J Nutr Health.  2024 Aug;57(4):435-450. 10.4163/jnh.2024.57.4.435.

Development of evaluation components and criteria for the Korean Healthy Diet and assessment of the adherence status among Korean adults

Affiliations
  • 1Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Republic of Korea
  • 2Institute of Health and Environment, Seoul National University, Seoul 08826, Republic of Korea

Abstract

Purpose
This study developed the evaluation components and criteria for the Korean Healthy Diet (KHD) and assessed the current compliance of Koreans.
Methods
The study reviewed domestic and international dietary guidelines and literature and conducted an online survey of 514 Korean adults to understand their nutritional perceptions, specifically the perceived importance of health and incorporation into usual diet. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) were used to investigate food and nutrient intake patterns and examine the relationship between intake and metabolic syndrome (MetS). Based on these data, the components and criteria for a KHD were established by sex and age, and adherence was assessed.
Results
The KHD evaluation included 13 dietary components: carbohydrates, sugar, fiber, protein, total fat, saturated fat, sodium, calcium, mixed grains, meat·fish·eggs·beans, vegetables, fruits, and dairy products. Applying the selected components and criteria to data from the KNHANES (2019-2021), the average KHD adherence score for Korean adults was 5.465 ± 0.023 out of a maximum score of 13. The score significantly increased with age (4.766 ± 0.044 for 19-29 years; 5.276±0.032 for 30-49 years; 6.109 ± 0.033 for 50-64 years), and women (5.642 ± 0.028) had higher scores than men (5.284 ± 0.030) (p < 0.05). Furthermore, the total score significantly differed between those with MetS (5.518 ± 0.045) and those without (5.568 ± 0.026) after adjusted for sex and age (p < 0.05). When scoring the dietary components, sugar (0.852 ± 0.004) and proteins (0.881 ± 0.004) scored relatively higher in the association with MetS, whereas calcium (0.148 ± 0.004) and mixed grains (0.225 ± 0.005) scored relatively lower.
Conclusions
The KHD evaluation criteria could be used as a tool for screening and monitoring the overall diet quality of Koreans.

Keyword

healthy diet; evaluation methodology; Korea
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