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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.
References
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Table 1.
General characteristics of urban and rural elderly
| Variables | Urban (n = 867) | Rural (n = 372) | Total (n = 1,239) | p3) |
|---|---|---|---|---|
| Gender | ||||
| Male | 377 (41.7)1) | 166 (44.1) | 543 (42.3) | 0.386 |
| Female | 490 (58.3) | 206 (55.9) | 696 (57.7) | |
| Age (yr) | ||||
| 65 ∼ 74 | 592 (65.3) | 208 (54.5) | 800 (62.5) | < 0.001 |
| ≥ 75 | 275 (34.7) | 164 (45.5) | 439 (37.5) | |
| Mean (yr) | 72.6 ± 0.22) | 73.8 ± 0.4 | 73.2 ± 0.2 | 0.005 |
| Educational level | ||||
| ≤ Elementary | 503 (59.9) | 263 (70.8) | 766 (62.7) | |
| Middle | 119 (13.6) | 50 (12.8) | 169 (13.4) | 0.025 |
| High | 146 (16.1) | 43 (11.9) | 189 (15.0) | |
| ≥ College | 99 (10.4) | 16 (4.5) | 115 (8.9) | |
| Household income | ||||
| 1 quartile | 364 (43.4) | 221 (59.9) | 585 (47.7) | |
| 2 quartile | 259 (29.0) | 70 (19.1) | 329 (26.4) | 0.003 |
| 3 quartile | 131 (14.6) | 53 (14.3) | 184 (14.5) | |
| 4 quartile | 113 (13.0) | 28 (6.7) | 141 (11.4) | |
| Mean (10,000 won) | 205.8 ± 13.52) | 164.0 ± 27.0 | 184.9 ± 14.4 | 0.187 |
| Single household | ||||
| Yes | 174 (18.6) | 76 (20.0) | 250 (19) | 0.657 |
| No | 693 (81.4) | 296 (80.0) | 989 (81) |
Table 2.
Dietary behavior of urban and rural elderly
| Variables | Urban (n = 867) | Rural (n = 372) | Total (n = 1,239) | p3) |
|---|---|---|---|---|
| Skipping meals | ||||
| Breakfast | 50 (6.3)1) | 10 (3.0) | 60 (5.4) | 0.075 |
| Lunch | 66 (7.7) | 16 (4.2) | 82 (6.8) | 0.059 |
| Dinner | 54 (6.5) | 12 (3.0) | 66 (5.6) | 0.030 |
| Frequency of eating out (/week) | 1.7 ± 0.12) | 1.0 ± 0.1 | 1.4 ± 0.1 | < 0.001 |
| Participation in nutrition education | 40 (4.8) | 13 (3.8) | 53 (4.6) | 0.490 |
Table 3.
Food group consumption of urban and rural elderly
| Variables | Crude1) | Model 12) | p1) | p2) | p3) | ||
|---|---|---|---|---|---|---|---|
| Urban (n = 867) | Rural (n = 372) | Urban (n = 867) | Rural (n = 372) | ||||
| Water (cup)4) | 4.4 ± 0.1 | 3.9 ± 0.1 | 4.4 ± 0.1 | 4.0 ± 0.1 | 0.014 | 0.028 | 0.039 |
| Cereals and grain products (g) | 280.4 ± 6.0 | 310.8 ± 14.3 | 282.4 ± 0.6 | 315.7 ± 13.8 | 0.051 | 0.027 | 0.998 |
| Potatoes and starches (g) | 40.5 ± 4.8 | 37.8 ± 5.9 | 39.5 ± 4.5 | 39.9 ± 6.0 | 0.732 | 0.957 | 0.051 |
