Journal List > J Nutr Health > v.48(4) > 1081406

J Nutr Health. 2015 Aug;48(4):371-379. Korean.
Published online August 31, 2015.
© 2015 The Korean Nutrition Society
Socio-economic status is associated with the risk of inadequate energy intake among Korean elderly
Eun Jin So,1,2 and Hyojee Joung2
1The Catholic University of Korea Seoul St. Mary's Hospital, Seoul 137-701, Korea.
2Department of Public Health Nutrition of Graduate School of Public Health, Seoul National University, Seoul 151-742, Korea.

To whom correspondence should be addressed. tel: +82-2-880-2716, Email:
Received April 15, 2015; Revised May 15, 2015; Accepted June 08, 2015.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



This study was conducted to evaluate the factors influencing inadequate energy intake among Korean elderly.


Our study included 1,869 elderly people (over 60 years old) who completed a dietary survey from the fifth Korean NHANES (2010). Factors that could affect the nutritional status of the elderly included age, family status, socio-economic factors (education, family income, livelihood security, employment), and health related factors (having chronic disease, functional status, diet therapy, depression, and suicidal thoughts). Energy and protein intake were assessed using the dietary intake data from 24hr recall method.


The percentage of people who consumed energy less than 75% of EEA for Koreans was 23.7% in men, 31.1% in women. The carbohydrate contribution to the total energy intake in the inadequate energy intake group was significantly higher than that in the adequate intake group (p < 0.05). Factors significantly related to inadequate energy intake after adjusting for age, family status, education, family income, employment, functional status, and suicidal thoughts were education (OR: 1.480 in men, 1.614 in women) and employment (OR: 1.751 in men, 1.464 in women), age 70 years or older in men (OR: 1.475), and living with family but without spouse in women (OR: 1.496).


In summary, the results imply that energy intake of elderly would be affected by the status of social environment with aging and nutrition-related policy for Korean elderly should be based on the social status as well as health related conditions.

