A cross-sectional study of the artificial intelligence and metaverse for healthy food and skin health

Introduction

The coronavirus disease 2019 (COVID-19) pandemic continues to have a significant impact on healthcare and social systems around the world. A continued coexistence of these two respiratory diseases (influenza and COVID-19) is expected. For this reason, studies on these two diseases are in progress (1). A study was conducted to investigate obesity rates, weight changes, and eating habits of South Korea (hereafter, Korea) dieters using big data in 2010, 2011, and 2012, when H1N1 influenza was prevalent worldwide. This study utilizes prognostic evaluation of COVID-19 with data concerning H1N1 influenza that was previously prevalent in Korea (2). The current situation in which severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutations continue to transform and spread and vaccines have limitations—should be recognized, and strategies should be established to maintain and promote health by adhering to the recommended actions proposed by the World Health Organization (WHO) (3,4).

In recent years, living standards in Korea have significantly improved, due to remarkable economic development. Recent improvements in nutritional condition, dietary lifestyle, and state-of-the-art medical facilities have expanded the lifespan of the Korean people. As a result, the percentage of elderly people in the population is increasing (5,6). According to the Year 2011 Population Prospects released by Statistics Korea (KOSTAT), Korea entered the aging society in 2000, when the percentage of elderly people exceeded 7.20%. The percentage of people aged 65 years and older is expected to go beyond 14.30% in 2018 and may reach 20% by 2026 when Korea enters the era of the ultra-aging society. This rapid aging of populations among Organization for Economic Cooperation and Development (OECD) member countries is expected to bring many social problems (7,8). Everyone desires a long life. However, because many of the elderly population suffer from chronic diseases, their quality of life deteriorates, thus increasing the financial burden of an aging population on the state through increased national insurance programs. According to KOSTAT3 reporting in 2013, the prevalence of diabetes among those aged >30 years increased from 8.60% in 2001 to 9.00% in 2012, whereas high blood pressure increased from 24.60% in 2007 to 29.00% in 2012. Moreover, the prevalence of hypercholesterolemia soared from 8.00% to 14.50% in 2012. These upward trends indicate a dramatic increase in chronic diseases in Korea. In particular, the increased prevalence of chronic diseases among people aged more than 65 years far surpassed than that of the elderly population (7,8).

The COVID-19 pandemic is ongoing and evolving, creating a situation of an era “With Corona” (WC) and long-COVID, which have changed our lives. The current situation is related to health and beauty. The sustainability of healthy beauty gives new meaning to well-being and well-dying as life concepts associated with old age. As with any study of the transition to meaningful health and beauty of life in the metaverse era, it is also possible to integrate health and beauty of life in the WC era. To do so, it is necessary to create a new mobile platform that encompasses three-dimensional (3D) health and beauty life using Web 3.0 and Direct-to-Customer Genetic Testing (DTC GT) in the artificial intelligence (AI) and metaverse. AI, metaverse, and healthcare are currently bringing in many innovations. AI technology is expected to bring about great change in the healthcare field. These changes are occurring on many fronts (9-13).

In addition, as the non-face-to-face society due to our recent disease expansion, the newly emerged metaverse world creates a new virtual experience within the physical world. The metaverse, where you can experience augmented reality, lifelogging, mirror world, and virtual reality, is a new life experience. Mixed reality (MR) moving to the metaverse creates an experience that can be experienced while maintaining physical distance during an epidemic, and those who are accustomed to the change will expand this new experience. Consumers having difficulty purchasing cosmetics due to rapid changes in non-face-to-face society caused by COVID-19 in the new normal era. This is the content that the metaverse should be used for the customer experience of consumers in the beauty and health-customized skin care market that manages the health of the transformed metaverse world (14-16).

Therefore, this study was conducted for prognosis after COVID-19 based on big data in 2012, when the new influenza was prevalent worldwide. Koreans’ interest and need for a healthy life, beauty information, and functional diet were investigated by age group based on past data related to the new influenza. Previous studies have defined the new middle-aged population as those aged 50 years and older. Since improvement in eating habits is considered the most important way to improve the quality of life and longevity of the new middle-aged population, health care services that consider various nutritional requirements for health and beauty in a new environment in the metaverse to fulfill the desire for a healthy life. was carried out for the purpose of providing. We present this article in accordance with the SURGE reporting checklist (available at https://jmai.amegroups.com/article/view/10.21037/jmai-24-189/rc).

