6% in those with a secure food status, 3.2% in those with an insecure food status without hunger, and 7.6% in those with an insecure food status with hunger (p < 0.001). Compared with that in participants with a household food secure status, the odds ratios (95% confidence intervals) for asthma were 1.12 (0.73–1.73) in those with a food-insecure household without hunger status and 2.44 (1.33–4.46) in those with a food-insecure household with hunger status after additionally adjusting for confounding factors. We found that household food insecurity with hunger was significantly associated with asthma prevalence in Korean adults. Implementation of household food security screening and public health intervention could be helpful to prevent and reduce asthma in adults.

Spatial Disparity in Food Environment and Household Economic Resources Related to Food Insecurity in Rural Korean Households with Older Adults

Different contextual factors of a household and a community, such as access to resources and transportation, may influence the level of food insecurity. The objective of this study was to identify how food environmental factors and economic resources were related to food insecurity in Korean older adults residing in different contexts of rural areas. Face-to-face interviews with 248 older adults residing in land (n = 149) and mountain (n = 99) rural areas were performed. In both areas, risk of food insecurity was increased for households with limited community food accessibility measured by having difficulties in food purchasing due to food stores far from home. There were discrepancies in factors related to increased risks of food insecurity between households in land and mountain areas. The experience of reducing food expenditure resulting from burden of heating costs during the winter in households in a mountain area whereas the percent proportion of housing fee and household cook’s physical disability in households residing in the land area were found to be factors associated with increased risks of food insecurity. For households residing in mountain areas, the risk of food insecurity was decreased when economic resources measured by average monthly income for the last one year was increased and there was farming or home gardening activity. Such spatial disparity might affect household food insecurity in rural areas. In addition, food environmental factors and economic resources may affect household food insecurity differently according to the diverse contexts of rural areas. Better understanding of spatial challenges in food insecurity faced by seniors in a large rural area would help prepare programs or policy change to strengthen and improve their food environments.

Food Acquisition through Private and Public Social Networks and Its Relationship with Household Food Security among Various Socioeconomic Statuses in South Korea

This study was conducted to understand food acquisition practices from social networks and its relationship with household food security. In-depth interviews and a survey on food security were conducted with twenty-nine mothers and one father in metropolitan areas of South Korea. Many families acquired food from their extended families, mainly participants’ mothers. Between low-income and non-low-income households, there was a pattern of more active sharing of food through private networks among non-low-income households. Most of the low-income households received food support from public social networks, such as government and charity institutions. Despite the assistance, most of them perceived food insecurity. We hypothesized that the lack of private social support may exacerbate the food security status of low-income households, despite formal food assistance from government and social welfare institutions. Interviews revealed that certain food items were perceived as lacking, such as animal-based protein sources and fresh produce, which are relatively expensive in this setting. Future programs should consider what would alleviate food insecurity among low-income households and determine the right instruments and mode of resolving the unmet needs. Future research could evaluate the quantitative relationship between private resources and food insecurity in households with various income statuses.

Household food insecurity and dietary intake in Korea: results from the 2012 Korea National Health and Nutrition Examination Survey

OBJECTIVE

To examine the prevalence of household food insecurity and compare dietary intake by food security status in a representative Korean population.

DESIGN

Cross-sectional. Food security status of households was classified using an eighteen-item food security questionnaire. The nutrition survey comprised questions on dietary habits, a 24 h dietary recall and a semi-quantitative FFQ.

SETTING

The 2012 Korea National Health and Nutrition Examination Survey.

SUBJECTS

A total of 3007 households completed the food security questionnaire. Family members within each household aged ≥1 year (n 7118) participated in the nutrition survey.

RESULTS

Results from the 2012 survey indicated that 88.7% of Korean households showed food security. The remaining 11.3% (9.3% for food insecurity without hunger and 2.0% for food insecurity with hunger) were in food-insecure households. The prevalence of household food insecurity was 13.2% in households with children and 10.3% in households without children. Mean daily intakes of energy, fat and carbohydrates were not significantly different between food-secure and food-insecure adults. In contrast, mean daily intakes of protein, crude fibre, vitamins and minerals as well as weekly consumption frequencies of vegetables, seaweeds, fruits, fruit juice, nuts, and milk and milk products were significantly lower in food-insecure adults compared with food-secure adults.

CONCLUSIONS

The study demonstrated that food insecurity is associated with reduced intakes of healthy foods and nutrients essential for health and growth in a representative Korean population.

Associations between food insecurity and healthy behaviors among Korean adults

BACKGROUND/OBJECTIVES

Food insecurity has been suggested as being negatively associated with healthy behaviors and health status. This study was performed to identify the associations between food insecurity and healthy behaviors among Korean adults.

SUBJECTS/METHODS

The data used were the 2011 Community Health Survey, cross-sectional representative samples of 253 communities in Korea. Food insecurity was defined as when participants reported that their family sometimes or often did not get enough food to eat in the past year. Healthy behaviors were considered as non-smoking, non-high risk drinking, participation in physical activities, eating a regular breakfast, and maintaining a normal weight. Multiple logistic regression and multinomial logistic regression analyses were used to identify the association between food insecurity and healthy behaviors.

RESULTS

The prevalence of food insecurity was 4.4% (men 3.9%, women 4.9%). Men with food insecurity had lower odds ratios (ORs) for non-smoking, 0.75 (95% CI: 0.68-0.82), participation in physical activities, 0.82 (95% CI: 0.76-0.90), and eating a regular breakfast, 0.66 (95% CI: 0.59-0.74), whereas they had a higher OR for maintaining a normal weight, 1.19 (95% CI: 1.09-1.30), than men with food security. Women with food insecurity had lower ORs for non-smoking, 0.77 (95% CI: 0.66-0.89), and eating a regular breakfast, 0.79 (95% CI: 0.72-0.88). For men, ORs for obesity were 0.78 (95% CI: 0.70-0.87) for overweight and 0.56 (95% CI: 0.39-0.82) for mild obesity. For women, the OR for moderate obesity was 2.04 (95% CI: 1.14-3.63) as compared with normal weight.

CONCLUSIONS

Food insecurity has a different impact on healthy behaviors. Provision of coping strategies for food insecurity might be critical to improve healthy behaviors among the population.