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"Korea National Health and Nutrition Examination Survey"

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"Korea National Health and Nutrition Examination Survey"

Original Articles
Secular trends in dietary patterns among South Korean primary school–aged children based on the 2007–2022 Korea National Health and Nutrition Examination Survey
Adiyasuren Dookhuu, Diana Shubekova, Juhae Kim, Minji Kang
Clin Nutr Res 2026;15(3):149-160.   Published online July 31, 2026
DOI: https://doi.org/10.7762/cnr.2026.0018

Objective

This study aimed to identify dietary patterns and examine their associations with sociodemographic and lifestyle characteristics among South Korean primary school–aged children.
Methods
Data from 10,173 children aged 6–12 years who participated in the 2007–2022 Korea National Health and Nutrition Examination Survey were analyzed. Their dietary intake was assessed using a 24-hour dietary recall, and dietary patterns were derived from the energy contributions of 26 food groups through cluster analysis.
Results
Three patterns were identified: rice-based pattern (47.3%), flour-based pattern (17.7%), and diversified type (35.1%). From 2007 to 2022, the prevalence of the rice-based pattern declined substantially (56.6%–32.6%), whereas that of the diversified type markedly increased (27.3%–47.0%). Survey-weighted analyses revealed that the dietary patterns were significantly associated with age, household income, vigorous physical activity, meal-skipping, eating-out frequency, and dietary supplement use (all, P<0.05). Children following the flour-based pattern tended to be older, skip breakfast more often, and engage in less vigorous physical activities. The rice-based pattern included a higher proportion of children from low-income households, whereas the diversified type showed more favorable socioeconomic characteristics and family breakfast practices. Overall, the rice-based and flour-based patterns were associated with less favorable lifestyle behaviors than the diversified type.
Conclusion
Dietary patterns among South Korean primary school–aged children appear to be closely related to socioeconomic status and daily health behaviors. Nutrition education and public health interventions promoting balanced diets, reduced meal skipping, and healthier lifestyles during childhood are needed.
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Objective

This study investigated the association between plant-based diet indices—overall plant-based diet index (PDI), healthful PDI (hPDI), and unhealthful PDI (uPDI)—and depressive symptoms in South Korean adults.
Methods
This cross-sectional study analyzed 5,846 participants (aged 19–64 years) using data from the 2014 and 2016 South Korea National Health and Nutrition Examination Survey. Dietary intake was assessed with a semiquantitative food frequency questionnaire, from which PDIs were derived. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Survey-weighted linear and logistic regression models were applied to assess associations, adjusting for sociodemographic, lifestyle, and clinical factors.
Results
In fully adjusted models, higher overall PDI and hPDI were associated with lower PHQ-9 scores (β=−0.23; 95% confidence interval [CI], −0.41 to −0.04 and β=−0.16; 95% CI, −0.30 to −0.02 per 10-unit increment, respectively), whereas higher uPDI scores were associated with higher PHQ-9 scores (β=0.21; 95% CI, 0.07 to 0.35 per 10-unit increment). For clinical depressive symptoms (PHQ-9 ≥10), each 10-unit increase in overall PDI was associated with a 33% reduction in odds (odds ratio, 0.67; 95% CI, 0.50 to 0.89). Associations for hPDI and uPDI were attenuated and not statistically significant. Subgroup analyses revealed that these associations varied by sex, age, and obesity status.
Conclusion
Greater adherence to healthy plant-based foods and lower intake of less healthy plant-based foods were associated with fewer depressive symptoms among South Korean adults. These findings highlight the importance of plant-based food quality, rather than quantity alone, in supporting mental health.
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Cataracts are a major cause of visual impairment worldwide, particularly among older adults, with an increasing prevalence due to population aging. Surgery is the primary treatment; however, preventive strategies are crucial for reducing the disease burden. This study aimed to investigate dietary and health-related factors associated with cataract occurrence and develop a predictive model using machine learning. Data were derived from the Korea National Health and Nutrition Examination Survey 2015–2017. The study included 190 women aged 60–79 years: 124 with cataracts and 66 controls. Analyzed variables included sociodemographic, behavioral, chronic disease, and dietary intake factors. After data preprocessing, 4 machine learning algorithms: support vector machine (SVM), random forest (RF), eXtreme gradient boosting, and multilayer perceptron were used. Model performance was evaluated using accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUROC) and precision-recall curves. Among the tested models, the SVM achieved the best performance under stratified 10-fold cross-validation, with 71% accuracy, 86% precision, 73% recall, 79% F1-score, 65% AUROC, and 81% AUPRC. According to our findings, the odds of having cataracts can be effectively predicted using dietary and health data without relying on specialized ophthalmic equipment. The proposed model demonstrates the potential of machine learning-based tools for early identification and prevention of cataracts. Future studies with larger and more diverse samples, as well as integrating additional data sources such as genomics and lifestyle factors, are warranted to refine predictive accuracy and enhance personalized nutrition-based interventions.