Methods

Big data

Data for 2012 from the 5^th Korea National Health and Nutrition Examination Survey (KNHANES V-3) conducted by the KOSTAT were used in this study. A survey was conducted with 7,214 people aged over 1 year old to assess their daily nutrient-specific intake, together with a further evaluation of the intake experience rate of dietary supplements for less than 1 year for 3,150 people aged 50 years and older. The study also utilized data from KNHANES V-3 to assess the health and nutritional status of Korean people in accordance with Article 16 of the National Health Promotion Act. After obtaining approval for the use of KNHANES V-3 raw data from the KNHANES headquarters, we received raw data and analysis guidelines. The raw data and the guidelines for analysis were provided and applied with its approval number (2012-01EXP-01-2C).

Participants and procedures on survey research

This survey conducted an offline face-to-face survey for 4 weeks from May 1^st to May 30^th, 2023, and the subjects of this study were men in their aged 50s or older in Seoul Metropolitan City, Gwangju Metropolitan City, Busan Metropolitan City, and Jeju Special Self-Governing Province in Republic of Korea. All participants signed an informed consent form and could cancel their participation at any time during the study, and the study was conducted in accordance with the Helsinki II Declaration. Also, all procedures performed in studies involving human participants were in accordance with the Ethical Standards of Dongguk University and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Providing questionnaires to voluntarily participating workers was not perceived as a hazardous activity that required special screening. The study was not a clinical trial, and the data had been robustly anonymized and thus the study did not require ethics committee approval. Since the minimum sample size was 374 based on the population of 2,000, at 95% confidence level, and tolerance of 0.05, a total of 400 people were surveyed in this study.

Validity and reliability of the questionnaire

To verify the reliability and validity of the three scales, the number of samples of 30 was confirmed through a pretest, and the results of reconfirming the number of samples of 374 for the final analysis after entering this survey.

Statistical analysis

Frequency analysis was conducted on the survey data collected for this study using the IBM SPSS Statistics 19 program to identify the choice factors of the target respondents. Moreover, Cronbach’s alpha (χ²) for scales of 1–5 was performed as one of the survey tools for this study, while cross-sectional analysis and Chi-squared tests (χ²) were performed on categorical questions to determine differences in the responses between age groups (17). Moreover, the analysis of variance (ANOVA) analysis with the scale of 1 to 5 was conducted on ordinal questions to identify the differences in the responses among the age groups. In the case of any significant difference in the results, the DUNCAN test was performed as a tool for the post-hoc analysis (18,19). The collected data were coded, organized, and analyzed using the Statistical Package for Social Science (SPSS) WIN25.0 software. The significance levels for verification in this study were set at P<0.05, P<0.01, and P<0.001.

Results

Characteristics of survey respondents and choice factors for development of a functional diet

Tables 1-3 present the demographic characteristics of the survey respondents. In terms of gender, 144 respondents were male (38.5%) and the remaining 230 respondents were female (61.5%). In terms of age, 152 people (40.6%) responding to the survey were aged 50–54 years, 108 respondents (28.9%) were aged 55–59 years, 72 people (19.3%) were aged 60–64 years, 22 respondents (5.9%) were 65–69 years, and 20 people (5.3%) were 70 years and older. The question posed was “Is it necessary to have nutritional information about diets?” The score of the age group of 65–69 years was 4.14 points, which was the highest. The score of the age group of 55–59 years was 3.94, which was the lowest. No statistically significant disparities were observed by comparing differences between age groups.

Regarding the question “Is it necessary to select a diet to fit their health status (depending on the type of diseases)?” the age group of 50–54 years scored 4.16 points, which was the highest, whereas that of the age group of 65–69 years was 4.00 points, which was the lowest. No statistically significant disparities were observed by comparing differences between age groups. Regarding the question “Is it necessary to reinforce nutrients when cooking a meal?” the score for 60–64 years was 4.04 points, which was the highest, while the 65–69 years age group was 3.77 points, which was the lowest.

Survey on age-specific levels of interest in and necessity for healthy life-cosmetologically information and dermatological disorders

Table 4 shows the results of comparative analysis on differences in the prevalence of diseases by age. For the 60–64 years age group, the majority had hypercholesterolemia, followed by not having any specific diseases and having arthritis/herniated cervical discs. For the 65–69 years age group, most did not have any specific diseases, followed by having diabetes and hypercholesterolemia. Of those older than 70 years, the majority had diabetes, followed by those with high blood pressure and generally not having any specific diseases. Because there was a variation in the pattern of distribution for age-specific rates of diseases, there were statistically significant differences between the age groups (χ²=110.34, P<0.001).

