Journal of Nutrition and Health (J Nutr Health) 2015; 48(2): 192 ~ 198 http://dx.doi.org/10.4163/jnh.2015.48.2.192 pissn 2288-3886 / eissn 2288-3959 Research Article 30 세이상한국성인의결혼상태와채소섭취와의연관성분석 : 2007~2010 년국민건강영양조사자료를이용하여 백예지 1 정효지 1,2 신상아 2,3 서울대학교보건대학원, 1 서울대학교보건환경연구소, 2 동경대학교의학대학원 3 The association between vegetable intake and marital status in Korean adults aged 30 years and over: based on the 2007~2010 Korea National Health and Nutrition Examination Survey Baek, Yeji 1 Joung, Hyojee 1,2 Shin, Sangah 2,3 1 Graduate School of Public Health, Seoul National University, Seoul 151-742, Korea 2 Institute of Health and Environment, Seoul National University, Seoul 151-742, Korea 3 AXA Department of Health and Human Security, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan ABSTRACT Purpose: The aim of this study was to examine associations between marital status and vegetable intake. Methods: Data were from participants 30 years and over (n = 18,190) in the 2007~2010 Korea National Health and Nutrition Examination Survey. Marital status was divided into three groups: married, never married, and separated/divorced/widowed. Vegetable intake was estimated from the twenty-four hour dietary recall. Data were analyzed using a chi-square test, analysis of covariance, least squares means, and logistic regression. Results: Married respondents tend to consume more vegetables, including kimchi, than all other marital status groups. Vegetable intake, excluding kimchi, was lowest among 30~64 yearold respondents who had never married. Elderly men (65 years and older) who were never married/separated/divorced/ widowed had significantly lower vegetable intake than elderly men who were married (p = 0.0008). When considering the Korean dietary reference intake (KDRIs), elderly men who were never married/separated/divorced/widowed, compared with elderly men who were married, had a significantly higher odds ratio for consuming fewer vegetables than the KDRIs (OR = 1.64, 95% CI: 1.13~2.37). Conclusion: The findings of this study indicate that marital status might influence vegetable intake and the probability of consuming fewer vegetables than the