Keywords: inadequate energy intake; elderly; socio-economic factors


Table 1
Profile of inadequate energy intake among Korean elderly by sex
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Table 2
Intakes and distribution of macronutrients contribution of energy intakes among Korean elderly by sex
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Table 3
Major food sources of energy intakes among Korean elderly by sex
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Table 4
Environmental factors associated with inadequate energy intake by sex using logistic regression analysis1)
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1. Statistics Korea. 2010 Population and housing census report. Daejoen: Statistics Korea; 2012. pp. 21-24.
2. Lee SY, Lee JW. The limitation of the individualism approach on chronic diseases. Health Soc Sci 2011;29:211–236.
3. Bird CE, Rieker PP. In: Gender and health: the effects of constrained choices and social policies. New York (NY): Cambridge University Press; 2008.
4. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2013: Korea National Health and Nutrition Examination Survey (KNHANES VI-1). Cheongju: Korea Centers for Disease Control and Prevention; 2014.
5. López-Contreras MJ, López MÁ, Canteras M, Candela ME, Zamora S, Pérez-Llamas F. Identification of different nutritional status groups in institutionalized elderly people by cluster analysis. Nutr Hosp 2014;29(3):602–610.
6. Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 2003;22(3):235–239.
7. Phillips RM. Nutrition and depression in the community-based oldest-old. Home Healthc Nurse 2012;30(8):462–471.
8. Sánchez-García S, Sánchez-Arenas R, García-Peña C, Rosas-Carrasco O, Avila-Funes JA, Ruiz-Arregui L, Juárez-Cedillo T. Frailty among community-dwelling elderly Mexican people: prevalence and association with sociodemographic characteristics, health state and the use of health services. Geriatr Gerontol Int 2014;14(2):395–402.
9. Salminen H, Sääf M, Johansson SE, Ringertz H, Strender LE. Nutritional status, as determined by the Mini-Nutritional Assessment, and osteoporosis: a cross-sectional study of an elderly female population. Eur J Clin Nutr 2006;60(4):486–493.
10. Collins CE, Kershaw J, Brockington S. Effect of nutritional supplements on wound healing in home-nursed elderly: a randomized trial. Nutrition 2005;21(2):147–155.
11. Lee L. Associations between dietary intake and health status in Korean elderly population. Korean J Nutr 2002;35(1):124–136.
12. 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.
13. Jung HJ, Song WO, Paik HY, Joung H. Dietary characteristics of macronutrient intake and the status of metabolic syndrome among Koreans. Korean J Nutr 2011;44(2):119–130.
14. Suh HJ, Kim BH. Comparison of self-living ability, obesity indices and nutrient intake according to physical fitness among the elderly in rural areas. Korean J Food Nutr 2009;22(4):577–586.
15. Song ES, Kim EJ, Kim MH, Choi MK. Comparative study on dietary life and nutrient intakes of elderly persons at nursing home or their home in Chungnam. J East Asian Soc Diet Life 2011;21(5):649–660.
16. Ahn H, Kang J, Lee H. Nutrition status of elderly female patients in long-term care hospital according to meal types and eating ability. Korean J Community Nutr 2014;19(2):187–197.
17. Ahmed T, Haboubi N. Assessment and management of nutrition in older people and its importance to health. Clin Interv Aging 2010;5:207–216.
18. Brownie S. Why are elderly individuals at risk of nutritional deficiency? Int J Nurs Pract 2006;12(2):110–118.
19. Chao SY, Houser RF, Tennstedt S, Jacques P, Dwyer JT. Food and nutrition care indicators: experts' views on quality indicators for food and nutrition services in assisted-living facilities for older adults. J Am Diet Assoc 2007;107(9):1590–1598.
20. Guigoz Y, Lauque S, Vellas BJ. Identifying the elderly at risk for malnutrition. The Mini Nutritional Assessment. Clin Geriatr Med 2002;18(4):737–757.
21. Holmes S. Barriers to effective nutritional care for older adults. Nurs Stand 2006;21(3):50–54.
22. Preyde M, Brassard K. Evidence-based risk factors for adverse health outcomes in older patients after discharge home and assessment tools: a systematic review. J Evid Based Soc Work 2011;8(5):445–468.
23. Wham CA, Teh RO, Robinson M, Kerse NM. What is associated with nutrition risk in very old age? J Nutr Health Aging 2011;15(4):247–251.
24. Donini LM, Scardella P, Piombo L, Neri B, Asprino R, Proietti AR, Carcaterra S, Cava E, Cataldi S, Cucinotta D, Di Bella G, Barbagallo M, Morrone A. Malnutrition in elderly: social and economic determinants. J Nutr Health Aging 2013;17(1):9–15.
25. Wham C, Carr R, Heller F. Country of origin predicts nutrition risk among community living older people. J Nutr Health Aging 2011;15(4):253–258.