Table 5 shows age-specific nutritional requirements. Out of the entire respondents, 188 people said vitamins; 62 (16.6%) people said other essential nutrients; the remaining 52 people mentioned protein. In all the age groups, vitamins were the number one essential nutrient. Therefore, no statistically meaningful disparities were observed among the age groups.

Discussion

Main findings

As sustainable health and beauty have become more important since the COVID-19 pandemic, there is an urgent need to develop functional foods with enhanced biological activity for disease prevention and treatment in line with recent trends. This study was conducted to develop content for nutritionally enhanced functional foods that can be customized for specific diseases by utilizing influenza epidemic indicators before 2012 and basic data for future COVID-19-related research. In addition, by developing content in AI and the metaverse in the Web 3.0 era, the possibility of continuous improvement and development of sustainable living, beauty, and dermatological diseases for people around the world was confirmed.

What does analyzing past nutritional data from the H1N1 pandemic have to do with the future potential of AI and the metaverse?

Many people died in 2010, 2011, and 2012, when the H1N1 influenza was prevalent worldwide, much like the recent outbreak of COVID-19. Studies are underway to utilize the prognostic evaluation of COVID-19 (2). The seriousness of obesity and health issues are recognized in the current situation triggered over a long period, whereby the deepening of sustainable mental and physical health against infectious diseases (such as the prolonged COVID-19 pandemic) are required (3). As SARS-CoV-2 mutations continue to spread, we need to discuss various ways of maintaining and promoting health (4). Given that an improvement in dietary lifestyle is important for enriching the quality of life of the new aging population over 50 years old, the aim of this study was to identify the characteristics of consumer segments by analyzing choice factors and demands for disease-specific functional nutrient-fortified diets customized to the needs of different age groups. Moreover, conducting surveys on the necessity of establishing an AI and U-healthcare service (20-23) and the levels of interest and intention to utilize information technology (IT) are also important aims for this study. According to KNHANES V-3, about the most interesting nutritional information cited by people who tend to read such information, the 50–64 years age group was found to prioritize information in the order of calories, cholesterol, and fat, whereas the 65 years and older age group prioritized calories, proteins, and saccharides. In Korea, the labeling of calories and nutrients is mandatory for all food products, according to the Food Sanitation Act (17). Although the government is implementing and further expanding the labeling of the nutritional values of the food products, enforcement remains difficult because of differences between labeled and measured contents. The government needs to make greater effort to expand the current mandatory labeling system to other food additives and allergenic ingredients to provide accurate information about the functions and ingredients of food products so that consumers are guaranteed their right to choose healthy foods options (24-27). Based on improvement of these diet choice factors, further studies need to be conducted on functional diets. Moreover, because the study observed significant differences between age groups in terms of their levels of interest in hygiene and freshness of diets, packaging of food products, brands, and product descriptions, food companies should implement strict quality management from production to distribution to ensure product reliability to help develop a functional diet into a food product. Moreover, food companies should also differentiate their marketing strategies by segmenting target consumer markets for developing food products (24,28,29).

What is already known about this topic, and what does this study add?

As shown in Table 5, respondents aged over 50 years with chronic diseases cited vitamins as their most interesting essential nutrients, accounting for 50.3% of the sample, while 55.3% of the sample with chronic diseases were aware of the nutritional requirements and essential diet information for their diseases. However, the autonomous management of health care can cause some problems, because of the discrepancy between their actual knowledge and nutritional requirements of their condition. To verify and complement the results of this study, frequency analysis was conducted on trends in daily nutrient-specific intake of those aged more than 50 years and the rate of dietary supplements for less than 1 year, by utilizing data from 2012 of the KNHANES V-3 (Tables 6,7). The actual average intake of nutrients from food compared with the daily recommended nutrient requirement was in the favorable range of 100–143%. The results of the survey indicate that although they consumed enough dietary energy from food, they were heavily dependent on dietary supplements (27,30). The level of interest in chronic diseases and necessity for health care tend to increase with age. People who feel they are not consuming enough nutrients from their food tend to take in nutrients through dietary supplements (31-41). Because of the spread of this perception, the Korean dietary supplement market is growing, and the intake of dietary supplements is increasing. Studies on dietary supplements such as vitamins have been conducted since 1950s, and research has been carried out to identify social and demographic characteristics as well as lifestyle-related factors (42-46). According to a study conducted by the National Health and Nutrition Examination Survey (NHANES), the intake rate of dietary supplements such as vitamins among adults is as much as 52%. Moreover, 35% of those surveyed mentioned taking dietary supplements containing 13 types of multiple vitamins and 16 types of minerals (40,47,48). According to KNHANES V-3, the percentage of those respondents taking dietary supplements has increased continuously since 2005. This demonstrates overconsumption and a heavy dependency on antioxidants and vitamins. Since the daily intake of nutrients from food of the Korean people is very close to the daily recommended nutritional requirement, they do not need to take additional dietary supplements such as vitamins (33-39).

