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. 2024 Feb;63(1):279-289.
doi: 10.1007/s00394-023-03258-x. Epub 2023 Nov 24.

Eating patterns in Korean adults, 1998-2018: increased energy contribution of ultra-processed foods in main meals and snacks

Sukyoung Jung  1 , Jee Young Kim #  2 , Sohyun Park #  3   4
Affiliations

Eating patterns in Korean adults, 1998-2018: increased energy contribution of ultra-processed foods in main meals and snacks

Sukyoung Jung et al. Eur J Nutr. 2024 Feb.

Abstract

Purpose: Unfavorable changes in eating patterns over time may contribute to upward trends in chronic diseases, such as obesity. We examined 20-year trends in the percentage of energy from main meals and snacks and the food sources of each eating occasion among Korean adults.

Methods: This study used nationally representative data from the 1st, 4th, and 7th Korea National Health and Nutrition Examination Surveys (1998, 2007-2009, and 2016-2018) among adults aged 20-69 years (n = 29,389). Each eating occasion (breakfast, lunch, dinner, and snacks) was defined by respondents during a 24-h dietary recall interview. To identify the food sources of each eating occasion, we used the NOVA system. The percentage of energy at each eating occasion and that from each NOVA group across survey cycles were estimated, and tests for linear trends were conducted using orthogonal polynomial contrasts in linear regression models. All analyses accounted for the complex survey design.

Results: After adjusting for age and sex, the percentage of energy from breakfast decreased from 25.0% in 1998 to 16.7% in 2018 (difference, - 8.2%; standard error [SE], 0.3), whereas that from dinner and snacks increased from 31.1 to 33.8% (difference, + 2.7%; SE, 0.4) and from 14.0 to 19.0% (difference, + 5.0%; SE, 0.5), respectively (all P < 0.001). At all eating occasions, the percentage of energy from minimally processed foods declined (difference, - 18.6% for breakfast; - 13.1% for lunch; - 21.1% for dinner; - 20.7% for snacks), while that from ultra-processed foods increased (difference, + 17.0% for breakfast; + 11.3% for lunch; + 18.0% for dinner; + 30.7% for snacks). When stratified by age, the given trends were shown to a greater extent in younger adults (< 50 years old) than in older adults (≥ 50 years old).

Conclusions: The eating patterns of Korean adults changed from 1998 to 2018, with the greatest decrease in energy intake from breakfast and the greatest increase from snacking. At all eating occasions, the contribution of minimally processed foods declined, while that of ultra-processed foods increased, especially among younger adults.

Keywords: Eating patterns; Energy intake; Korea National Health and Nutrition Examination Survey; Snacking; Trend.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Trends in the percentage of energy intake from NOVA groups for main meals and snacks by KNHANES cycle, Korean adults aged 20–69 years. MPF unprocessed or minimally processed foods, PCI processed culinary ingredients, PF processed foods, UPF ultra-processed foods, KNHANES National Health and Nutrition Examination Survey, SE standard error. Note: The estimates were obtained after adjusting for age and sex using the linear regression model. P values for trends were estimated with the survey cycles modeled as an orthogonal polynomial
Fig. 2
Fig. 2
Trends in the percentage of energy intake from main meals and snacks by KNHANES cycle, Korean adults aged 20–69 years, stratified by age. KNHANES National Health and Nutrition Examination Survey, SE standard error. Note: The estimated mean and SE were obtained after adjusting for sex using the linear regression model. P values for trends were estimated with the survey cycles modeled as an orthogonal polynomial. P values for interaction were determined by including the interaction term of survey cycle and age in the linear regression model
Fig. 3
Fig. 3
Trends in the percentage of energy intake from minimally processed and ultra-processed foods for main meals and snacks by KNHANES cycle, Korean adults aged 20–69 years, stratified by age. MPF unprocessed or minimally processed foods, UPF ultra-processed foods, KNHANES National Health and Nutrition Examination Survey, SE standard error. Note: The estimates were obtained after adjusting for sex using the linear regression model. P values for trends were estimated with the survey cycles modeled as an orthogonal polynomial. P values for interaction were determined by including the interaction term of survey cycle and age in the linear regression model
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