KDRIs. In particular, being never married/separated/divorced/ widowed might adversely affect vegetable consumption among elderly men, although assessing the causal effect of marital status from this cross-sectional study is difficult. KEY WORDS: vegetables, marital status, KNHANES 서론 결혼은건강상태에영향을줄수있는사회인구학적인요인중의하나로남녀모두에있어서매우중요한삶의기본요소이다. 1 결혼이건강에미치는긍정적인영향을설명하는결혼자원모델 (Marital resource model) 이론에따르면, 결혼한사람은그렇지않은사람에비해경제적, 사회적자원을많이누리고보다건강한생활습관을추구하는경향이있다. 2 이때문에결혼은더나은건강상태를유 지할가능성을높게해주며, 질병발생을사전에예방하는역할도할수있다. 2 또한결혼이건강에미치는영향을설명하는이론으로혼인의선택작용과유배우보호작용이라는이론도있다. 혼인의선택작용이론은정신적, 육체적및사회적으로건강한사람이결혼을하기쉽고, 결혼한상태에서도건강하지못한사람은결혼이해체되기쉽다는이론이다. 3 유배우보호작용이론은결혼이사회통제, 경제적도움, 정서적지지와같은보호적인환경을제공함으로써남녀모두를사망으로부터보호하는작용을한다는 Received: July 3, 2014 / Revised: August 29, 2014 / Accepted: March 9, 2015 To whom correspondence should be addressed. tel: +82-2-880-2781, e-mail: ivory8320@gmail.com 2015 The Korean Nutrition Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Journal of Nutrition and Health (J Nutr Health) 2015; 48(2): 192 ~ 198 / 193 이론이다. 3 이러한이론들을토대로결혼상태와건강상태와의연관성은여러연구에서다뤄진바있으며주로결혼상태와수명, 4-6 결혼상태와우울, 7-10 결혼상태와식생활및영양상태 11-14 의관계를파악하고자했다. 그외에도결혼상태가인지기능, 체중, 식품안정성또는주관적건강인지도등에미치는영향을다룬연구 15-20 들도있다. 결혼상태는인구변동과사회구조의변화를직접적으로반영하며 1 다양하고복잡한형태로건강과연관성이있는것으로보인다. 식생활역시결혼상태에의한영향을받을수있으나, 결혼상태와건강한식생활과의명확한관계는아직밝혀진바없다. 특히대부분의국내연구에서결혼상태는사회경제적수준을나타내는보정변수로만사용되어, 결혼상태가건강에미치는영향에대한연구는부족한상황이다. 21 건강한식생활의중요한한가지요소로충분한채소섭취를들수있는데, 보건복지부에서는성인및어르신을위한식생활지침에서여러가지색깔의다양한채소를매일먹을것을권장하고있다. 22 관련된선행연구에따르면, 일일 3회이상채소와과일을섭취할때 1회미만섭취하는집단보다뇌졸중, 협심증, 심혈관계질환으로인한사망위험이낮았다. 23 또한채소및과일섭취가대장선종암화단계별과정에다양하게영향을미치는것으로나타난연구결과도있으며 24 여자에게서유방암의발병위험을줄여준다는결과도있다. 25 국민건강영양조사자료를이용한국내연구에의하면한국인 30세이상성인중세계암연구재단의채소와과일권장량인일일 400 g 이상을섭취한사람의비율은전체대상자의 25.7% 로 26 우리나라국민의채소와과일섭취가매우부족한실정이고, 채소와과일의섭취증가가필요함을보여준다. 채소의경우즉석식품처럼구매해서바로섭취하는식품이아니라, 가정에서손질과조리과정을거쳐섭취하는식품이다. 이러한과정에서시간과노력이요구되기때문에, 결혼상태가채소섭취에영향을미칠수있다. 이에본연구는 2007~2010년국민건강영양조사자료를이용하여한국성인의결혼상태와채소섭취와의연관성을분석하고자하였다. 이를위해결혼상태에따른채소섭취량을성별, 연령대별로비교하였다. 또한성별, 연령대별로결혼상태에따라채소를권장섭취횟수보다부족하게섭취할위험도를분석하였다. 연구방법 분석대상 2007~2010년국민건강영양조사에참여한 30세이상의성인남녀를대상으로하였다. 건강설문조사와영양조사 에참여해성별, 연령, 결혼관련문항에대한응답자료가존재하는총 18,190명을분석대상으로하였다. 분석내용및방법결혼상태및사회인구학적특성결혼상태는유배우자동거, 결혼한적없음, 별거 / 이혼 / 사별인세집단으로구분하였다. 