Recently, various studies using the AI and metaverse are progressing rapidly. The contents of this are summarized in Table 8. For indoor and outdoor positioning and navigation, ARIANNA+ is utilized to build complete virtual routes. As such, ARIANNA+ is trained to recognize objects or buildings. This adds the possibility for users to have enhanced interactions with their surroundings through convolutional neural network (CNN). This provides a variety of customer experiences for the visually impaired (50). In addition, research on dental education using metaverse has also been conducted. The perspective of health through the metaverse is also expanding. Recent cardiovascular disease research is advancing its applications, particularly medical visits. This will support cardiovascular interventions. This will be necessary to reshape the way medical education is delivered. It is believed that it will help improve health problems due to the recent increase in the elderly population. In addition, obstacles are expected in various areas such as security, technology, legislation, and regulation, but it is concluded that continuous research will be needed in the future (51). In a study on the future value and direction of customized cosmetics according to the health of the times, the problems of users who directly test and purchase cosmetics in the beauty and health customized market were analyzed. He said that he would have to develop to be able to experience (16,49,52-55).

We explore the potential of AI and the metaverse, but how can these technologies be effectively implemented in health and beauty?

Recently, AI and the metaverse have been utilized in various fields of digital health and beauty (49). First, in cardiology, Skalidis et al. said that cardiology in the digital age is evolving from AI to metaverse education (56). Second, in dermatology, Fernández-Parrado et al. said that there is a possibility of utilizing the metaverse to dermoverse in the field of dermatology (57). Third, in plastic surgery, Sun et al. said that the application of the metaverse to plastic surgery is still in the initial stage of exploration, and a new medical model of plastic surgery supported by the metaverse is worth looking forward to (58). Fourth, in radiology, Silva et al. emphasized the possible application as a complementary tool for the classroom in their academic experience in oral and maxillofacial radiology (59,60).

Limitations of this study

However, this study has several limitations. First, the use of data from 2012 and the relative lack of research on COVID-19 (1-4). If dietary supplements are included in prescription drugs for these conditions, additional nutrients are needed. Second, there is a lack of clinical and practical research on the potential of new technologies that can improve health and beauty by utilizing AI and the metaverse. Accordingly, there will be a difficult learning curve before these innovative educational tools, enhanced by deep interaction virtual reality technology, can be fully utilized (49,56-59). Therefore, more systematic guidance on nutritional information and fortified diets that can support this is needed. In addition, research on patient needs and the use of big data that can be customized to specific types of essential nutrients and precise dosages through DTC GT according to age and disease will be necessary. Therefore, research on AI and the metaverse in terms of health and beauty should be continuously conducted (60).

Conclusions

This research was conducted to find out health information by age group for AI and metaverse app development in the Web 3.0 era for sustainable life, cosmetology, and for treating the dermatological disorders for people around the world. This study will be contributing to the development of content of nutritionally fortified functional foods that can be customized for specific diseases by utilizing the 2012 indicators of the previous influenza outbreak and basic data for future COVID-19-related research. The results of KNHANES V-3 indicate that although they (aged 50 years and older) consumed enough dietary nutrient from food, they were heavily dependent on dietary supplements. Finally, AI and the metaverse have been utilized in various fields of health and beauty digitally.

Acknowledgments

Funding: None.

Footnote

Reporting Checklist: The authors have completed the SURGE reporting checklist. Available at https://jmai.amegroups.com/article/view/10.21037/jmai-24-189/rc

Data Sharing Statement: Available at https://jmai.amegroups.com/article/view/10.21037/jmai-24-189/dss

Peer Review File: Available at https://jmai.amegroups.com/article/view/10.21037/jmai-24-189/prf

Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://jmai.amegroups.com/article/view/10.21037/jmai-24-189/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. All participants signed an informed consent form and could cancel their participation at any time during the study, in accordance with the Helsinki II Declaration. Also, all procedures performed in this study involving human participants were in accordance with the Ethical Standards of Dongguk University and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Providing questionnaires to voluntarily participating workers was not perceived as a hazardous activity that required special screening. The study was not a clinical trial, and the data had been robustly anonymized and thus the study did not require ethics committee approval.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

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