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Association Between Basic Immunization Status and Stunting in Toddlers Aged 12-59 Months in Indonesia
Eka Desi Purwanti, Siti Masitoh, Sudarto Ronoatmodjo
J Prev Med Public Health. 2025;58(3):298-306.   Published online January 30, 2025
DOI: https://doi.org/10.3961/jpmph.24.230
  • 1,518 View
  • 286 Download
AbstractAbstract AbstractSummary PDF
Objectives
Immunization has been identified as a specific nutrition-related intervention to address the direct causes of stunting. This study examines the association between basic immunization status and stunting among toddlers in Indonesia.
Methods
We conducted a cross-sectional analysis using data from the 2021 Study of Indonesia’s Nutritional Status. A total of 70 267 toddlers, aged 12 months to 59 months, were examined. Cox regression was employed to calculate adjusted prevalence ratios (aPRs) with their 95% confidence intervals (CIs).
Results
The prevalence of stunting among children aged 12 months to 59 months in Indonesia was 23.1%, while 74.9% of children under 5 years old had complete basic immunization status. Multivariable analysis revealed a statistically significant association between basic immunization status and the incidence of stunting. Relative to toddlers with complete basic immunization, those with incomplete (partial) immunization were at a 1.18 times higher risk of stunting (aPR, 1.18; 95% CI, 1.15 to 1.22). Furthermore, toddlers who had not been immunized at all faced an even greater stunting risk (aPR, 1.27; 95% CI, 1.17 to 1.37). This association persisted after adjusting for variables such as maternal education, economic status, and the child’s birth weight.
Conclusions
Basic immunization status influences the incidence of stunting in toddlers aged 12 months to 59 months. Thus, parents must ensure that their children’s immunizations are completed according to the recommended schedule. Additionally, it is crucial to increase parental awareness regarding health service utilization, disease prevention, and the nutritional needs of toddlers.
Summary
Key Message
Stunting remains a major public health concern in Indonesia. Immunization is recognized as a specific nutrition-related intervention to address its direct causes. Using data from 70,267 toddlers aged 12–59 months, this study found that children with partial or no basic immunization had significantly higher risks of stunting (aPR 1.18 and 1.27, respectively) compared to fully immunized peers. Given the high stunting prevalence (23.1%) and suboptimal immunization coverage (74.9%), the findings underscore the need to strengthen immunization programs and enhance parental awareness of health service utilization, disease prevention, and the nutritional needs of young children.
Effects of the Local Environment and Nutritional Status on the Incidence of Acute Respiratory Infections Among Children Under 5 Years Old in Indonesia
Tri Bayu Purnama, Keita Wagatsuma, Masdalina Pane, Reiko Saito
J Prev Med Public Health. 2024;57(5):461-470.   Published online August 2, 2024
DOI: https://doi.org/10.3961/jpmph.24.246
  • 3,124 View
  • 332 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
This study aimed to map the incidence of acute respiratory infections (ARIs) among under-5 children in Indonesia, address the triple burden of malnutrition, and analyze the impact of malnutrition on ARIs, taking into account the environmental and wealth disparities in Indonesia.
Methods
This study utilized an ecological design, analyzing aggregate data from the Indonesia Nutrition Survey, 2022. It encompassed 33 provinces and 486 districts/cities, involving a total of 334 878 children under 5 years of age. Partial least squares structural equation modeling was employed to investigate the relationships among wealth, environment, malnutrition (stunting, wasting, and underweight), and ARIs.
Results
The proportion of ARI cases in Indonesia was generally concentrated in central Sumatra, the western and eastern parts of Java, and eastern Papua. In contrast, the northern part of Sumatra, central Kalimantan, central Sulawesi, and central Papua had a higher proportion of malnutrition cases compared to other regions. Negative associations were found between malnutrition and ARIs (path coefficient =-0.072; p<0.01) and between wealth and environment (path coefficient =-0.633; p<0.001), malnutrition (path coefficient=-0.399; p<0.001), and ARIs (path coefficient=-0.918; p<0.001).
Conclusions
An increasing wealth index is expected to contribute to reducing ARIs, malnutrition and environmental burdens in the future. This study emphasizes the necessity for focused strategies that address both immediate health challenges and the underlying socioeconomic determinants to improve child health outcomes in the Indonesian context.
Summary
Key Message
In Indonesia, Acute Respiratory Infections (ARI) cases were predominantly concentrated in central Sumatra, western and eastern Java, and eastern Papua, while malnutrition cases were more prevalent in northern Sumatra, central Kalimantan, central Sulawesi, and central Papua. A negative association was observed between malnutrition and ARIs. Additionally, wealth had significant negative associations with the environment, malnutrition, and ARIs, suggesting socio-environmental disparities contribute to health outcomes in these regions.