다른사회인구학적특성으로는성별, 연령, 가구소득, 교육수준, 직업수준, 체중상태의자료를이용하였고이중연령은 30~64세, 65세이상인두집단으로분류하였다. 가구소득은월평균가구총소득을하, 중, 상으로분류하였다. 교육수준은초졸이하, 중졸및고졸, 대졸이상으로분류하였다. 직업수준은비육체노동, 육체노동, 비경제활동으로분류하였다. 비육체노동은관리자, 전문가및관련종사자, 사무종사자를포함하였고, 육체노동은서비스및판매종사자, 농림어업숙련종사자, 기능원, 장치와기계조작및조립종사자, 단순노무종사자를포함하였다. 주부, 학생, 무직은비경제활동으로분류하였다. 체중상태의경우 BMI (Body Mass Index, kg/m 2 ) 를기준으로저체중 (BMI < 18.5), 정상 (18.5 BMI < 25), 비만 (25 BMI) 으로분류하였다. 건강행태건강행태변수는음주상태, 흡연상태, 주관적건강상태를이용하였다. 음주상태는최근 1년동안의음주경험을묻는문항의응답을월 1회이하, 월 2~4회, 주 2회이상으로분류하였다. 현재흡연여부를묻는문항을이용해담배를피운적없거나과거에피운적있음, 현재흡연중으로흡연상태를구분하였다. 주관적건강상태는평소에생각하는건강상태를보통 / 좋음, 나쁨으로구분하였다. 설문문항의자세한내용은국민건강영양조사원시자료이용지침서에제시되어있다. 27 채소섭취채소섭취량은 24시간회상법으로수집한영양조사자료를사용하였다. 채소를권장섭취횟수보다적게섭취할위험도는 2010년한국인영양섭취기준 28 에근거하여산출하였다. 채소류의권장섭취횟수는성인기 (19~64세) 남녀모두 1일 7회, 노인기 (65세이상 ) 남자 1일 7회, 여자 1일 5회이다. 권장섭취횟수에따라연령을 19~64세, 65세이상으로구분하여권장섭취횟수만큼섭취하는지의여부를성별, 연령대별로분석하였다. 섭취중량 (g) 으로제시되어있는영양조사자료를섭취횟수로환산하기위해서, 채소식품별 100 g에해당하는 1인 1회분량횟수를나타낸데이터베이스 29 를사용하였다. 예를들어시금치를 100 g 섭취
194 / 한국성인의결혼상태와채소섭취 하였을경우, 시금치의 1인 1회분량인 70 g에근거해섭취횟수는 1.43 (100/57 = 1.43) 으로계산하였다. 자세한내용은해당문헌에제시되어있다 29. 통계분석국민건강영양조사표본설계는복합표본설계방법 (Complex sampling design) 을사용하였으므로가중치, 층화변수, 집락변수를고려한 SAS의 Proc Survey 문을사용하여분석하였다. 결혼상태에따른특성은교차분석을통하여빈도와비율을산출하였다. 집단간분포차이는카이제곱검정 (Chi-square test) 을이용해분석하였다. 성별, 연령대별결혼상태에따른채소의평균섭취량은보정변수를고려하여공분산분석 (ANCOVA) 을이용해차이를검정하고보정평균 (Least-squares means) 을추정하였다. 결혼상태에따라채소를권장섭취횟수보다부족하게섭취할위험도 (Odds ratio) 는로지스틱회귀분석 (Logistic regression) 방법을사용하여구하였다. 분석은성별, 연령대별로층화하 여, 보정하지않은모형과보정한모형두가지를수행하였다. 채소의평균섭취량및권장섭취횟수보다부족하게섭취할위험도분석에서보정변수는가구소득, 교육수준, 직업수준, 체중상태, 흡연상태, 주관적건강상태, 총에너지섭취량이었고가구소득과직업수준의교호작용을고려하였다. 65세이상집단의경우결혼한적없는대상자수가적어서 (n = 12) 분석시 유배우자동거집단 과 결혼한적없음 / 별거 / 이혼 / 사별 두집단을비교하였다. 모든분석은 SAS 9.3 (SAS institute Inc., Cary, NC, USA) 을이용하였고, 통계적유의성검정은 p <.05 수준으로하였다. 결 대상자의일반적특성결혼상태에따른분석대상자의사회인구학적, 건강행태의일반적특성및채소권장섭취횟수준수여부를복합표본설계추출방법을이용하여구한후, Table 1에제시하였 과 Table 1. Characteristics of the survey respondents by marital status Married (n = 14,573) Never married (n = 628) n % n % n % Sep/Div/Wid (n = 2,989) p value 1) Sex Age (years) Household income Education Occupation BMI (kg/m 2 ) Alcohol consumption Smoking status Subjective health status Meeting the KDRIs for servings of vegetables Men 6,433 