Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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Comparative analysis of dietary behavior and nutrient intake of elderly in urban and rural areas for development of "Village Lunch Table" program: Based on 2014 Korea National Health and Nutrition Examination Survey data

농촌 노인의 마을 밥상 개선 프로그램 개발을 위한 도시와 농촌 노인의 식생활 행태 및 영양소 섭취 상태 비교분석 : 2014년 국민건강영양조사 자료를 이용하여

  • Lee, Youngmi (Department of Food and Nutrition, Myongji University) ;
  • Choi, Yourim (Department of Food and Nutrition, Myongji University) ;
  • Park, Hae Ryun (Department of Food and Nutrition, Myongji University) ;
  • Song, Kyung Hee (Department of Food and Nutrition, Myongji University) ;
  • Lee, Kyung Eun (Department of Food and Nutrition, Seoul Women's University) ;
  • Yoo, Chang (Department of Food and Nutrition, Seoul Women's University) ;
  • Lim, Young Suk (Department of Food and Nutrition, Myongji University)
  • 이영미 (명지대학교식품영양학과) ;
  • 최유림 (명지대학교식품영양학과) ;
  • 박혜련 (명지대학교식품영양학과) ;
  • 송경희 (명지대학교식품영양학과) ;
  • 이경은 (서울여자대학교식품영양학과) ;
  • 유창희 (서울여자대학교식품영양학과) ;
  • 임영숙 (명지대학교식품영양학과)
  • Received : 2017.03.20
  • Accepted : 2017.04.11
  • Published : 2017.04.30
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Abstract

Purpose: We conducted comparative analysis of dietary behavior and food and nutrient intakes of Korean elderly in urban and rural areas using the 2014 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: This study was conducted on 1,239 participants (urban elderly: 867, rural elderly: 372) aged 65 years and over who participated in the health examination and nutrition survey in the 6th 2014 KNHANES. Dietary behaviors, including skipping meals, eating out frequencies, and food and nutrient intakes were analyzed using 24-hour recall data. Analysis of complex sample design data through SPSS 19.0 was used for the analysis. Results: The rate of skipping dinner was higher in urban (6.5%) than in rural elderly (3.6%) (p < 0.05), and the frequency of eating out per week of urban elderly (1.73) was higher than that of rural elderly (1.35) (p < 0.001). The rural elderly consumed a greater amount of grain compared to urban elderly, whereas consumption of water, seaweed food, and dairy products was lower in rural than in urban areas (p < 0.05). The rural elderly consumed significantly less highly unsaturated fatty acids, n-6 fatty acids, phosphorus, iron, vitamin A, carotene, niacin, and vitamin C in comparison with elderly in urban areas. Comparison of the percentages of Dietary Reference Intakes for Koreans (KDRIs) between the two groups showed that intakes of vitamin A and vitamin C were significantly lower in the rural elderly than in urban elderly. Conclusion: The elderly in rural areas showed unbalanced food and nutrient intakes compared to the elderly in urban areas. Therefore, customized nutrition education according to residential areas should be developed and provided to rural elderly to improve their health and nutritional status.