Citations

Citations to this article as recorded by  
  • Prevalence and risk factors of acute respiratory infection and diarrhea among children under 5 years old in low-middle wealth household, Indonesia
    Tri Bayu Purnama, Keita Wagatsuma, Reiko Saito
    Infectious Diseases of Poverty.2025;[Epub]     CrossRef
  • Geographical variation in community-acquired pneumonia prevalence during the COVID-19 pandemic in northern Sumatra, Indonesia
    Tri Bayu Purnama, Keita Wagatsuma, Masdalina Pane, Reiko Saito
    Discover Public Health.2025;[Epub]     CrossRef
The Relationship Between Thiamine Intake and Long Sleep Duration: Results From the Korea National Health and Nutrition Examination Survey
Dongkyu Lee, Kwanghyun Kim, Youngrong Lee, Kyungwon Oh, Sun Jae Jung
J Prev Med Public Health. 2022;55(6):520-528.   Published online October 14, 2022
DOI: https://doi.org/10.3961/jpmph.22.313
  • 6,466 View
  • 165 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Thiamine is thought to modify sleeping patterns, while alcohol use diminishes internal thiamine levels. We investigated the association between thiamine intake and sleep duration and explored possible heterogeneity in the effect according to alcohol use.
Methods
In total, 15 384 participants aged 19-64 were obtained from the Korea National Health and Nutrition Examination Survey 2012-2016. Nutrient intake, including thiamine, was measured using a food frequency questionnaire. Sleep duration was measured by a self-reported questionnaire. The highest thiamine intake quartile was set as the reference group. Participants were divided into 3 groups, with 7-8 hours of daily sleep as a reference group and those who slept more or less than that as “oversleeping” and “insufficient sleeping,” respectively. Multivariate logistic regression was used, adjusting for socioeconomic, medical, and nutritional factors. Additionally, participants were stratified according to high-risk alcohol use defined by the World Health Organization standards on alcohol use.
Results
Low thiamine intake was associated with oversleeping (Q3: odds ratio [OR], 1.06; 95% confidence interval [CI], 0.86 to 1.32; Q2: OR, 1.24; 95% CI, 0.99 to 1.55; Q1: OR, 1.49; 95% CI, 1.16 to 1.91) and showed a significant trend for higher ORs at lower intake levels (p-trend<0.001). The effect was stronger in the high-risk alcohol use group (Q1: OR, 1.78; 95% CI, 1.28 to 2.49).
Conclusions
Low thiamine intake was associated with oversleeping, and alcohol use intensified that association. These results were found in a context where overt clinical symptoms due to thiamine deficiency are considered rare. More awareness of the potential relationship of thiamine intake with oversleeping and its related risks should be considered.
Summary
Korean summary
국민건강영양조사 자료에서 낮은 비타민 B1 섭취가 과도한 수면시간과 연관성이 있으며, 고위험 알코올 섭취군에서 더 큰 상관성을 보였다. 현저한 임상 증상이 나타나지 않는 선에서의 섭취부족도 잠재적으로 과도한 수면시간 및 이와 관련된 건강에 대한 부정적 효과들과 관련이 있을 수 있어 주의가 필요하다.

