Korean Journal of Community Nutrition

Volume 9(2); April 2004

Original Articles

[English]
Comparison of Nutrient Intakes between Disabled Children(Mental Retardation, Autism and Cerebral Palsy) and Non-disabled Children: Comparison According to the Types of Handicap: Eun Kyung Kim, Eun Kyeong Kim, Eun Mi Kim; Korean J Community Nutr 2004;9(2):121-134. Published online April 30, 2004

Abstract PDF: Purpose
of this study was to compare nutrient intakes of disabled children and non-disabled children. Subjects consisted of 86 disabled children from a special education school and 127 non-disabled children from an elementary school in Seoul. Nutrient intakes were assessed by modified 24-hr recall method, with the help of children's parents and teachers. Almost all nutrient intakes (energy, protein, fat, carbohydrates, vitamin B1 and niacin) of children with cerebral palsy were significantly lower than those of other groups. But nutrient intakes per body weight of children with cerebral palsy were not significantly different with those of other groups. There was no significant difference between disabled and non-disabled children in almost % RDA (rate of actual intake to RDA) except of energy %RDA in children with cerebral palsy. NARs (nutrient adequacy ratio) for energy and vitamin B1 of children with cerebral palsy were significantly lower than those of children with autism and mental retardation, and non-disabled children. The proportions of energy, carbohydrate and protein intakes from lunch were significantly higher than those from breakfast and dinner in children with mental retardation and autism. The nutrient intakes of disabled children were different between other groups according to the type of handicap. For example, children with cerebral palsy had the risk of undernutrition. On the other hand, autistic children had the tendency of overnutrition. These results suggest that nutrition educational programs and educational materials for disabled children, their teachers and their parents should be developed considering the type of handicap.

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[English]
Dietary Behaviors, Food Preferences and Its Relationships with Personality Traits in Sixth Grader's of Elementary School: Jeong Ja Paik, Hee Suk Lee; Korean J Community Nutr 2004;9(2):135-141. Published online April 30, 2004

Abstract PDF: Although many studies have focused on dietary habits and behaviors among children, few have looked at individual dietary behaviors and food preferences and their relationships with personality traits. This study examined the relationships between children's dietary behaviors, food preferences and personality traits using a random sample of 236 sixth graders in Chuncheon. Results showed a high prevalence of undesirable dietary behaviors among children: 42.8% of the children had skipped breakfast at least twice a week, 53% had overeaten, 45.8% had eaten irregularly, and 66.5% had eaten an unbalanced meal. These undesirable dietary behaviors were negatively associated with such personality traits as sociability, responsibility, emotional stability, activity, and superiority. When asked about food preference, fruits were most popular while vegetables were least desirable. Total food preference scores were positively correlated with emotional stability (r = .204), activeness (r = .247), sociability (r = .156), responsibility (r = .249), and superiority (r = .133). Preference for meats had negative correlations with responsibility (r = -.133), sociability (r = -.146), and superiority (r = -.132), while preference for vegetables was positively correlated with these personality traits (r = .292, .244, and .230, respectively). In conclusion, the more desirable dietary behaviors and the higher total food preference scores, the more positive the child's personality traits. In addition, preference for vegetables was associated with positive personality traits. The findings suggest the need for continuous attention and guidance on desirable dietary habits for school children both at home and at school.

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[English]
A Study on the Changes of Maternal Dietary Iron Intakes, Its Bioavailability, and Iron Status during Pregnancy: Jeong A Lee, Jong Im Lee, Hyeon Sook Lim; Korean J Community Nutr 2004;9(2):142-150. Published online April 30, 2004

Abstract PDF: To increase both iron and enhancers for iron absorption through diets should be a basic strategy to sufficiently provide increased iron for pregnancy. Previous studies reported that iron intakes of Korean pregnant women were short and their iron status deteriorated as pregnancy progressed. However, there is little data about the bioavailability of dietary iron during pregnancy. Therefore, this study was conducted to determine the changes of dietary iron intakes, its bioa-vailability and iron status during pregnancy longitudinally in Korean women. A total of 151 pregnant women in their first trimester of pregnancy voluntarily participated. Among them, 72 women finished the research protocol during the second trimester and 55 did it during the third trimester. Dietary intakes of total iron, both non-heme and heme iron, as well as enhancers, both MPF (meat, poulty, and fish) and vitamin C, increased significantly as pregnancy progressed. As the results, bioavailability of dietary iron and iron absorbed increased significantly as pregnancy progressed. However, the amount of iron absorbed at each trimester did not meet considerably the iron needed during pregnancy. All five indices examined in the study, Hb level, Hct, serum concentrations of ferritin and sTfR (soluble transferrin receptor), and sTfR:ferritin ratio, showed that iron status of the subjects deteriorated as pregnancy progressed. The rate of anemia of the subjects increased as pregnancy progressed although more than 80% of the subjects took iron supplements after the 20th week of pregnancy. These results imply that it is needed to provide more iron especially, heme iron and dietary enhancers to prevent the deterioration of iron status during pregnancy. Future research on bioavaila-blility of supplemental iron should be performed to determine the iron balance precisely.