본 연구는 제 6기 2차년도 국민건강영양조사 (2014년) 자료를 이용하여 거주 지역에 따른 노인의 식생활 행태와 식품 및 영양소 섭취의 차이를 분석하였다. 대상자는 65세 이상 노인으로 건강 설문, 검진조사, 식품섭취조사에 모두 응답한 1,239명 (남 543명, 여 696명)을 선정하였으며, 거주지역에 따라 대상자를 농촌 노인 (867명)과 도시 노인 (372명)으로 분류하였다. 대상자의 끼니결식 여부, 주당 외식횟수, 영양교육 여부, 식품군별 섭취량, 영양소 섭취량을 분석하였으며, 권장섭취량 또는 충분섭취량 대비 영양소 섭취수준은 2015년 한국인 영양소 섭취기준 (KDRIs)과 비교하여분석하였다. 주요연구결과를요약하면다음과같다. 거주 지역에 따른 대상자의 조사 전날 아침, 점심식사의 결식 여부는 유의적인 차이가 나타나지 않았으나, 저녁식사의 경우 도시 노인의 결식률이 농촌 노인에 비해 유의적으로 높았으며 (p = 0.030), 주당 외식횟수도 도시 노인이 농촌 노인에 비해 유의적으로 높았다 (p < 0.001). 영양교육의 여부는 유의적인 차이가 나타나지 않았으나, 농촌, 도시 노인 모두 5% 미만이었다. 거주 지역에 따른 대상자의 식품군별 섭취량을 연령, 성별, 에너지 섭취량을 보정하여 분석한 결과, 농촌 노인의 경우, 물 (p = 0.028), 과실류 (p = 0.006), 해조류 (p = 0.040), 우유및유제품류 (p = 0.045) 섭취가 도시 노인에 비해 유의적으로 낮았다. 반면에 곡류 섭취는 도시 노인에 비해 유의적으로 높았다 (p = 0.027). 연령, 성별, 에너지 섭취량, 교육 및 소득수준을 보정하여 분석한 결과를 보아도 농촌노인의 물 (p = 0.039)과 과실류 (p= 0.006)의 섭취가 도시노인에 비해 유의적으로 낮았다. 두 지역 노인들의 영양소 섭취량을 비교해 보면, 연령, 성별, 에너지 섭취량을 보정하여 분석한 결과, 농촌 노인의 경우, 다가불포화지방산 (p = 0.025), n-6계 지방산 (p = 0.023), 인 (p = 0.039), 철 (p = 0.035), 비타민A (p = 0.009), 카로틴 (p = 0.013), 니아신(p < 0.001), 비타민 C (p = 0.004) 섭취량이 도시 노인에 비해 유의적으로 낮았다. 교육 및 소득수준까지 모두 보정한 경우에도 농촌 노인의 철 (p = 0.042), 비타민 A (p = 0.023), 카로틴 (p = 0.025), 니아신(p < 0.003), 비타민 C (p = 0.009) 섭취량이 도시 노인보다 유의적으로 낮았다. 이러한 결과는 농촌 노인들이 특히 비타민 C, 비타민 A, 카로틴, 니아신의 섭취량과 관련이 있는 과실류와 우유 및 유제품류의 섭취가 유의적으로 낮은 것과 관련이 있어 보인다. 한편 영양소섭취기준 대비 영양소 섭취수준은 농촌 노인의 경우, 비타민 A (p = 0.016), 비타민 C (p = 0.003) 섭취수준이 도시 노인에 비해 유의적으로 낮았으며, 리보플라빈, 칼륨의 섭취수준은 80% 에 미치지 못하였다. 특히 칼슘 섭취수준은 농촌, 도시 노인 모두 60% 이하였다. 이러한 영양섭취 문제는 특히 농촌 노인의 건강에 부정적인 영향을 미칠 수 있으며, 지역별 영양불균형을 초래할 수 있다. 도시, 농촌 지역의 특성에 따라 대상자들이 식품을 구입하고 이용하는 식생활행태가 다를 것이며, 이러한 식환경 특성은 대상자의 영양소 섭취에 영향을 미친다. 본 연구에서는 이러한 식생활 환경 전부를 반영하지 못한 아쉬운 점이 있으나, 두 지역에서 유의한 차이를 보였던 사회경제지표인 소득 및 교육 수준, 연령, 성별, 에너지 섭취량을 모두 반영해서 살펴보았고 이러한 점을 고려해 볼 때 여전히 농촌 노인의 식생활행태와 영양소 섭취는 도시 노인에 비해 문제가 심각함을 확인할 수 있었다. 따라서 농촌 노인의 식생활을 개선하기 위해서는 우선적으로 대상과 환경특성을 반영한 맞춤형 교육 프로그램의 개발이 필요하며, 식품이나 음식을 직접 제공하는 식생활 개선 프로그램이 마련되고활성화되어야할것이다.