Citations

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  • Host–Gut Microbiota Interactions: Exploring the Potential Role of Vitamin B1 and B2 in the Microbiota–Gut–Brain Axis and Anxiety, Stress, and Sleep Quality
    Yingxuan Tao, Murong Wu, Boyao Su, Heng Lin, Qianzi Li, Yuhong He, Tian Zhong, Ying Xiao, Xi Yu
    Nutrients.2025; 17(11): 1894.     CrossRef
  • The Therapeutic Potential of Vitamins B1, B3 and B6 in Charcot–Marie–Tooth Disease with the Compromised Status of Vitamin-Dependent Processes
    Victoria Bunik
    Biology.2023; 12(7): 897.     CrossRef
  • Enhancing Sleep Quality: Assessing the Efficacy of a Fixed Combination of Linden, Hawthorn, Vitamin B1, and Melatonin
    Matteo De Simone, Rosario De Feo, Anis Choucha, Elena Ciaglia, Francis Fezeu
    Medical Sciences.2023; 12(1): 2.     CrossRef
Associations of Handgrip Strength and Handgrip Strength Asymmetry With Depression in the Elderly in Korea: A Cross-sectional Study
Kyungduk Hurh, Yoonsik Park, Gyu Ri Kim, Sung-In Jang, Eun-Cheol Park
J Prev Med Public Health. 2021;54(1):63-72.   Published online December 30, 2020
DOI: https://doi.org/10.3961/jpmph.20.315
  • 6,302 View
  • 177 Download
  • 23 Web of Science
  • 23 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Recent studies have suggested that assessing handgrip strength (HGS) asymmetry together with HGS may be helpful for evaluating problems in geriatric patients. This study aimed to identify whether HGS asymmetry, weakness, or both were associated with depression in Korean older adults.
Methods
This study included 4274 subjects from the sixth and seventh Korea National Health and Nutrition Examination Survey. Depression was measured using the Patient Health Questionnaire-9. The maximum HGS of the dominant hand was used as a representative value. HGS symmetry was categorized by the ratio of the HGS of the dominant hand to that of non-dominant hand. The odds ratio (OR) for depression was calculated according to the HGS and its symmetry.
Results
In total, 240 (12.5%) men and 534 (22.7%) women had depression. HGS or HGS asymmetry showed no statistically significant associations with depression in elderly men. Elevated odds of depression were observed in elderly women with low HGS (OR, 1.93; 95% confidence interval [CI], 1.33 to 2.81) or prominent HGS asymmetry (OR, 1.46; 95% CI, 1.02 to 2.08). There was a positive additive interaction between asymmetric HGS and weakness, as women with low and prominently asymmetric HGS showed higher odds of depression (OR, 3.77; 95% CI, 2.16 to 6.59) than women with high and symmetric HGS.
Conclusions
Depression in elderly Korean women was associated with both low and asymmetric HGS. Our findings support the potential value of HGS asymmetry as an indicator of HGS.
Summary
Korean summary
본 연구에서는 국민건강영양조사 자료를 이용하여, 국내 60세 이상 노인 인구에서 악력 저하 및 양손 악력의 비대칭과 우울증 유병과의 상관관계를 분석하였다. 분석 결과 60세 이상 여성에서 악력 저하 및 양손 악력의 비대칭이 우울증 유병과 관련이 있었으며, 악력 저하와 비대칭이 동반된 경우에는 우울증 유병에 대하여 상가작용이 존재하였다. 이는 향후 노인의 악력 측정 시, 양손 악력의 비대칭에 대하여도 주목할 필요가 있음을 시사한다.

