Abstract
BACKGROUND: In the context of increased health risks for individuals with underlying conditions due to the coronavirus disease 2019 (COVID-19) pandemic, this study investigated whether dietary improvements differ based on the diagnosis of chronic diseases. METHODS: This study used data from the Korea National Health and Nutrition Examination Survey from 2013 to 2021, including 45,391 individuals aged 19 years and older. Diet quality was assessed by the Korean Healthy Eating Index (KHEI) scores. The samples were stratified into subgroups based on the status and diagnosis of hypertension, type 2 diabetes mellitus, and dyslipidemia. Weighted linear regression was utilized to calculate the β coefficients and β(diff) with 95% confidence intervals (CIs). Weighted differences in KHEI scores based on the diagnostic status were calculated. RESULTS: The weighted average KHEI score showed a declining trend in 2013-2019 (β, -0.46 [95% CI, -0.55, -0.36]) but an increasing trend in 2020-2021 (β, 1.24 [95% CI, 0.45, 2.02]), indicating a significant change in trend with the onset of the pandemic (β(diff), 1.70 [95% CI, 0.92, 2.49]). Individuals with hypertension, type 2 diabetes mellitus, or dyslipidemia had higher KHEI scores compared to those without these chronic conditions. Among individuals with these chronic diseases, those diagnosed had significantly higher average scores compared to those who were undiagnosed. During the pandemic, the disparity in average KHEI scores based on diagnosis status increased even further. CONCLUSION: Diagnoses of hypertension, type 2 diabetes mellitus, and dyslipidemia appear to be positively associated with dietary improvements. During the COVID-19 pandemic, individuals aware of their chronic conditions were more attentive to their diets than those undiagnosed.