OBJECTIVES: Sarcopenic obesity is closely related to aging and the prevalence of various chronic diseases and frailty. The purpose of this study was to analyze whether diet quality is related to obesity, sarcopenia, and sarcopenic obesity, and if so, to explore the difference in that relationship between urban and rural settings.METHODS: Using data from the Korea National Health and Nutrition Examination Survey of 2016-2018, a total of 7,151 participants aged 40 years or older were analyzed. Sarcopenia was diagnosed using handgrip strength. Diet quality was assessed using Korea Healthy Eating Index (KHEI) scores, and obesity was determined based on participants’ abdominal circumference. Multinomial logistic analysis was used for testing statistical significance.RESULTS: Rural participants had significantly lower KHEI scores and a higher prevalence of sarcopenic obesity than urban participants. The study findings demonstrate that participants without obesity, sarcopenia, or sarcopenic obesity had significantly higher KHEI scores in both rural and urban settings. Multinomial regression analysis further revealed that a higher KHEI score was associated with a lower risk of sarcopenia and sarcopenic obesity among urban residents, while only the risk of obesity was lower with higher diet quality scores among rural residents.CONCLUSIONS: Since diet quality and health status were lower in rural areas, it is important to address this regional disparity with appropriate policy measures. To mitigate urban health disparities, urban residents in poor health with few resources should also be supported.

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Background: Food literacy (FL) is important as the ability to consider the unique aspects of food in our lives, society, and environment. The main objectives of this study were as follows: (1) to revisit the definition of FL, considering the cultural, relational, and ecological aspects that were often neglected in previous research, and (2) to develop a measurement tool for adults. Methods: Expert workshops, the Delphi survey, the test–retest survey, and one-on-one interviews were conducted. The content validity ratio was calculated from the Delphi survey. The correlation coefficient of each item was measured twice, and the Cronbach’s alpha was calculated. Results: This study proposed a new definition of FL, including future-oriented values, and suggested three main domains with 33 items: (1) 14 questions in nutrition and safety FL (Cronbach’s α = 0.877, average correlation coefficient = 0.70), (2) 8 questions in cultural and relational FL (Cronbach’s α = 0.705, average correlation coefficient = 0.71), and (3) 11 questions in socio-ecological FL (Cronbach’s α = 0.737, average correlation coefficient = 0.61). Conclusions: This newly developed questionnaire should be tested in different populations; however, this questionnaire can be a basis for measuring and improving FL for healthy, joyful, and sustainable diets for adults.

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