Citations

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  • Association of handgrip strength asymmetry and weakness with intrinsic capacity impairment among older adults in China
    Decheng Li, Yunhe Wang, Shuai Guo, Ziyang Ren, Binbin Su, Lichuan Zhang, Zuliyaer Talifu, Xiaoying Zheng
    Experimental Gerontology.2025; 199: 112656.     CrossRef
  • Longitudinal association between handgrip strength and depressive symptoms in middle-aged and older Chinese adults: mediating role of functional limitation
    Yanchang Liu, Junling Cui, Xin Luo, Zhuzhu Wang, Ziyi Shen, Yan Fang, Chengcheng Li, Jingfang Hong
    Frontiers in Public Health.2025;[Epub]     CrossRef
  • Association of handgrip strength weakness and asymmetry with cognitive impairment and depressive symptoms in older Chinese adults
    Nazhakaiti Abudukelimu, Peng Zhang, Jing Du, Min Li, Yupei Shen, Yanyan Mao, Difei Wang, Qianxi Zhu
    Scientific Reports.2025;[Epub]     CrossRef
  • Association between handgrip strength, handgrip strength asymmetry, and anxiety in Korean older adults: The Korean National Health and Nutrition Examination Survey 2022
    Sang-Youn Choi, Su-Min Park, Eun-Cheol Park, Marina De Rui
    PLOS ONE.2025; 20(4): e0315256.     CrossRef
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    Ya Ting Wu, Miao Yen Chen, Yung Cheng Huang, Chieh Yu Liu
    International Journal of Yoga.2025; 18(1): 27.     CrossRef
  • Association between handgrip strength asymmetry and all‐cause mortality in United States–based older adults: A cross‐sectional study
    Xiufang Kong, Wei Wang
    Journal of Parenteral and Enteral Nutrition.2025;[Epub]     CrossRef
  • Risk factors associated with weak and asymmetric handgrip strength in older Chinese adults
    Minghui Weng, Jianlin Pu, Binyou Wang, Yilin Wang
    American Journal of Human Biology.2024;[Epub]     CrossRef
  • Association of handgrip strength asymmetry and weakness with depression among middle-aged and older population in China: A cohort study
    Quhong Song, Xiaoyu Shu, Yanli Zhao, Ning Ge, Jirong Yue
    Journal of Affective Disorders.2024; 363: 401.     CrossRef
  • Association of handgrip strength with health care utilisation among older adults: A longitudinal study in China
    Yueyue You, Xiaobing Wu, Ziyang Zhang, Fengzhu Xie, Yali Lin, Deliang Lv, Zhiguang Zhao
    Journal of Global Health.2024;[Epub]     CrossRef
  • A hand-in-hand phenomenon in older adults: Increased risk of frailty in geriatric outpatients associated with handgrip strength asymmetry and weakness
    Merve Güner, Serdar Ceylan, Arzu Okyar Baş, Meltem Koca, Yelda Öztürk, Burcu Balam Doğu, Meltem Gülhan Hali̇l, Mustafa Cankurtaran, Cafer Balci
    Clinical Nutrition.2024; 43(10): 2381.     CrossRef
  • Evaluation of Handgrip Strength Asymmetry to Assess Sarcopenia in Older Patients with Chronic Low Back Pain: A Retrospective Cross-Sectional Study
    H.J. Kim, Shin Hyung Kim
    The Journal of Frailty & Aging.2024; 13(4): 421.     CrossRef
  • Handgrip strength asymmetry cut points to identify slow gait speed in six low- and middle-income countries: A cross-sectional analysis with 12,669 older adults
    Pedro Pugliesi Abdalla, Lucimere Bohn, Emerson Sebastião, André Pereira dos Santos, Marcio Fernando Tasinafo Junior, Leonardo Santos Lopes da Silva, Thiago Cândido Alves, Euripedes Barsanulfo Gonçalves Gomide, Ana Claudia Rossini Venturini, Jorge Mota, Da
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    Yuyi Zhang, Weiliang Tan, Xiaolan Xi, Hui Yang, Ke Zhang, Shengnan Li, Xuefen Chen, Hui Zuo
    Frontiers in Nutrition.2023;[Epub]     CrossRef
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    Xueyi Miao, Lingyu Ding, Jinling Lu, Hanfei Zhu, Kang Zhao, Xinyi Xu, Shuqin Zhu, Li Chen, Jieman Hu, Qin Xu
    Journal of Geriatric Oncology.2023; 14(7): 101583.     CrossRef
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    Duanfang Cai, Hongli Zhang, Yilin Wang
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    Yuying Zhang, Weiqing Chen, Bing Cao, Li Lin, Jinghua Li, Vivian Yawei Guo
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    Yilin Wang, Yalian Huang, Xiaoyan Chen
    Postgraduate Medical Journal.2023; 99(1178): 1246.     CrossRef
  • Short sleeping duration is associated with a higher risk of asymmetric handgrip strength among older Chinese males: a cross-sectional study evidence from the China health and retirement longitudinal study
    Yilin Wang, Mei Li, Xiaoyan Chen
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    Jihyun Baek, Yunmi Kim, Hyun-Young Kim
    Asia Pacific Journal of Public Health.2022; 34(6-7): 649.     CrossRef
  • Association between changes in handgrip strength and depression in Korean adults: a longitudinal panel study
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  • Muscle Strength Moderates the Relationship between Nutritional Health Risk and Depression in Korean Older Adults
    Jeonghyeon Kim, Seamon Kang, Haeryun Hong, Hyunsik Kang, Ju-Hyoung Kim, Sang-Koo Woo
    Nutrients.2022; 14(3): 665.     CrossRef
  • Depressive symptoms and physical function among the elderly in nursing homes during the COVID-19 pandemic in China: A cross-sectional study
    Lunan Gao, Jinhong Yang, Jiang Liu, Tingting Xin, Yuxiu Liu
    Medicine.2022; 101(47): e31929.     CrossRef
  • Association between handgrip strength asymmetry and falls in elderly Koreans: A nationwide population-based cross-sectional study
    Young Joo Go, Duk Chul Lee, Hye Jun Lee
    Archives of Gerontology and Geriatrics.2021; 96: 104470.     CrossRef
Housing Conditions Contribute to Underweight in Children: An Example From Rural Villages in Southeast Sulawesi, Indonesia
Tasnim Tasnim, Gouranga Dasvarma, Lillian Mwanri
J Prev Med Public Health. 2017;50(5):328-335.   Published online September 7, 2017
DOI: https://doi.org/10.3961/jpmph.17.046
  • 7,987 View
  • 205 Download
  • 4 Crossref
AbstractAbstract PDF
Objectives
The prevalence of underweight in children under 5 years of age is anomalously high in Konawe District, Southeast Sulawesi Province, Indonesia. This state of affairs may be related to poor housing conditions, such as limited access to clean water, the absence of a sanitary latrine, and the use of poor housing materials. Therefore, this study aimed to examine the effect of housing conditions on underweight in under-5 children in Konawe District. Methods: This study was conducted in 2013 in 5 health centres in Konawe District, Southeast Sulawesi Province, and used a case-control study design. The study recruited 400 under-5 children, including 100 of whom were cases and 300 of whom were age-matched controls (1:3). Cases were underweight children, while the controls were children with a normal nutritional status. The independent variables were the availability and types of water and latrine facilities and housing materials (roof, wall, and floor). The statistical analysis used Cox regression. Results: A lack of water availability (odds ratio [OR], 5.0; 95% confidence interval [CI], 2.7 to 9.5; p<0.001), a lack of latrine availability in the home (OR, 2.5; 95% CI, 1.5 to 4.0; p<0.001), and poor-quality roofing materials (OR, 1.7; 95% CI, 1.1 to 2.7; p<0.02) significantly contributed to underweight in children. In contrast, the walls and the floors did not contribute to under-5 year children being underweight (p=0.09 and p=0.71, respectively). Conclusions: Sanitation facilities and roofing were identified as important factors to address in order to improve children’s nutritional status. Children’s health status was directly impacted by food intake via their nutritional status.
Summary