51.8 395 75.1 468 21.3 Women 8,140 48.2 233 24.9 2,521 78.7 30-64 11,437 87.4 616 99.2 1,191 50.0 65 3,136 12.6 12 0.8 1,798 50.0 Low 2,636 13.2 146 22.0 1,373 40.2 Mid 7,605 55.5 312 51.3 1,161 45.5 High 4,096 31.3 156 26.8 353 14.3 Elementary school or less 3,966 20.1 46 4.7 2,008 59.9 Middle, high school 6,739 49.7 266 45.3 773 33.1 College or more 3,785 30.2 310 50.0 160 7.0 Non manual 2,464 21.4 224 34.1 125 6.0 Manual 6,214 44.3 228 40.6 995 36.1 Not employed or home makers 5,716 34.4 168 25.3 1,809 58.0 < 18.5 509 3.3 39 5.2 113 3.3 18.5 BMI < 25 9,255 63.1 409 63.4 1,787 60.4 25 4,674 33.6 175 31.4 1,061 36.3 1/mo 8,480 52.9 295 41.6 2,211 69.7 2-4/mo 2,805 21.8 165 31.2 338 13.3 2+/week 3,191 25.3 161 27.2 404 17.0 Never/ Former 9,444 58.8 290 39.6 2,246 71.9 Current 5,069 41.2 334 60.4 711 28.1 Good/ Normal 11,125 80.4 510 83.7 1,736 62.4 Bad 3,370 19.6 112 16.3 1,211 37.6 Yes 6,488 47.1 277 47.1 1,083 37.8 No 8,085 52.9 351 52.9 1,906 62.2 0.018 The column "n" presents real sample values and the column "%" values expanded to the Korean population. Abbreviations: Spe, Seperated; Div, Divorced; Wid, Widowed; BMI, Body mass index; KDRIs, Korean dietary reference intakes 1) by chi-square test
Journal of Nutrition and Health (J Nutr Health) 2015; 48(2): 192 ~ 198 / 195 다. 결혼상태에따른성별, 연령대별, 가구소득, 교육수준, 직업수준, 체중상태, 음주상태, 흡연상태, 주관적건강상태, 채소권장섭취횟수준수여부의분포는통계적으로유의하게차이가있었다. 결혼상태에따른일일평균채소섭취량비교성별, 연령대별보정변수를고려하고결혼상태에따른일일평균채소섭취량을추정한결과를 Fig. 1에나타내었다. 채소섭취량은김치를제외한채소류와김치를포함한채소류로구분하였다. 김치를제외한채소류와김치를포함한채소류섭취량모두, 남녀 30~64세에서결혼한적없는집단의섭취량이다른집단과비교해가장낮았고, 65세이상의경우결혼한적없음 / 별거 / 이혼 / 사별집단의섭취량이유배우자동거집단과비교해낮았다. 남자 65세이상에서결혼한적없음 / 별거 / 이혼 / 사별집단이유배우자동거집단과비교해김치를제외한채소섭취량과김치를포함한채소섭취량이낮았다 (p = 0.0472, p = 0.0008). 여자 30~64세, 65세이상에서유배우자동거집단의김치를포함한채소섭취량이다른집단과비교해가장높았으나집단간의차이가통계적으로유의하지는않았다. 채소를권장섭취횟수보다부족하게섭취할위험도채소를한국인영양섭취기준에따른권장섭취횟수보다 부족하게섭취할위험도를로지스틱회귀분석 (logistic regression) 을이용하여분석하였다 (Table 2). 남자 30~64 세에서는보정전유배우자동거집단과비교해채소를권장섭취횟수보다부족하게섭취할위험도가결혼한적없는집단이 1.30배 (95% CI: 1.03~1.62), 별거 / 이혼 / 사별집단이 1.19배 (95% CI: 0.89~1.59) 높았다. 그러나보정변수를고려하였을때통계적유의수준은사라졌다. 65세이상남자에서보정전결혼한적없음 / 별거 / 이혼 / 사별집단이채소를권장섭취횟수보다적게섭취할위험도는유배우자동거집단과비교해 1.82배높았고, 보정변수를고려하여도위험도는 1.64로통계적으로유의하였다 (95% CI: 1.13 ~2.37). 