Association of healthy lifestyle and dietary practices with prediabetes among young Korean adults: sex-specific findings from KNHANES 2020–2024

BACKGROUND/OBJECTIVES: Despite the increasing prevalence of prediabetes among young Korean adults, evidence regarding modifiable lifestyle and dietary factors in this population remains limited. This study investigated the association of healthy lifestyle and dietary practices with prediabetes among Korean adults aged 19-34 yrs using sex-specific analyses. SUBJECTS/METHODS: This cross-sectional study examined data from 3,865 participants (1,805 men and 2,060 women) in the Korea National Health and Nutrition Examination Survey 2020-2024. Prediabetes was defined as a fasting plasma glucose level of 100-125 mg/dL or a glycated hemoglobin level of 5.7-6.4% without diagnosed diabetes. Healthy lifestyle practices included nonsmoking, moderating drinking, and walking. Healthy dietary practices comprised appropriate fat intake (15-30% of energy), sodium intake of ≤ 2,300 mg/day, fruit and vegetable intake of ≥ 500 g/day, and nutrition label use. Multivariable logistic regression analyses were conducted to estimate odds ratios (ORs) and 95% confidence intervals (CIs). No significant association was detected between healthy lifestyle practices and prediabetes in either sex. CONCLUSION: Healthy dietary practices were inversely associated with prediabetes among young Korean men, whereas healthy lifestyle practice indicators showed no significant correlation. These findings suggest that early, sex-specific dietary strategies may be relevant for metabolic risk management among young adults.