Citations

Citations to this article as recorded by  
  • Stunting incident prevention: a systematic literature review
    Fitri R. Fadmi, Kuntoro Kuntoro, Bambang Widjanarko Otok, Soenarnatalina Melaniani
    Journal of Public Health in Africa.2023; 14(2): 6.     CrossRef
  • Achieving Zero Stunting: A Sustainable Development Goal Interlinkage Approach at District Level
    Ahmad Komarulzaman, Robi Andoyo, Zuzy Anna, Aisyah Amatul Ghina, Putri Riswani Halim, Herlina Napitupulu, Monica Ruth Karunia, Annisa Andriani
    Sustainability.2023; 15(11): 8890.     CrossRef
  • Korelasi Karakteristik Fisik Rumah dan Tingkat Kerentanan Sosio-Ekonomi di Tepian Sungai Kapuas Pontianak
    Ely Nurhidayati, Trida Ridho Fariz
    Jurnal Wilayah dan Lingkungan.2021; 9(1): 50.     CrossRef
  • Demographic and Social-Economic Determinants of Malnutrition among Children (0-23 Months Old) in Kenya
    Teresia Mbogori, James Muriuki
    International Journal of Child Health and Nutrition.2021; 10(3): 80.     CrossRef
Socioeconomic Inequality in Malnutrition in Under-5 Children in Iran: Evidence From the Multiple Indicator Demographic and Health Survey, 2010
Abdollah Almasian Kia, Aziz Rezapour, Ardeshir Khosravi, Vajiheh Afzali Abarghouei
J Prev Med Public Health. 2017;50(3):201-209.   Published online May 10, 2017
DOI: https://doi.org/10.3961/jpmph.17.028
  • 10,074 View
  • 289 Download
  • 17 Crossref
AbstractAbstract PDF
Objectives
The aim of this study was to assess the socioeconomic inequality in malnutrition in under-5 children in Iran in order to help policymakers reduce such inequality.
Methods
Data on 8443 under-5 children were extracted from the Iran Multiple Indicator Demographic and Health Survey. The wealth index was used as proxy for socioeconomic status. Socioeconomic inequality in stunting, underweight, and wasting was calculated using the concentration index. The concentration index was calculated for the whole sample, as well as for subcategories defined in terms of categories such as area of residence (urban and rural) and the sex of children.
Results
Stunting was observed to be more prevalent than underweight or wasting. The results of the concentration index at the national level, as well as in rural and urban areas and in terms of children’s sex, showed that inequality in stunting and underweight was statistically significant and that children in the lower quintiles were more malnourished. The wasting index was not sensitive to socioeconomic status, and its concentration index value was not statistically significant.
Conclusions
This study showed that it can be misleading to assess the mean levels of malnutrition at the national level without knowledge of the distribution of malnutrition among socioeconomic groups. Significant socioeconomic inequalities in stunting and underweight were observed at the national level and in both urban and rural areas. Regarding the influence of nutrition on the health and economic well-being of preschool-aged children, it is necessary for the government to focus on taking targeted measures to reduce malnutrition and to focus on poorer groups within society who bear a greater burden of malnutrition.
Summary