26. Mahadevan M, Hartwell HJ, Feldman CH, Ruzsilla JA, Raines ER. Assisted-living elderly and the mealtime experience. J Hum Nutr Diet 2014;27(2):152–161.
27. Nijs KA, de Graaf C, Kok FJ, van Staveren WA. Effect of family style mealtimes on quality of life, physical performance, and body weight of nursing home residents: cluster randomised controlled trial. BMJ 2006;332(7551):1180–1184.
28. Jürschik P, Torres J, Solá R, Nuin C, Botigué T, Lavedán A. High rates of malnutrition in older adults receiving different levels of health care in Lleida, Catalonia: an assessment of contributory factors. J Nutr Elder 2010;29(4):410–422.
29. Dorner B, Friedrich EK, Posthauer ME. Practice paper of the American Dietetic Association: individualized nutrition approaches for older adults in health care communities. J Am Diet Assoc 2010;110(10):1554–1563.
30. Dorner B, Friedrich EK, Posthauer ME. American Dietetic Association. Position of the American Dietetic Association: individualized nutrition approaches for older adults in health care communities. J Am Diet Assoc 2010;110(10):1549–1553.
31. Park HS, Ra DS. The effect of social support on the life satisfaction of older workers - focus on the empowerment as a mediator. J Welf Aged 2008;40:147–172.
32. Hu SH, Kim JD, Jung TY. Analysis of employment effects on life satisfaction of the elderly. J Korean Gerontol Soc 2011;31(4):1103–1118.
33. Jeong KH, Lee YK, Park BM, Lee SJ, Lee YH. In: Analysis of the survey of living conditions and welfare needs of Korean older persons. Seoul: Korea Institute for Health and Social Affairs; 2012.
34. VanItallie TB. Subsyndromal depression in the elderly: underdiagnosed and undertreated. Metabolism 2005;54(5) Suppl 1:39–44.
35. Tsai HJ. Nutrition risk, functional dependence, and co-morbidities affect depressive symptoms in Taiwanese aged 53 years and over: a population-based longitudinal study. J Psychosom Res 2013;75(2):173–177.
36. Yim KS. Health-related behavioral factors associated with nutritional risks in Korean aged 50 years and over. Korean J Community Nutr 2007;12(5):592–605.
37. The Korean Nutrition Society. Dietary reference intakes for Koreans. 1st revision. Seoul: The Korean Nutrition Society; 2010.
38. Lorber J, Moore LJ. In: Gender and the social construction of illness. 2nd edition. Walnut Creek (CA): Altamira Press; 2002.
39. Hwang JY, Ru SY, Ryu HK, Park HJ, Kim WY. Socioeconomic factors relating to obesity and inadequate nutrient intake in women in low income families residing in Seoul. Korean J Nutr 2009;42(2):171–182.
40. Feldblum I, German L, Castel H, Harman-Boehm I, Bilenko N, Eisinger M, Fraser D, Shahar DR. Characteristics of undernourished older medical patients and the identification of predictors for undernutrition status. Nutr J 2007;6(1):37.
41. Lee HS. The factors influencing health-related quality of life in the elderly: focused on the general characteristics, health habits, mental health, chronic diseases, and nutrient intake status: data from the fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2012. Korean J Community Nutr 2014;19(5):479–489.
42. Jeong WY, Jeong SE. Study on the relations between the economic characteristics and life satisfaction by income levels among single elderly households. J Korean Gerontol Soc 2011;31(4):1119–1134.
43. Nam KM, Choi WG. The relationship between the productive activity factors of employed elderly people and successful aging -focused on the mediating effect of empowerment. J Welf Aged 2009;45:347–371.
44. World Health Organization (CH). Women and health: today's evidence tomorrow's agenda. Geneva: World Health Organization; 2009.
45. Woods NF, LaCroix AZ, Gray SL, Aragaki A, Cochrane BB, Brunner RL, Masaki K, Murray A, Newman AB. Women's Health Initiative. Frailty: emergence and consequences in women aged 65 and older in the Women's Health Initiative Observational Study. J Am Geriatr Soc 2005;53(8):1321–1330.
46. Shahar DR, Schultz R, Shahar A, Wing RR. The effect of widowhood on weight change, dietary intake, and eating behavior in the elderly population. J Aging Health 2001;13(2):189–199.
47. Rosenbloom CA, Whittington FJ. The effects of bereavement on eating behaviors and nutrient intakes in elderly widowed persons. J Gerontol 1993;48(4):S223–S229.
48. Paquet C, St-Arnaud-McKenzie D, Ma Z, Kergoat MJ, Ferland G, Dubé L. More than just not being alone: the number, nature, and complementarity of meal-time social interactions influence food intake in hospitalized elderly patients. Gerontologist 2008;48(5):603–611.
49. Lee LH. Bone health status of Korean elderly people and dietary factors related to bone mineral density. J Res Ins Korean Educ 2006;24:1–19.