Keywords

References

  1. Dean WR, Sharkey JR. Rural and urban differences in the associations between characteristics of the community food environment and fruit and vegetable intake. J Nutr Educ Behav 2011; 43(6): 426-433. https://doi.org/10.1016/j.jneb.2010.07.001
  2. Statistics Korea. Elderly person statistics: 2016 [Internet]. Daejeon: Statistics Korea; 2016 [cited 2017 Mar 4]. Avalible from: http://kostat.go.kr/portal/korea/kor_nw/2/1/ index.board?bmode=read&aSeq=356426&pageNo=13&row-Num=10&amSeq=&sTarget=title&sTxt=.
  3. Schunemann HJ, Sperati F, Barba M, Santesso N, Melegari C, Akl EA, Guyatt G, Muti P. An instrument to assess quality of life in relation to nutrition: item generation, item reduction and initial validation. Health Qual Life Outcomes 2010; 8(1): 26. https://doi.org/10.1186/1477-7525-8-26
  4. Jang JY, Kim MJ, Han JS. A study on food frequency, dietary habits and nutrition knowledge of the elderly who intake high sodium. J Korean Soc Food Sci Nutr 2009; 38(10): 1362-1372. https://doi.org/10.3746/jkfn.2009.38.10.1362
  5. Han SS, Kim SH. A study on the influence of the dietary intake upon bone mineral density in Korean aged. Korean J Nutr 1988; 21(5): 333-347.
  6. Lim YS, Cho KJ, Nam HJ, Lee KH, Park H. A comparative study of nutrient intakes and factors to influence on nutrient intake between low-income elderly living in urban and rural areas. J Korean Soc Food Sci Nutr 2000; 29(2): 257-267.
  7. National Health Insurance Corporation (KR); Health Insurance Review & Assessment Service (KR). National health insurance statistical yearbook: 2010. Seoul: National Health Insurance Corporation; 2011.
  8. Lee JW, Kim KA, Lee MS. Nutritional intake status of the elderly taking free congregate lunch meals compared to the middleincome class elderly. Korean J Community Nutr 1998; 3(4): 594-608.
  9. Kim OS, Ryu HS. The study on blood lipid levels according to the food habits and food intake patterns in Korean elderly. Korean J Food Nutr 2009; 22(3): 421-429.
  10. Chen SH, Cheng HY, Chuang YH, Shao JH. Nutritional status and its health-related factors among older adults in rural and urban areas. J Adv Nurs 2015; 71(1): 42-53. https://doi.org/10.1111/jan.12462
  11. Cho YE, Lee SL, Cho EH, Lomeda RA, Kwak EH, Kim YH, Kwun IS. Comparison of nutrient intakes of Korean elderly people living in rural area between 24-hour recall and food frequency method. J Korean Soc Food Sci Nutr 2006; 35(6): 698-707. https://doi.org/10.3746/jkfn.2006.35.6.698
  12. Kang M, Joung H, Lim JH, Lee YS, Song YJ. Secular trend in dietary patterns in a Korean adult population, using the 1998, 2001, and 2005 Korean National Health and Nutrition Examination Survey. Korean J Nutr 2011; 44(2): 152-161. https://doi.org/10.4163/kjn.2011.44.2.152
  13. Bianchetti A, Rozzini R, Carabellese C, Zanetti O, Trabucchi M. Nutritional intake, socioeconomic conditions, and health status in a large elderly population. J Am Geriatr Soc 1990; 38(5): 521-526. https://doi.org/10.1111/j.1532-5415.1990.tb02401.x
  14. Gu W, Rennie KL, Lin X, Wang Y, Yu Z. Differences in bone mineral status between urban and rural Chinese men and women. Bone 2007; 41(3): 393-399. https://doi.org/10.1016/j.bone.2007.05.010
  15. Lee MJ, Kim JH, Park OJ, Lee YM. A study on the needs for nutrition management program for elderly who use welfare facilities. Korean J Community Nutr 2016; 21(1): 65-74. https://doi.org/10.5720/kjcn.2016.21.1.65
  16. Kim MK, Han JI, Chung YJ. Dietary behavior related to salty food intake of adults living in a rural area according to saline sensitivity. Korean J Nutr 2011; 44(6): 537-550. https://doi.org/10.4163/kjn.2011.44.6.537
  17. Kwak CS, Yon M, Lee MS, Oh SI, Park SC. Investigation on influencing environmental factors on health status of Korean septuagenarians dwelling in longevity region in Jeonla province. Korean J Community Nutr 2014; 19(2): 142-162. https://doi.org/10.5720/kjcn.2014.19.2.142
