Development of Korean Healthy Eating Index for adults using the Korea National Health and Nutrition Examination Survey data

Sung-Min Yook; Sohee Park; Hyun-Kyung Moon; Kirang Kim; Jae Eun Shim; Ji-Yun Hwang

doi:10.4163/jnh.2015.48.5.419

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Yook, Park, Moon, Kim, Shim, and Hwang: Development of Korean Healthy Eating Index for adults using the Korea National Health and Nutrition Examination Survey data

Research Article

Journal of Nutrition and Health 2015; 48(5): 419-428.

Published online: 30 October 2015

DOI: https://doi.org/10.4163/jnh.2015.48.5.419

Development of Korean Healthy Eating Index for adults using the Korea National Health and Nutrition Examination Survey data

Sung-Min Yook^1,^**, Sohee Park^2,^**, Hyun-Kyung Moon³, Kirang Kim³, Jae Eun Shim⁴, Ji-Yun Hwang⁵

¹Department of Foodservice Management and Nutrition, Sangmyung University, Seoul 03016, Korea.

²Department of Biostatistics, Graduate School of Public Health, Yonsei University, Seoul 03722, Korea.

³Department of Food Science and Nutrition, Dankook University, Chungnam 31116, Korea.

⁴Department of Food and Nutrition, Daejeon University, Daejeon 34520, Korea.

⁵Nutrition Education Major, Graduate School of Education, Sangmyung University, Seoul 03016, Korea.

To whom correspondence should be addressed. tel: +82-2-781-7521, jiyunhk@smu.ac.kr

Equal contributor:

**These two authors contributed to this work equally.

Received 4 September 2015 Revised 26 September 2015 Accepted 8 October 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The current study was conducted in order to develop the Korean Healthy Eating Index (KHEI) for assessing adherence to national dietary guidelines and comprehensive diet quality of healthy Korean adults using the 5th Korea National Health and Nutrition Examination Survey (KNHANES) data.

Methods

The candidate components of KHEI were selected based on literature reviews, dietary guidelines for Korean adults, 2010 Dietary Reference Intakes for Koreans (2010 KDRI), and objectives of HP 2020. The associations between candidate components and risk of obesity, abdominal obesity, and metabolic syndrome were assessed using the 5th KNHANES data. The expert review process was also performed.

Results

Diets that meet the food group recommendations per each energy level receive maximum scores for the 9 adequacy components of the index. Scores for amounts between zero and the standard are prorated linearly. For the three moderation components among the total of five, population probability densities were examined when setting the standards for minimum and maximum scores. Maximum scores for the total of 14 components are 100 points and each component has maximum scores of 5 (fruit intakes excluding juice, fruit intake including juice, vegetable intakes excluding Kimchi and pickles, vegetable intake including Kimchi or pickles, ratio of white meat to read meat, whole grains intake, refined grains intake, and percentages of energy intake from carbohydrate) or 10 points (protein foods intake, milk and dairy food intake, having breakfast, sodium intake, percentages of energy intake from empty calorie foods, and percentages of energy intake from fat). The KHEI is a measure of diet quality as specified by the key diet recommendations of the dietary guidelines and 2010 KDRIs.

Conclusion

The KHEI will be used as a tool for monitoring diet quality of the Korean population and subpopulations, evaluation of nutrition interventions and research.

Keywords: Korean Healthy Eating Index, development, diet quality, KNHANES

Figures and Tables

Fig. 1

Overall flow of development process of Korean Healthy Eating Index (KHEI)

Fig. 2

Example of scoring standard : percentages of energy from fat

Fig. 3

The flow of selection process among candidates

Table 1

Components and scoring standards for Korean Healthy Eating Index

1) 2010 Dietary Reference Intakes for Koreans (Reference No. 27) 2) Dietary guidelines for Korean adults (Reference No. 24) 3) McCullough et al. (Reference No. 15)

Table 2

Score distribution of Korean Healthy Eating Index using the Korea National Health and Nutrition Examination Survey V (2010-2012)

Notes

This work was supported by Research Program funded by the Korea Centers for Disease Control and Prevention (2014-E35006-00).

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