Comparison of Dietary Behaviors and the Prevalence of Metabolic Syndrome in Single- and Multi-Person Households among Korean Adults

Abstract

Changes in household dynamics in Korea, such as the transition from multi- to single-person households, have led to changes in individuals' dietary behavior patterns and health status. Thus, this study aimed to compare dietary behaviors and determine the prevalence of metabolic syndrome (MetS) as well as explore factors associated with MetS according to household type among Korean adults. Using data from the Korea National Health and Nutrition Examination Survey 2014-2018, we included 21,944 Korean adults with available health examination and dietary recall data. Based on self-reported information, individuals were divided into two household types: single- and multi-person households. We used multivariable logistic regression to estimate the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for MetS and its components after adjusting for potential covariates. Among the study population, 9.19% and 90.81% lived in single-person and multi-person households, respectively. Individuals in single-person households had a higher energy intake overall and a greater percentage of energy from animal protein; total, saturated, and monounsaturated fats; and animal source foods and a lower percentage of energy from carbohydrates, plant protein, and plant source foods than those from multi-person households (all, p < 0.05). Individuals living in single-person rather than multi-person households were more likely to consume milk/dairy products, alcoholic and non-alcoholic beverages, oils/fats, and others but were less likely to consume vegetables/mushrooms, fruits, seaweeds, and fish/shellfish (all, p < 0.05). Living alone was associated with higher energy intake from main meals and foods prepared away from home but a lower dietary variety score and fewer total main meals consumed (all, p < 0.05). Skipping breakfast, frequent eating out, food insecurity, and MetS combination phenotypes significantly differed by household type. Individuals living alone had higher odds of MetS (AOR: 1.14, 95% CI: 1.02-1.29), abdominal obesity (AOR: 1.14, 95% CI: 1.01-1.28), elevated blood pressure (AOR: 1.28, 95% CI: 1.12-1.47), and elevated fasting blood glucose (AOR: 1.18, 95% CI: 1.05-1.33) than those living with others. Compared with those in multi-person households, individuals in single-person households tend to have health and dietary behaviors that increase vulnerability to MetS; therefore, establishing health care strategies and nutrition policies according to household type is necessary.

Keywords: Korea National Health and Nutrition Examination Survey; Korean adults; household types; metabolic syndrome; single-person households.

Figure 1

Flowchart of the study population.

Figure 2

Distribution of Korean adults’ macronutrient intake according to household type, KNHANES 2014–2018. KNHANES, Korea National Health and Nutrition Examination Survey; AMDR, acceptable macronutrient distribution range. AMDR for carbohydrates, proteins, and fats were 55–65%, 7–20%, and 15–30%, respectively.

Figure 3

Prevalence of metabolic syndrome and its components among Korean adults according to household type, KNHANES 2014–2018. KNHANES, Korea National Health and Nutrition Examination Survey; MetS, metabolic syndrome; WC, waist circumference; TG, triglycerides; BP, blood pressure; FBG, fasting blood glucose; HDL-C, high-density lipoprotein cholesterol. Multiple logistic regression analyses were performed to estimate the prevalence of MetS and its components after adjusting for sex, age, education level, household income, marital status, occupation, region, drinking status, smoking status, and regular physical activity (* p < 0.05, ** p < 0.01). ¹ MetS was defined as the presence of at least three of the following conditions: (1) excessive WC, (2) elevated TG, (3) elevated BP, (4) elevated FBG, and (5) low HDL-C.

Figure 4

Prevalence of each metabolic syndrome component combination among Korean adults according to household type, KNHANES 2014–2018. KNHANES, Korea National Health and Nutrition Examination Survey; WC, waist circumference; TG, triglycerides; BP, blood pressure; FBG, fasting blood glucose; HDL-C, high-density lipoprotein cholesterol. ¹ Each component of MetS was defined as follows: (1) excessive WC (WC ≥ 90 cm in men and ≥85 cm in women); (2) elevated TG (fasting TG ≥ 150 mg/dL or receiving treatment for hypertriglyceridemia); (3) elevated BP (systolic BP ≥ 130 mmHg or diastolic BP ≥ 85 mmHg or receiving treatment for or previously diagnosed with hypertension); (4) elevated FBG (FBG ≥ 100 mg/dL or receiving treatment for or previously diagnosed with type 2 diabetes mellitus); and (5) low HDL-C (fasting HDL-C < 40 mg/dL in men and < 50 mg/dL in women).