  18. Kwon JH, Yoon HJ, Moon HJ, Lee JM, Son YH, Park SH, Lee HK, Lee SK. Antropometric and health status of the elderly women attending a health promotion program in an urban community. Korean J Community Nutr 2002; 7(6): 762-768.
  19. Yoon HJ, Lee HK, Lee SK. The health status and nutrient intakes of elderly female in Daegu area. Korean J Community Nutr 2007; 12(1): 50-57.
  20. Lee KH, Park MY. Nutrient intake of the rural elderly living in Kyungnam: focusing on health and aging status, and life-satisfaction. Korean J Community Nutr 2001; 6(5): 773-788.
  21. Kim HR, Ju MJ, Moon HK, Kim HY. Comparative analysis of dietary intake for introduction of meal service in pavilion of the elderly living in rural area. Korean J Food Cult 2007; 22(6): 765-774.
  22. Lim Y, Cho K, Nam H, Lee K, Park H. A comparative study of nutrient intakes and factors to influence on nutrient intake between low-income elderly living in urban and rural areas. J Korean Soc Food Sci Nutr 2000; 29(2): 257-267.
  23. Porter EJ. Problems with preparing food reported by frail older women living alone at home. ANS Adv Nurs Sci 2007; 30(2): 159-174. https://doi.org/10.1097/01.ANS.0000271106.42043.be
  24. Yap KB, Niti M, Ng TP. Nutrition screening among communitydwelling older adults in Singapore. Singapore Med J 2007; 48(10): 911-916.
  25. Lim YJ, Choi YS. Seasonal nutrient intakes of elderly women living alone as compared to those living with family in the Gyeongbuk rural area. Korean J Community Nutr 2007; 12(1): 58-67.
  26. Pearson JM, Schlettwein-Gsell D, van Staveren W, de Groot L. Living alone does not adversely affect nutrient intake and nutritional status of 70- to 75-year-old men and women in small towns across Europe. Int J Food Sci Nutr 1998; 49(2): 131-139. https://doi.org/10.3109/09637489809089393
  27. Davis MA, Murphy SP, Neuhaus JM, Lein D. Living arrangements and dietary quality of older U.S. adults. J Am Diet Assoc 1990; 90(12): 1667-1672.
  28. Kim Y, Seo S, Kwon O, Cho MS. Comparisons of dietary behavior, food intake, and satisfaction with food-related life between the elderly living in urban and rural areas. Korean J Nutr 2012; 45(3): 252-263. https://doi.org/10.4163/kjn.2012.45.3.252
  29. Yim KS, Lee TY. Sociodemographic factors associated with nutrients intake of elderly in Korea. Korean J Nutr 2004; 37(3): 210-222.
  30. Ahn SJ, Kang SA. A study on the food habits and dietary behaviors among the Korean elderly. Korean J Soc Food Cookery Sci 1999; 15(1): 81-94.
  31. Fraser GE, Welch A, Luben R, Bingham SA, Day NE. The effect of age, sex, and education on food consumption of a middle-aged English cohort-EPIC in East Anglia. Prev Med 2000; 30(1): 26-34. https://doi.org/10.1006/pmed.1999.0598
  32. Payette H, Shatenstein B. Determinants of healthy eating in community- dwelling elderly people. Can J Public Health 2005; 96 Suppl 3: S27-S31.
  33. Kim EM, Choi MK. An analysis of food consumption patterns of the elderly from the Korea national health and nutrition examination survey (KNHANES V-1). J Korean Soc Food Sci Nutr 2013; 42(5): 818-827. https://doi.org/10.3746/jkfn.2013.42.5.818
  34. Moon HK, Kim JE, Kim EH. Dietary intake assessment by the number of chronic diseases and the season for elderly living in rural area. Korean J Nutr 2009; 42(3): 221-233. https://doi.org/10.4163/kjn.2009.42.3.221
  35. Choe JS, Ahn EM, Kwon SO, Park YH, Lee J. Dietary factors affecting bone mineral density in Korean rural postmenopausal women. Korean J Nutr 2012; 45(5): 470-478. https://doi.org/10.4163/kjn.2012.45.5.470
  36. Chun SS, Yoon EJ. A comparative study of taste preference, food consumption frequency, and nutrition intake between the elderly in their 80's living in long life regions in Jeollanam-do and a part of Seoul. Korean J Food Nutr 2016; 29(1): 115-127. https://doi.org/10.9799/ksfan.2016.29.1.115

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