Citations

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    Betregiorgis Zegeye, Gebretsadik Shibre, Dina Idriss-Wheeler, Sanni Yaya
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A Trend Analysis of the Prevalence, Awareness, Treatment, and Control of Hypertension by Age Group
Jong Youn Moon, Kwan Jun Park, Young Hwangbo, Mee Ri Lee, Byoung In Yoo, Jong Hye Won, Yoon Hyung Park
J Prev Med Public Health. 2013;46(6):353-359.   Published online November 28, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.6.353
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AbstractAbstract PDF
Objectives

We examined the trends in prevalence, awareness, treatment, and control of hypertension in Korea as a basis for improving hypertension control programs.

Methods

12 598 participants of the Korean National Health and Nutrition Examination Survey were included in this study. Weighted linear regression to test time trends from 2007 to 2011 was performed.

Results

The prevalence of hypertension was 20.7% in 2007, 29.4% in 2009, and 26.2% in 2011. Awareness of hypertension was 64.8% in 2007 and 61.1% in 2011. Awareness in those aged 65 and over was greater than in younger groups (age 19 to 44 and 45 to 64; p<0.001). The treatment rates were 58.4% in 2007 and 56.8% in 2011. The treatment rate was greater for those 65 and over than for younger age groups (p<0.001). The percentage of controlled hypertension was 37.6% in 2011. The percentage of controlled hypertension in those 65 and over was higher than in younger age groups (p<0.001). The treatment-control rates were 65.9% in 2007 and 67.7% in 2011. The prevalence of hypertension was higher in the males (p<0.001), while the awareness (p<0.001), treatment (p<0.001), and control (p<0.001) rates were higher in the females.

Conclusions

The prevalence of hypertension was increasing and the hypertension awareness, treatment, and control rates were low in younger age groups and males.

Summary

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Special Article
Overview of the Burden of Diseases in North Korea
Yo Han Lee, Seok-Jun Yoon, Young Ae Kim, Ji Won Yeom, In-Hwan Oh
J Prev Med Public Health. 2013;46(3):111-117.   Published online May 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.3.111
  • 24,549 View
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AbstractAbstract PDF

This article evaluates the overall current disease burden of North Korea through the recent databases of international organizations. It is notable that North Korea as a nation is exhibiting a relatively low burden from deaths and that there is greater burden from deaths caused by non-communicable diseases than from those caused by communicable diseases and malnutrition. However, the absolute magnitude of problems from communicable diseases like TB and from child malnutrition, which will increase the disease burden in the future, remains great. North Korea, which needs to handle both communicable and nutritional conditions, and non-communicable diseases, whose burden is ever more increasing in the nation, can now be understood as a country with the 'double-burden' of disease.

Summary

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Original Articles
Inappropriate Survey Design Analysis of the Korean National Health and Nutrition Examination Survey May Produce Biased Results
Yangho Kim, Sunmin Park, Nam-Soo Kim, Byung-Kook Lee
J Prev Med Public Health. 2013;46(2):96-104.   Published online March 28, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.2.96
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AbstractAbstract PDF
Objectives

The inherent nature of the Korean National Health and Nutrition Examination Survey (KNHANES) design requires special analysis by incorporating sample weights, stratification, and clustering not used in ordinary statistical procedures.

Methods

This study investigated the proportion of research papers that have used an appropriate statistical methodology out of the research papers analyzing the KNHANES cited in the PubMed online system from 2007 to 2012. We also compared differences in mean and regression estimates between the ordinary statistical data analyses without sampling weight and design-based data analyses using the KNHANES 2008 to 2010.