| Sugars and sweets (g) | 9.3 ± 0.9 | 6.9 ± 0.7 | 9.4 ± 1.0 | 7.0 ± 0.7 | 0.049 | 0.052 | 0.051 |
| Legumes and their products (g) | 41.9 ± 2.9 | 41.6 ± 5.0 | 42.5 ± 2.9 | 42.5 ± 4.9 | 0.966 | 0.996 | 0.950 |
| Seeds and nuts (g) | 9.0 ± 1.7 | 7.9 ± 2.0 | 9.1 ± 1.8 | 8.4 ± 2.1 | 0.154 | 0.792 | 0.634 |
| Vegetables (g) | 345.1 ± 11.5 | 321.1 ± 18.9 | 346.0 ± 11.3 | 331.2 ± 17.5 | 0.282 | 0.474 | 0.179 |
| Mushrooms (g) | 3.9 ± 1.4 | 2.8 ± 0.9 | 3.8 ± 1.4 | 3.1 ± 0.9 | 0.522 | 0.636 | 0.690 |
| Fruits (g) | 190.7 ± 9.5 | 143.3 ± 10.2 | 187.9 ± 9.2 | 149.9 ± 10.1 | 0.001 | 0.006 | 0.006 |
| Seaweeds (g) | 33.7 ± 5.0 | 16.7 ± 5.0 | 33.1 ± 4.8 | 18.7 ± 5.3 | 0.018 | 0.040 | 0.050 |
| Beverages (g) | 114.1 ± 9.0 | 101.0 ± 10.1 | 118.4 ± 9.2 | 107.7 ± 9.6 | 0.333 | 0.420 | 0.466 |
| Seasonings (g) | 28.5 ± 2.2 | 26.3 ± 1.5 | 29.1 ± 2.4 | 26.9 ± 1.5 | 0.412 | 0.486 | 0.365 |
| Oils and fats (plant) (g) | 5.0 ± 0.4 | 4.5 ± 0.5 | 5.1 ± 0.4 | 4.7 ± 0.5 | 0.400 | 0.542 | 0.380 |
| Meats and their products (g) | 52.5 ± 4.7 | 58.6 ± 10.1 | 53.9 ± 4.8 | 60.1 ± 9.6 | 0.586 | 0.562 | 0.589 |
| Eggs (g) | 13.5 ± 1.2 | 13.7 ± 2.2 | 13.6 ± 1.3 | 14.0 ± 2.2 | 0.957 | 0.876 | 0.468 |
| Fishes and shellfishes (g) | 104.2 ± 8.0 | 89.0 ± 14.3 | 104.1 ± 7.0 | 92.0 ± 14.0 | 0.357 | 0.452 | 0.408 |
| Milk and dairy products (g) | 60.0 ± 5.1 | 40.7 ± 6.6 | 59.2 ± 5.13 | 42.5 ± 6.5 | 0.023 | 0.045 | 0.083 |
Table 4.
Nutrient intake of urban and rural elderly
| Variables | Crude1) | Model 12) | |||||
|---|---|---|---|---|---|---|---|
| Urban (n = 867) | Rural (n = 372) | Urban (n = 867) | Rural (n = 372) | p1) | p2) | p3) | |
| Energy (kcal) | 1,686.6 ± 30.9 | 1,729.3 ± 61.9 | 1,703.2 ± 29.3 | 1,770.2 ± 53.8 | 0.542 | 0.278 | 0.154 |
| Protein (g) | 54.1 ± 1.3 | 54.1 ± 2.6 | 54.5 ± 0.71 | 53.3 ± 1.3 | 0.979 | 0.433 | 0.859 |
| Fat (g) | 26.1 ± 1.1 | 23.3 ± 2.0 | 26.2 ± 0.8 | 22.8 ± 1.8 | 0.242 | 0.086 | 0.197 |
| Saturated fat acid (g) | 7.2 ± 0.3 | 6.4 ± 0.5 | 7.2 ± 0.2 | 6.3 ± 0.5 | 0.21 | 0.075 | 0.184 |
| Mono unsaturated fat acid (g) | 7.6 ± 0.4 | 6.7 ± 0.8 | 7.6 ± 0.3 | 6.5 ± 0.7 | 0.332 | 0.132 | 0.271 |
| Poly unsaturated fat acid (g) | 7.4 ± 0.3 | 6.3 ± 0.5 | 7.4 ± 0.3 | 6.1 ± 0.4 | 0.066 | 0.025 | 0.073 |
| n-3 fat acid (g) | 1.3 ± 0.1 | 1.2 ± 0.1 | 1.3 ± 0.1 | 1.2 ± 0.1 | 0.551 | 0.380 | 0.778 |
| n-6 fat acid (g) | 6.1 ± 0.3 | 5.1 ± 0.4 | 6.1 ± 0.2 | 5.0 ± 0.4 | 0.049 | 0.023 | 0.059 |