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Chronic obstructive pulmonary disease (COPD) is a major respiratory disorder characterized by irreversible airflow limitation. The role of diet in the prevention and management of COPD is receiving increasing attention. This study aimed to examine the association between the composite intake of vegetables, fruits, meat, and fish and pulmonary function as well as COPD prevalence in a representative sample of Korean adults aged ≥ 40 years using data from the 7th Korea National Health and Nutrition Examination Survey. Higher vegetable intake was associated with significantly better pulmonary function parameters, including forced vital capacity (p < 0.001), forced vital capacity percent predicted (p = 0.050), forced expiratory volume (FEV) in 1 second (FEV1; p < 0.001), FEV1 percent predicted (p = 0.038), FEV in 6 seconds (p < 0.001), and peak expiratory flow (p < 0.001). Furthermore, individuals with a high combined intake of vegetables, fruits, meat, and fish demonstrated a 0.261-fold lower COPD prevalence than those without such intake (p = 0.039). The dietary inflammatory index (DII) was significantly lower among participants without COPD than among those with COPD (mean DII = −3.6947, p = 0.002), indicating that a diet rich in anti-inflammatory nutrients can help reduce COPD risk. These findings suggest that vegetable consumption supports improved respiratory function, and a composite dietary pattern incorporating various food groups may help reduce the prevalence of COPD in the adult population.

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The prevalence of metabolic syndrome (MetS) and its cost are increasing due to lifestyle changes and aging. This study aimed to develop a deep neural network model for prediction and classification of MetS according to nutrient intake and other MetS-related factors. This study included 17,848 individuals aged 40–69 years from the Korea National Health and Nutrition Examination Survey (2013–2018). We set MetS (3–5 risk factors present) as the dependent variable and 52 MetS-related factors and nutrient intake variables as independent variables in a regression analysis. The analysis compared and analyzed model accuracy, precision and recall by conventional logistic regression, machine learning-based logistic regression and deep learning. The accuracy of train data was 81.2089, and the accuracy of test data was 81.1485 in a MetS classification and prediction model developed in this study. These accuracies were higher than those obtained by conventional logistic regression or machine learning-based logistic regression. Precision, recall, and F1-score also showed the high accuracy in the deep learning model. Blood alanine aminotransferase (β = 12.2035) level showed the highest regression coefficient followed by blood aspartate aminotransferase (β = 11.771) level, waist circumference (β = 10.8555), body mass index (β = 10.3842), and blood glycated hemoglobin (β = 10.1802) level. Fats (cholesterol [β = −2.0545] and saturated fatty acid [β = −2.0483]) showed high regression coefficients among nutrient intakes. The deep learning model for classification and prediction on MetS showed a higher accuracy than conventional logistic regression or machine learning-based logistic regression.

Citations

Citations to this article as recorded by  
  • Application of Artificial Intelligence in the Diagnosis, Prediction, and Management of Metabolic Syndrome: A Systematic Review
    Aynaz Esmailzadeh, Narges Norouzkhani, Sara Sezavar Dokhtfaroughi, Alireza Rasoulian, Mohammad Reza Mazaheri Habibi
    Health Science Reports.2026;[Epub]     CrossRef
  • Metabolomics and nutrient intake reveal metabolite–nutrient interactions in metabolic syndrome: insights from the Korean Genome and Epidemiology Study
    Minyeong Kim, Suyeon Lee, Junguk Hur, Dayeon Shin
    Nutrition Journal.2025;[Epub]     CrossRef
  • Investigating the Influence of Heavy Metals and Environmental Factors on Metabolic Syndrome Risk Based on Nutrient Intake: Machine Learning Analysis of Data from the Eighth Korea National Health and Nutrition Examination Survey (KNHANES)
    Seungpil Jeong, Yean-Jung Choi
    Nutrients.2024; 16(5): 724.     CrossRef
  • Employing broad learning and non-invasive risk factor to improve the early diagnosis of metabolic syndrome
    Junwei Duan, Yuxuan Wang, Long Chen, C. L. Philip Chen, Ronghua Zhang
    iScience.2024; 27(1): 108644.     CrossRef
  • A comprehensive multi-task deep learning approach for predicting metabolic syndrome with genetic, nutritional, and clinical data
    Minhyuk Lee, Taesung Park, Ji-Yeon Shin, Mira Park
    Scientific Reports.2024;[Epub]     CrossRef
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