Nutritional risk assessment using estimated usual nutrient intake in Korean adults: analysis of the 8th (2019–2021) Korea National Health and Nutrition Examination Survey data
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BACKGROUND/OBJECTIVES: This study aimed to perform a nutritional risk assessment in Korean adults by estimating the usual intake of energy and nutrients from foods, including dietary supplement (DS) intake, and assessing the prevalence of excessive and inadequate intake. SUBJECTS/METHODS: The usual intake for adults aged 19 to 69 yrs was estimated usingthe National Cancer Institute method, applying the within- and between-person variance from the 2009 Korea National Health and Nutrition Examination Survey (KNHANES) to one- day dietary recall data from the 2019–2021 KNHANES. The usual intake from foods only was calculated using this approach. The DS intake was then added to estimate the total nutrient intake. Nutrient adequacy was assessed according to gender and age using the 2020 Korean Dietary Reference Intakes. RESULTS: The distribution of the usual intake estimates differed significantly from the one- day values. In particular, the one-day intake underestimated the prevalence of excessive sodium intake (68.5%) compared to the usual intake (83.8%), while inadequate protein intake prevalence was overestimated considerably (21.6% vs. 5.6%). Men showed a higher prevalence of excessive energy, protein, fat, and sodium intake, while women showed a higher prevalence of inadequate intake, particularly for iron (45.5%), even after accounting for DS intake. Micronutrient inadequacy was more common in younger adults, whereas adults aged 30 yrs and older showed a higher prevalence of excessive intake with DS use. Although DSs helped reduce the prevalence of inadequate intake (e.g., vitamin A: 74.8% to 61.2%), they also slightly increased the prevalence of excessive intake in some nutrients. CONCLUSION: Estimating the usual nutrient intake offers a more robust and realistic nutritional risk assessment than using the one-day dietary recall data as it stands. This study revealed disparities in nutritional intake according to gender and age, and highlighted the dual role of DSs. Public health strategies should support food-based nutrient adequacy before promoting DS use and provide targeted interventions for vulnerable groups.
Abstract
BACKGROUND/OBJECTIVES: This study aimed to perform a nutritional risk assessment in Korean adults by estimating the usual intake of energy and nutrients from foods, including dietary supplement (DS) intake, and assessing the prevalence of excessive and inadequate intake. SUBJECTS/METHODS: The usual intake for adults aged 19 to 69 yrs was estimated usingthe National Cancer Institute method, applying the within- and between-person variance from the 2009 Korea National Health and Nutrition Examination Survey (KNHANES) to one- day dietary recall data from the 2019–2021 KNHANES. The usual intake from foods only was calculated using this approach. The DS intake was then added to estimate the total nutrient intake. Nutrient adequacy was assessed according to gender and age using the 2020 Korean Dietary Reference Intakes. RESULTS: The distribution of the usual intake estimates differed significantly from the one- day values. In particular, the one-day intake underestimated the prevalence of excessive sodium intake (68.5%) compared to the usual intake (83.8%), while inadequate protein intake prevalence was overestimated considerably (21.6% vs. 5.6%). Men showed a higher prevalence of excessive energy, protein, fat, and sodium intake, while women showed a higher prevalence of inadequate intake, particularly for iron (45.5%), even after accounting for DS intake. Micronutrient inadequacy was more common in younger adults, whereas adults aged 30 yrs and older showed a higher prevalence of excessive intake with DS use. Although DSs helped reduce the prevalence of inadequate intake (e.g., vitamin A: 74.8% to 61.2%), they also slightly increased the prevalence of excessive intake in some nutrients. CONCLUSION: Estimating the usual nutrient intake offers a more robust and realistic nutritional risk assessment than using the one-day dietary recall data as it stands. This study revealed disparities in nutritional intake according to gender and age, and highlighted the dual role of DSs. Public health strategies should support food-based nutrient adequacy before promoting DS use and provide targeted interventions for vulnerable groups.