Results

Of the 247 research articles cited in PubMed, only 19.8% of all articles used survey design analysis, compared with 80.2% of articles that used ordinary statistical analysis, treating KNHANES data as if it were collected using a simple random sampling method. Means and standard errors differed between the ordinary statistical data analyses and design-based analyses, and the standard errors in the design-based analyses tended to be larger than those in the ordinary statistical data analyses.

Conclusions

Ignoring complex survey design can result in biased estimates and overstated significance levels. Sample weights, stratification, and clustering of the design must be incorporated into analyses to ensure the development of appropriate estimates and standard errors of these estimates.

Summary

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Nutritional Status and the Characteristics Related to Malnutrition in Children Under Five Years of Age in Nghean, Vietnam.
Nguyen Ngoc Hien, Sin Kam
J Prev Med Public Health. 2008;41(4):232-240.
DOI: https://doi.org/10.3961/jpmph.2008.41.4.232
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AbstractAbstract PDF
OBJECTIVES
This study was conducted to assess the nutritional status and characteristics related to malnutrition in children less than five years of age in Nghean, Vietnam. METHODS: In this study, which was conducted in November 2007, 650 child-mother pairs were selected using a two-stage cluster sampling methodology. A structured questionnaire was then administered to the mothers in their home settings. Anthropometric measurement was then used to determine if children were underweight (weight-for-age), wasting (weight-for-height) and stunting (height-for-age) based on reference data from the National Center for Health Statistics (NCHS)/World Health Organization (WHO). Logistic regression analysis was then used to describe the hierarchical relationships between potential risk factors and malnutrition. RESULTS: The mean Z-scores for weight-for-age, heightfor-age and weight-for-height were -1.46 (95% CI=-1.57, -1.35), -1.44 (95% CI=-1.56, -1.32) and -0.71 (95% CI=-0.82, -0.60), respectively. Of the children included in this study, 193 (31.8%) were underweight, 269 (44.3%) were stunting and 72 (11.9%) were wasting. Region of residence, the mother's level of education and occupation, household size, number of children in the family, weight at birth and duration of exclusive breastfeeding were found to be significantly related to malnutrition. CONCLUSIONS: The findings of this study indicate that malnutrition is still an important problem among children less than five years of age in Nghean, Vietnam. In addition, maternal, socio-economic and environment factors were found to be significant factors for malnutrition among children under five.
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English Abstract
The Association between Sleep and Obesity in Korean Adults.
Young Jun Park, Won Chul Lee, Hyeon Woo Yim, Young Moon Park
J Prev Med Public Health. 2007;40(6):454-460.
DOI: https://doi.org/10.3961/jpmph.2007.40.6.454
  • 7,651 View
  • 99 Download
  • 12 Crossref
AbstractAbstract PDF
OBJECTIVES
Obesity is currently an epidemic in Korea, and sleep duration is thought to be one of the risk factors for obesity. The objective of this study was to test the hypothesis that short sleep duration is associated with obesity in Korean adults. METHODS: The data from the 2001 Korean National Health and Nutrition Survey were used, and 6,174 subjects aged 18~80 years were included in the analysis. Sleep duration was measured using information obtained from self-reported questionnaires. Obesity, the main outcome variable, was measured according to body mass index. Multiple regression modeling was used to adjust for potential confounding variables. RESULTS: The study results revealed a negative association between sleep duration and body mass index among Korean adults. These associations persisted after controlling for the potential confounding variables. CONCLUSIONS: These findings support the hypothesis that sleep duration is associated with obesity in Korean adults. In addition, these observations support earlier experimental sleep studies and provide a basis for future studies on weight control intervention by increasing the amount of sleep.
Summary