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[English]
Retinol, beta-Carotene, and alpha-Tocopherol Concentrations in Maternal-Umbilical Cord Plasma and Their Relationships to Pregnancy Outcome: Geum Ju Lee, Min Sook Lee, Hong Seok Ahn; Korean J Community Nutr 2004;9(2):151-160. Published online April 30, 2004

Abstract PDF: The purpose of this study was to evaluate the intake of antioxidant vitamins and plasma concentrations of those in 60 maternal-infant pairs (30 in normal term delivery group, NT; 30 in preterm delivery group, PT). We also investigated the relationship between vitamin levels of maternal-umbilical cord plasma and pregnancy outcome. Mean energy intakes of NT and PT pregnant women were 93.2% and 85.4%, and their protein intakes were 113.3% and 110.9 % of the recommended dietary allowance (RDA), respectively. While vitamin A intakes were only 51.2% and 39.6% of the RDA in NT and PT pregnant women. The vitamin E intake was about 50% of the RDA (NT 6.27 mg, PT 7.78 mg). The levels of retinol in maternal plasma of NT and PT were 1.51 micronmol/l and 1.43 micronmol/l, respectively. The retinol levels in umbilical cord plasma in NT and PT were 0.72 micronmol/l and 0.61 micronmol/l, respectively. The level of beta-carotene in maternal plasma of NT was 0.49 micronmol/l, significantly (p < 0.01) higher than that of PT (0.31 micronmol/l). The beta-carotene of umbilical cord plasma of NT and PT were 0.02 micronmol/l and 0.01 micronmol/l, respectively. The plasma alpha- tocopherol of maternal of NT and PT were 29.51 micronmol/l and 27.17 micronmol/l, respectively. The alpha-tocopherol of umbilical cord plasma of NT and PT were 4.16 micronmol/l and 3.80 micronmol/l, respectively. The antioxidant vitamin levels retinol, beta-carotene, and alpha-tocopherol) in maternal plasma were significantly higher (p < 0.0001) than those in umbilical cord plasma. However, there was no correlation between the vitamin levels in maternal plasma and those in umbilical cord plasma. The maternal plasma beta-carotene level showed a positive correlation to gestational age. Also Apgar score at 1 min produced a positive correlation to maternal plasma beta-carotene level.

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[English]
The Characteristics of Dietary Habits of Obese, Overweight or Normal Subjects in Seoul: Mee Sook Lee; Korean J Community Nutr 2004;9(2):161-172. Published online April 30, 2004

Abstract PDF: The dietary habits of middle-aged obese, overweight and normal subjects were evaluated for the purpose of providing the background information of the degenerative disease control. A survey was conducted with 293 subjects (121 males and 172 females) between the ages 40 - 64 and they were divided into three groups of normal (BMI 18.5 - 22.9), overweight (BMI 23 - 24.9) and obese (BMI > or = 25) based on the criteria of Korean Obesity Association (2000). The mean age of the subjects was 52.0 +/- 7.3 (male) and 51.9 +/- 6.9 (female). Socioeconomic levels of subjects belong to the mid-upper class, since 71.9% of the males and 39.5% of the females received above a college education. More than 40% (44.6%) of males and 22.1% of females were obese, and educational background did not affect the obesity rate in males, whereas in females those who received lower education had a higher rate of obesity (p <0.001). The subjects had a similar degree of drinking to the national average value, but had a lower degree of smoking. The obese group had the higher rate of drinking (p <0.01) and smoking (p <0.01). The annual increase in weight, more than 4 kg, was 8.8% for normal group and 30.9% for obese group. However, there were no differences in the mean annual increase in weight among the three groups. In females there were greater tendencies of weight changes in obese group (p <0.05). About 44.9% of subjects responded that they were exercising regularly, and the obese group appeared to put into practice less than the other groups and to use more strenuous exercise. There was the greater rate of skipping dinner in the obese female group (p <0.05). The unbalanced dietary pattern was found more with normal group than the other groups (p <0.01). The food consumption frequency by food groups was not different among the groups. The obese group consumed less frequently meats, vegetables and fruits and had higher frequency in fish, legumes and their products, instant or fast food. In all subjects the higher rate of obesity was found with males than females and with those of heavier smoking and drinking, and in females the higher rate of obesity was found with lower education levels, skipping meals and having an unbalanced diet. In middle-aged subjects of this study with higher educational and socioeconomic background factors contributing to the effects of obesity may include smoking, drinking, educational background, skipping meals or unbalanced dietary pattern. The predictable characteristics for the development of obesity can be defined as sudden fluctuation of weights, exercise regularity and intakes of vegetables and fruits.

