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

Abstract

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.

Association of the Healthy Eating Index with Estimated Cardiovascular Age in Adults from the KNHANES 2013–2017

“…KHEI is developed by KCDC to evaluate comprehensive diet quality among Koreans. It includes adequacy of food intake comprising 8 items, moderation of saturated fatty acids, sugar, and sodium intake, and balanced energy, fat, and carbohydrate intake [ 9 , 14 ]. KHEI scores were calculated based on KNHANES.…”

“…The Korea Centers for Disease Control and Prevention (KCDC) has developed the Korean Healthy Eating Index (KHEI) for adults, based on literature reviews, which established dietary guidelines for Korean adults. The 2010 Dietary Reference Intake for Koreans (2010 KDRI) outlined the relationship between obesity, abdominal obesity, metabolic syndrome, and nutrition [ 9 ]. KHEI is a good measure to assess the diet quality of Korean adults [ 9 ].…”

“…The 2010 Dietary Reference Intake for Koreans (2010 KDRI) outlined the relationship between obesity, abdominal obesity, metabolic syndrome, and nutrition [ 9 ]. KHEI is a good measure to assess the diet quality of Korean adults [ 9 ]. KHEI includes a total of 14 components: 8 items recommended for adequate food consumption, including breakfast, mixed grain, fruit, fruit juice, vegetables, fermented vegetables, meat and milk and milk products, three items for moderate consumption (i.e., saturated fatty acids, sodium, sweets, and beverages), and three items for balanced consumption (i.e., carbohydrates, total fat, and energy) [ 9 ].…”

“…In the Korea National Health and Nutrition Examination Survey (KNHANES VI) (2013–2015), the total score of KHEI in Korean adults was found to be 63.3, with the total score in men lower than that of women. Among the different age groups, the KHEI score was lowest in young adults between 20 and 40 years of age [ 9 ]. These KHEI scores reflect Korean dietary patterns and eating habits and their influence on eCV-age.…”

Household food insecurity and dental caries in Korean adults

“…To measure overall quality of diet, the Korean Healthy Eating Index (KHEI) was assessed based on 14 components designed according to dietary reference intakes for Koreans in 2010. 29…”