| Carbohydrate (g) | 295.0 ± 5.2 | 310.0 ± 11.5 | 296 ± 2.5 | 304.1 ± 4.2 | 0.238 | 0.108 | 0.241 |
| Fiber (g) | 7.4 ± 0.2 | 7.5 ± 0.5 | 7.4 ± 0.2 | 7.5 ± 0.4 | 0.936 | 0.813 | 0.697 |
| Calcium (mg) | 428.9 ± 15.8 | 391.9 ± 21.9 | 430.0 ± 13.0 | 389.0 ± 17.6 | 0.176 | 0.070 | 0.117 |
| Phosphorus (mg) | 903.0 ± 21.1 | 868.6 ± 39.3 | 907.0 ± 11.5 | 861.1 ± 18.4 | 0.447 | 0.039 | 0.129 |
| Iron (mg) | 17.0 ± 0.8 | 15.5 ± 0.7 | 17.0 ± 0.6 | 15.4 ± 0.3 | 0.137 | 0.035 | 0.042 |
| Sodium (mg) | 3,075.3 ± 88.2 | 3,255.1 ± 164.7 | 3,099.2 ± 74.1 | 3,243.7 ± 138.0 | 0.348 | 0.368 | 0.402 |
| Potassium (mg) | 2,775.4 ± 71.1 | 2,652.3 ± 136.9 | 2,773.0 ± 49.4 | 2,631.2 ± 92.4 | 0.429 | 0.188 | 0.338 |
| Vitamin A (μg/RE) | 725.2 ± 45.3 | 566.1 ± 45.5 | 724.2 ± 45.6 | 559.3 ± 44.6 | 0.014 | 0.009 | 0.023 |
| Carotene (μg) | 3,942.5 ± 268.5 | 3,019.7 ± 268.8 | 3,930.4 ± 273.5 | 2,989.0 ± 255.0 | 0.016 | 0.013 | 0.025 |
| Retinol (μg) | 61.1 ± 6.6 | 52.3 ± 14.8 | 62.1 ± 6.5 | 51.13 ± 15.8 | 0.591 | 0.523 | 0.610 |
| Vitamin B1 (mg) | 1.7 ± 0.0 | 1.7 ± 0.1 | 1.7 ± 0.0 | 1.7 ± 0.0 | 0.798 | 0.217 | 0.305 |
| Vitamin B2 (mg) | 1.1 ± 0.0 | 1.0 ± 0.1 | 1.1 ± 0.0 | 1.0 ± 0.0 | 0.312 | 0.146 | 0.347 |
| Niacin (mg) | 13.0 ± 0.4 | 11.8 ± 0.5 | 13.1 ± 0.3 | 11.67 ± 0.3 | 0.071 | < 0.001 | 0.003 |
| Vitamin C (mg) | 108.7 ± 5.7 | 82.7 ± 6.5 | 107.4 ± 5.1 | 83.0 ± 6.4 | 0.003 | 0.004 | 0.009 |
Table 5.
Comparison of nutrient intake as a percentage of KDRIs of urban and rural elderly
| Variables | Urban (n = 867) | Rural (n = 372) | Total (n = 1,239) | p |
|---|---|---|---|---|
| Energy1) | 94.5 ± 1.7 | 96.2 ± 3.1 | 95.3 ± 1.8 | 0.651 |
| Protein2) | 108.8 ± 2.4 | 108.0 ± 4.9 | 108.4 ± 2.7 | 0.889 |
| Vitamin A2) | 117.9 ± 7.4 | 92.3 ± 7.5 | 105.1 ± 5.3 | 0.016 |
| Vitamin C2) | 108.7 ± 5.7 | 82.7 ± 6.5 | 95.7 ± 4.3 | 0.003 |
| Vitamin B12) | 148.1 ± 3.3 | 145.9 ± 6.1 | 147.0 ± 3.4 | 0.763 |
| Vitamin B22) | 78.4 ± 2.7 | 73.2 ± 4.4 | 75.8 ± 2.5 | 0.320 |
| Niacin2) | 86.9 ± 2.3 | 78.5 ± 3.5 | 82.7 ± 2.1 | 0.050 |
| Calcium2) | 57.6 ± 2.2 | 52.6 ± 3.0 | 55.1 ± 1.8 | 0.175 |
| Potassium3) | 130.0 ± 3.0 | 124.1 ± 5.6 | 126.5 ± 3.1 | 0.447 |
| Sodium3) | 247.3 ± 6.8 | 268.7 ± 13.2 | 258.0 ± 7.3 | 0.161 |
| Phosphorus3) | 79.3 ± 2.0 | 75.8 ± 3.9 | 77.5 ± 2.2 | 0.430 |
| Iron2) | 204.3 ± 9.5 | 188.1 ± 7.8 | 196.2 ± 6.1 | 0.192 |
Table 6.
Food consumption frequency of urban and rural elderly
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