Citations

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Original Articles
A Study on Food Intake and Associated Factors of the Urban Poor Elderly.
Bong Soo Cho, Don Kyoun Kim, Su Ill Lee, Byung Mann Cho, Yeung Ook Kim, Kwang Wook Koh
Korean J Prev Med. 1995;28(1):59-72.
  • 2,277 View
  • 20 Download
AbstractAbstract PDF
This study was carried out to analyse the food intake and associated factors of the urban poor elderly by comparing poor district, Unbong rental apartment in Bonsong 2 dong with other areas in Pusan. 135 elderlies(men 36, women 99) in Unbong rental apartment 136 elderlies(men 45, women 91 ) in the other areas were investigated during the period of March to August in l994. The assumption that the study area represented poor district was satisfied because the age and sex distribution was not significantly different, and the income of the study area was significantly lower than that of the control area. The variables of hospitalized in previous 12 month, gastrointestinal problem, alcohol drinking, cigarette smoking did not differ significantly. But the variables of chronic disease, take medicine, perceive, vitamin supplement differed significantly between two groups. Therefore some factors associated with health state in the study area are worse than those of the control areas. At most of all variables, nutrients intake of the study area did not reach the recommended dietary allowances(RDA) for Koreans, and that nutrient intakes of the study area were significantly lower than those of the control area. The hypothesis of this study that nutrient status depends on economical status was proved. As for the score of nutritional knowledge, the study area was significantly lower than the control area. But as for the score of nutritional behavior, two areas were not significantly different. The latter is counter result of our hypothesis, owing to the effect of the confounding factors including education etc. As for the correlation of variables, not only economic status and educational level, but the score of nutritional knowledge effects strongly on nutrient status in the study area, the poor district. Therefore, adequate nutritional education to the elderly in the poor district should be considered.
Summary
Correlation between Dietary Sodium and Electrocardiographic Left Ventricular Hypertrophy Among Hypertensives.
Daniel W Jones
Korean J Prev Med. 1994;27(2):226-229.
  • 1,996 View
  • 20 Download
AbstractAbstract PDF
In hypertensives, electrocardiographic left ventricular hypertrophy (LVH) is an independent risk factor for cardiovascular disease Animal and human studies suggest an association between left ventricular mass and dietary sodium (Na) intake. This study electrocardiographic LVH (S in VI + R in V5 > or = 3.5 mV). Blood pressure (BP), body in 40 otherwise healthy Korean patients with untreated essential hypertension on the standard Korean diet Among these variables, only Na excretion (mmol/day) was significantly different between those with and without LVH[LVH+:357+/-50, LVH-:268+/-25(p=0.04]. Thus, dietary sodium intake may be predictive of electrocardiographic LVH.
Summary
Lifestyle.
Hee Choul Ohrr
Korean J Prev Med. 1993;26(4):469-479.
  • 2,288 View
  • 23 Download
AbstractAbstract PDF
This article reviewed the historic and epidemiologic reasons for the emergence of health promotion with a special focus on lifestyle. Health effects of tobacco, alcohol, physical exercise, and nutrition were briefly presented by reviewing recent researches. Social environments supposed to limit the application of health promotion strategies are also mentioned.
Summary
A Study on the Nutritional Knowledge, Nutritional Attitude, Eating Practice and Food Intake of Womans University Students.
Eun Hee Ha, Sun Hee Kim, Ji Yong Kang
Korean J Prev Med. 1990;23(4):404-415.
  • 2,181 View
  • 39 Download
AbstractAbstract PDF
This study was conducted to analyze the relations among nutritional knowledge, nutritional attitude eating practice and total nutritional diagnosis and also to find the influencing factors of them. The survey was done during the period from April 1990 to June 1990 and the target population were Ewha Woman's University students (freshmen and senior) of whom 1,354 peoples were surveyed. The summarized results are as follows ; 1. For the learning environment, the percentage of completion on nutritional knowledge course was 28.6% and among them the department of foods and nutrition had the highest score(100.0%) and the next was dept. of medicine(53.4%). 2. To find the relation which the nutritional knowledge, nutritional attitude, eating practice and the total nutritional diagnosis influence on one another, the multiple correlation analysis was done. The attitude the practice were highly correlated with total nutritional diagnosis, but the correlation between nutritional knowledge and total nutritional diagnosis was not significant. The correlation between the practice and nutritional knowledge which were positively and significantly correlated with attitude respectively was positive but not significant. 3. The difference which were analyzed by department, grade and completion on knowledge course on the nutritional knowledge, attitude, eating practice were significant (p<0.01) by ANOVA. 4. The significant variables on nutritional diagnosis are the eating practice points, the grade, the knowledge course, the breakfast and the attitude (r2=10.3%) by multiple regression analysis. This study has the limitation that it did not consider the environmental factors of dietary life such as dietary culture, family environment, cultural habit. Therefore important points of these dietary studies are to extend to the practical nutritional education and dietary improvement for the national health not restricted to the local area or local population.
Summary

JPMPH : Journal of Preventive Medicine and Public Health
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