여자 30~64세에서는보정전유배우자동거집단에비해결혼한적없는집단이채소를권장섭취횟수보다부족하게섭취할위험이 1.41배높았고 (95% CI: 1.03~1.95), 보정변수고려시통계적유의수준은사라졌다. 별거 / 이혼 / 사별집단은유배우자동거집단과비교해채소를권장섭취횟수보다부족하게섭취할위험도가보정변수를고려하고 1.23배높았다 (95% CI: 1.01~1.49). 65세이상여자의경우, 보정전유배우자동거집단과비교해결혼한적없음 / 별거 / 이혼 / 사별인집단이채소를권장섭취횟수보다부족하게섭취할위험이 1.34배높았고 (95% CI: 1.10~ 1.61), 보정변수를고려하였을때통계적유의수준은사라졌다. Fig. 1. Least-squares means of vegetable intake by sex and age group, according to marital status* Abbreviations: Spe, Seperated; Div, Divorced; Wid, Widowed 65 y: comparison between married and never married/sep/div/wid *Adjusted for household income, education, occupation, BMI, smoking status, subjective health status, energy intake, and household income* occupation *p value < 0.05
196 / 한국성인의결혼상태와채소섭취 Table 2. Odds ratios(95% CI) from adjusted logistic regression models for less consumption of vegetable than the KDRIs 1) by sex and age group, according to marital status Married Never married Sep/Div/Wid OR OR 95% CI OR 95% CI Men Women Unadjusted 1 1.30 1.03 1.62 1.19 0.89 1.59 30~64 y Multivariate-adjusted 2) 1 1.11 0.87 1.42 1.00 0.72 1.38 65 y 3) Unadjusted 1 1.82 1.27 2.61 Multivariate-adjusted 1 1.64 1.13 2.37 30~64 y 65 y Unadjusted 1 1.41 1.03 1.95 1.29 1.08 1.54 Multivariate-adjusted 1 1.30 0.88 1.91 1.23 1.01 1.49 Unadjusted 1 1.34 1.10 1.61 Multivariate-adjusted 1 1.03 0.82 1.28 Abbreviations: KDRIs, Korean dietary reference intakes; Spe, Seperated; Div, Divorced; Wid, Widowed; OR, Odds ratios; CI, Confidence interval 1) KDRIs: 7 servings for 19-64 year-old men, women and 65-year-old men; 5 servings for 65-year-old women 2) Adjusted for household income, education, occupation, BMI, smoking status, subjective health status, energy intake, and occupation 3) 65 y: comparison between married and never married/sep/div/wid 고찰 본연구는결혼상태와채소섭취의연관성을분석하기위해, 2007~2010년국민건강영양조사자료를이용하여 30세이상한국성인의결혼상태에따른채소섭취량을비교하고, 채소를권장섭취횟수보다부족하게섭취할위험도를분석하였다. 연구결과김치를제외한채소류와김치를포함한채소류섭취량모두, 30~64세에서결혼한적없는집단의채소섭취량이유배우자동거집단, 별거 / 이혼 / 사별집단과비교해낮았다. 65세이상에서는결혼한적없음 / 별거 / 이혼 / 사별집단의섭취량이유배우자동거집단과비교해낮았다. 김치를포함한채소섭취량의경우, 남녀모두유배우자동거집단의채소섭취량이결혼한적없거나별거 / 이혼 / 사별집단과비교해가장높았다. 