한국 성인의 식생활평가지수와 혈청 비타민 D 농도와의 관련성: 2013–2015 국민건강영양조사 = Association between the Korean Healthy Eating Index and Serum Vitamin D Level in Korean Adults: 2013–2015 Korea National Health and Nutrition Examination Survey

국문 초록 (Abstract)

연구배경: 비타민 D는 칼슘과 인 대사의 핵심적인 분자 조절자이며, 여러 연구에서 혈청 비타민 D 농도와 다양한 만성질환 사이의 유의미한 연관성이 보고되었다. 그러나 식사의 질과 혈청 비타민 D 농도 사이의 관련성에 대한 연구는 제한적이다. 이에 본 연구에서는 한국 성인을 대상으로 한국식생활평가지수(Korean Healthy Eating Index, KHEI) 점수와 혈청 비타민 D 농도 간의 관련성을 조사하고자 하였다.
방법: 2013–2015년 국민건강영양조사에 참여한 만 20세 이상 성인 총 3,510명이 최종 분석 대상에 포함되었다. KHEI 점수는 사분위수로 분류하였으며, 일원배치 분산분석을 사용하여 각 사분위수에 따른 혈청 비타민 D 농도를 비교하였다. 또한 연령, 성별, 체질량지수, 현재 흡연 여부, 고위험 음주 여부, 신체 활동 여부, 직업 및 거주지를 보정하여 공분산 분석을 시행하였다.
결과: 연구 집단의 평균 연령±표준 편차는 46.6±0.3세였다. KHEI 점수는 다음과 같이 사분위수로 나누어 평가하였다; Q1 (16.0–55.1), Q2 (55.2–64.5), Q3 (55.2–64.5), Q4 (64.6–73.1). 다변량 보정 평균 비타민 D 농도는 KHEI 점수가 증가함에 따라 유의미하게 증가하였다(P=0.009).
결론: 한국 성인의 KHEI 점수와 혈청 비타민 D 농도는 유의미한 양의 상관관계가 있는 것으로 나타났다. 공중 보건 정책의 관점에서 적절한 혈청 비타민 D 수준을 유지하기 위해 건강한 식습관을 유지하는 것이 중요하다.

다국어 초록 (Multilingual Abstract)

Background: Vitamin D is a key molecular regulator of calcium and phosphate metabolism. Numerous reports have suggested a substantial association between serum vitamin D levels and various chronic diseases. However, few studies have explored the association between diet quality and serum vitamin D levels. We aimed to investigate the association between the Korean Healthy Eating Index (KHEI) score and serum vitamin D levels in Korean adults.
Methods: A total of 3,510 adults aged ≥20 years who participated in the 2013–2015 Korea National Health and Nutrition Examination Survey were included in the final analysis. The KHEI scores were categorized into quartiles. One-way analysis of variance was performed to compare serum vitamin D levels according to the KHEI score quartiles. Analysis of covariance was conducted after adjusting for age, sex, body mass index, current smoking, high-risk drinking, physical activity, occupation, and residence.
Results: The mean age±standard error of age of the study population was 46.4±0.3 years. The KHEI scores were categorized into quartiles: Q1 (16.0–55.1), Q2 (55.2–64.5), Q3 (55.2–64.5), and Q4 (64.6–73.1). The multivariable-adjusted mean serum vitamin D level significantly increased as the KHEI score increased (overall P=0.009).
Conclusion: The KHEI score is significantly associated with serum vitamin D levels in Korean adults. Considering public health policies, maintaining healthy dietary habits could be crucial for maintaining an adequate serum vitamin D level.

참고문헌 (Reference)

• 1 신새롬 ; 이승민, "한국 성인의 식생활평가지수에 기반한 전체 식사의 질과 대사증후군 구성요소 및 대사증후군 발생의 연관성" 대한지역사회영양학회 25 (25): 61-70, 2020
• 2 육성민 ; 박소희 ; 문현경 ; 김기랑 ; 심재은 ; 황지윤, "국민건강영양조사 자료를 이용한 한국 성인의 식생활평가지수 개발" 한국영양학회 48 (48): 419-428, 2015
• 3 Rizzoli R, "Vitamin D supplementation : upper limit for safety revisited?" 33 : 19-24, 2021
• 4 Park JH, "Vitamin D status in South Korean population : seven-year trend from the KNHANES" 97 : e11032-, 2018
• 5 de la Guía-Galipienso F, "Vitamin D and cardiovascular health" 40 : 2946-2957, 2021
• 6 최한석, "Vitamin D Status in Korea" 대한내분비학회 28 (28): 12-16, 2013
• 7 Calvo MS, "Survey of current vitamin D food fortification practices in the United States and Canada" 136 : 211-213, 2013
• 8 Zemel MB, "Role of dietary calcium and dairy products in modulating adiposity" 38 : 139-146, 2003
• 9 World Health Organization(WHO), "Prevention and management of osteoporosis:report of a WHO scientific group" WHO 2003
• 10 조희경 ; 임춘수 ; 조비룡, "Lifestyle and Dietary Factors Associated with Serum 25-Hydroxyvitamin D Levels in Korean Young Adults" 대한의학회 30 (30): 1110-1120, 2015
• 11 Reedy J, "Evaluation of the Healthy Eating Index-2015" 118 : 1622-1633, 2018
• 12 Gahche J, "Dietary supplement use among U. S. adults has increased since NHANES III(1988-1994)" 61 : 1-8, 2011
• 13 Moraeus L, "Diet diversity score and Healthy Eating Index in relation to diet quality and socio-demographic factors : results from a cross-sectional national dietary survey of Swedish adolescents" 23 : 1754-1765, 2020
• 14 Looman M, "Development and evaluation of the Dutch Healthy Diet Index 2015" 20 : 2289-2299, 2017
• 15 Pereira MA, "Dairy consumption, obesity, and the insulin resistance syndrome in young adults : the CARDIA Study" 287 : 2081-2089, 2002
• 16 Dudenkov DV, "Changing incidence of serum 25-hydroxyvitamin D values above 50 ng/mL : a 10-year population-based study" 90 : 577-586, 2015
• 17 Beydoun MA, "Associations among 25-hydroxyvitamin D, diet quality, and metabolic disturbance differ by adiposity in adults in the United States" 95 : 3814-3827, 2010
• 18 Ganji V, "Association of serum vitamin D concentrations with dietary patterns in children and adolescents" 17 : 58-, 2018
• 19 Fan Y, "Association between Healthy Eating Index-2015 and physical frailty among the United States elderly adults : the National Health and Nutrition Examination Survey(NHANES)2011-2014" 33 : 3245-3255, 2021