김치를포함한채소를권장섭취횟수보다부족하게섭취할위험도를평가한결과, 유배우자동거집단에비해결혼한적없거나별거 / 이혼 / 사별인경우, 채소를권장섭취횟수보다부족하게섭취할위험도가높아지는경향을보였다. 여자에서는 30-64세그리고남자에서는 65세이상에서별거 / 이혼 / 사별집단이유배우자동거집단과비교해채소를권장섭취횟수보다부족하게섭취할위험도가보정변수를고려하고통계적으로유의하게높았다. 본연구결과성별, 연령대에따라결혼상태에따른채소섭취량이나권장섭취횟수충족정도는서로다르게나타났으나 65세이상남자에서결혼한적없음 / 별거 / 이혼 / 사별집단이유배우자동거집단에비해채소섭취량이낮았고, 권장섭취횟수보다부족하게섭취할위험도가높았다. 남녀모두유배우자동거집단의김치를포함한채소섭취량이결혼한적없거나별거 / 이혼 / 사별집단과비교해높 았던본연구결과는미국의 40~70대남자와여자를대상으로한각각의연구에서결혼한상태였다가이혼또는사별한경우채소섭취가감소했다는결과와유사하였다. 13,14 영국성인을대상으로과일과채소섭취를평가한연구에서는대상자를과일, 채소섭취량에따라 4분위로분류하였을때, 남자에서결혼한상태인경우에결혼한적없거나별거 / 이혼 / 사별인경우보다과일과채소섭취량이유의하게높았으며여자에서는남자와비슷한경향은보였으나, 분포의차이가통계적으로유의하지않았다. 30 35~69세여자를대상으로영국에서수행한연구에서는결혼상태에따라채소섭취량에유의한차이가나타났으며, 결혼상태인집단이다른집단과비교해채소섭취량이가장높았다. 31 남자 65세이상에서별거 / 이혼 / 사별집단이유배우자동거집단과비교해채소를권장섭취횟수보다부족하게섭취할위험도가높았던본연구결과는캐나다노인집단을대상으로한연구에서 65세이상결혼한노인집단이결혼한적없는집단에비해채소, 과일을더욱많이섭취했다는연구결과와유사하였다. 32 중국노인집단의국민건강영양조사자료를이용하여수행된연구에서도, 이혼 / 사별집단이결혼상태인집단에비해과일, 채소를권장섭취횟수보다적게섭취할위험이통계적으로유의하게높았다. 33 이러한결과는노인의경우나이가들면서식품접근성이어려워지고, 식욕이줄어들며, 식품준비시불편사항이생겨채소섭취량이줄어들가능성이높기때문일것으로사료된다. 34 본연구결과 65세이상집단의경우여자보다는남자에서, 결혼한적없음 / 별거 / 이혼 / 사별집단에서채소섭취량이낮았고권장섭취보다부족하게섭취할위험도가높게나타났다. 이는가족구성원이건강한식생활에미치는역할을조사한연구결과를참고할수있다. 11 가족구성원
Journal of Nutrition and Health (J Nutr Health) 2015; 48(2): 192 ~ 198 / 197 의식품상호작용을살펴본연구결과, 남편보다는아내가상대방식사의질에영향을미치는정도가크게나타났으며, 가족내에서식품을선정하고준비하는데에는아내의역할이중요함을나타내었다. 11 한편신선한식품, 영양적인균형, 열량 / 염분 / 당분 / 지방등의과다섭취에얼마나신경을쓰는가로식사에대한관심도를알아본연구에의하면, 여자보다는남자일경우이러한관심도가낮았으며직업에있어서식품위생에가장관심을높게보인집단은가정주부였다. 35 본연구결과남자 65세이상결혼한적없음 / 별거 / 이혼 / 사별집단의낮은채소섭취는노화에따른식품접근성감소와식욕저하, 식품준비시발생하는불편사항증가와건강한식생활에영향을줄수있는아내의부재가합해져발생했을수있다. 본연구는몇가지제한점이있다. 첫째, 본연구는조사당시의결혼상태만을측정하였기때문에결혼상태에대한구체적인정보를얻지못하였다. 예를들어, 현재결혼상태의지속기간, 결혼생활의만족도와같은정보는반영하지못하였다. 앞으로결혼상태에대한세부정보를고려하여, 식생활과의연관성을분석할연구가필요하다. 둘째, 본연구는단면연구로수행되었기때문에채소섭취와결혼상태사이의시간상선후관계를알수없었다. 이에둘사이의인과관계를정확하게파악하는데한계가있었다. 셋째, 본연구에서평가한채소섭취량은 1일 24시간회상법으로수행한식사조사자료를이용했기때문에, 대상자들의평소섭취량을반영하지못하였을수있다. 마지막으로건강한식생활에는결혼상태외에도성별, 연령, 가구소득, 교육수준, 식환경등의특성이영향을줄수있다고알려져있다. 34,36 본연구에서는결혼상태에만초점을맞추었기때문에다른변수들은고려하지않았으나, 향후이들의상호작용과결혼상태에대한만족도등도함께살펴볼수있을것이다. 이러한제한점에도불구하고, 본연구는기초자료가부족한상황에서한국인을대상으로결혼상태에따라채소섭취량을성별, 연령대별로비교하고, 채소를부족하게섭취할위험도를분석했다는점에서의의가있다. 또한표본조사의대표성을가진국민건강영양조사자료를이용한만큼연구결과를일반화할수있을것이다. 본연구결과는채소섭취증가를위한교육및정책개발시에기초자료로활용할수있으며, 향후결혼상태와채소섭취를비롯한식생활과의연관성을보는연구의근거자료로도사용할수있을것이다. 요약 본연구는 30 세이상한국성인의결혼상태와채소섭취 와의연관성을분석하고자하였다. 이를위해 2007~2010 년국민건강영양조사자료를이용하여조사참가자의성별, 연령대별채소섭취량을비교하고, 채소를권장섭취횟수보다부족하게섭취할위험도를분석하였다. 분석결과, 결혼상태에따라성별, 연령대별채소섭취량에차이가있었다. 남녀모두유배우자동거집단의김치를포함한채소섭취량이결혼한적없는집단과별거 / 이혼 / 사별집단과비교해가장높았다. 김치를포함한채소를권장섭취횟수보다적게섭취할위험도는유배우자동거집단에비해결혼한적없거나별거 / 이혼 / 사별인경우높아지는경향을보였다. 65세이상남자의경우결혼한적없음 / 별거 / 이혼 / 사별집단은유배우자동거집단과비교해채소섭취량이낮았으며, 채소를권장섭취횟수보다적게섭취할위험도는높았다. 결혼상태와채소섭취량의관계를명확히파악하기위해서는결혼상태와식생활의변화를함께조사할수있는코호트연구가수행돼야한다. 또한결혼상태의지속기간, 결혼상태의만족도등결혼상태를다양하게파악할수있는정보와함께, 식생활상태를평가할수있는자료를수집해야한다. References 1. Chun SS. A study on the indices of life expectancy by marital status. J Korean Public Health Assoc 1999; 25(1): 83-99. 2. Son JY, Han GH. The effects of marital status on health among older adults: the mediating effects of economic resources and social networks. Korean J Fam Welf 2012; 35: 5-40. 3. Park K. Marital status effects on sex-specific mortality: a theoretical integration. Korean J Sociol 1994; 28: 117-137. 4. Kaplan RM, Kronick RG. Marital status and longevity in the United States population. J Epidemiol Community Health 2006; 60(9): 760-765. 5. Dupre ME, Beck AN, Meadows SO. Marital trajectories and mortality among US adults. Am J Epidemiol 2009; 170(5): 546-555. 6. Choi H, Marks NF. Socioeconomic status, marital status continuity and change, marital conflict, and mortality. J Aging Health 2011; 23(4): 714-742. 7. Jang SN, Kawachi I, Chang J, Boo K, Shin HG, Lee H, Cho SI. Marital status, gender, and depression: analysis of the baseline survey of the Korean Longitudinal Study of Ageing (KLoSA). Soc Sci Med 2009; 69(11): 1608-1615. 8. Clavarino A, Hayatbakhsh MR, Williams GM, Bor W, O'Callaghan M, Najman JM. Depression following marital problems: different impacts on mothers and their children? A 21-year prospective study. Soc Psychiatry Psychiatr Epidemiol 2011; 46(9): 833-841. 9. Gabriel B, Beach SR, Bodenmann G. Depression, marital satisfaction and communication in couples: investigating gender differences. Behav Ther 2010; 41(3): 306-316. 10. Jeon GS, Lee JY. Impact of marital status on depression and suicidal ideation among Korean adults: focused on the difference by
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