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[English]
Validation and Calibration of Semi-Quantitative Food Frequency Questionnaire: With Participants of the Korean Health and Genome Study: Younjhin Ahn, Ji Eun Lee, Nam Han Cho, Chol Shin, Chan Park, Berm Seok Oh, Kuchan Kimm; Korean J Community Nutr 2004;9(2):173-182. Published online April 30, 2004

Abstract PDF: We carried out a validation-calibration study of the food frequency questionnaire (FFQ) that we had previously developed for a community-based cohort of the Korean Genome and Health Study of the Korea National Genome Research Institute. We have collected a total of 254 3-day diet records (DRs) from 400 subjects, 200 each randomly selected from the two study cohorts of Ansung and Ansan. FFQ was administered at the time of cohort recruitment in 2001, and DRs were collected during a two month period from January through February of 2002. The mean age was 52.2 years. Farming for men and housewife for women were the most common occupations. The majority of the subjects had undergone 6~12 years of education. The general characteristics including demographic and other data were not different from the total cohort subjects. Absolute levels of consumed nutrients including total energy (energy), protein, fat, carbohydrate, calcium, phosphorus, sodium, potassium, iron, retinol, carotene, vitamin A, thiamin, riboflavin, niacin and vitamin C were compared. The average of energy intake was not significantly different between the data collected by the 2 methods. However, consumptions of protein and fat were higher in data of DRs, whereas that of carbohydrate was higher in FFQ data. Significant correlation of each nutrient consumption between the data sets was observed (p <0.05) except in the case of iron, while the average correlation coefficient between them was 0.22 ranging from 0.33 for energy to 0.11 for iron. The results of cross classification by quantile for exact classification ranged from 25.2% (carotene) to 35.0% (phosphorus), and from 64.6% (vitamin A) to 76.4% (retinol) for adjacent classification. The proportion of completely opposite classification was 8.1% in average. Calibration slope was estimated by regression and calibration parameters ranged from 0.025 for carotene to 0.423 for niacin. We conclude that the FFQ we have developed is an appropriate tool for assessing the nutrient intakes as ranking exposures in epidemiology studies in view that amounts of consumed nutrients obtained by FFQ were similar to those collected by DRs, that correlations between consumed nutrients collected by these methods were significant, and that classification results were relatively fair. The correlation coefficients, however, were lower than expected, which may be mainly due to the survey season. In fact, any short-term dietary survey cannot accurately reflect the overall dietary intakes that change heavily depending on seasons. Further studies including the analysis of chemical indices would be helpful for the studies of causal relationship between the diet and disease.

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[English]
Identifying the Customers' Menu Selection Attributes in Food Court-Styled B & I Foodservice Operation: Hae Young Lee, Sun Jung Ahn, Il Sun Yang; Korean J Community Nutr 2004;9(2):183-190. Published online April 30, 2004

Abstract PDF: This study was designed to identify how customers considered menu selection attributes on menu choice, and so the instrument for measuring that question was developed and menu selection behavior types were analyzed by customers' characteristics. Cronbach's alpha to assess the internal reliability of the developed scales was 0.8361, which indicated to be highly reliable. Construct validity was assessed by principal components factor analysis with a Varimax rotation to identify underlying dimensions of menu selection and then four factors explaining 55.618% of the total variance were found. These factors were labeled as 'quality of meals', 'attractiveness of meals', 'healthfulness of meals' and 'variety of meals', respectively. As a result of analysis on menu selection factors, 'quality of meals'(3.82 out of 5) was the highest consideration followed by 'variety of meals'(3.51), 'healthfulness of meals'(3.49) and 'attractiveness of meals'(3.34), so that menu marketing approaches in the perspective of quality of meals would do lead customers' selection rates, customer satisfaction and then sales highly. Frequent visitor selected menu indifferently but customers who were interested in food and menu highly, who perceived meals' quality highly, and who were satisfied with overall foodservice did with concern. On the basis of these results of study for the target of food court-style B & I foodservice operation, which was introduced as an ideal model in future foodservice market by the concept of 'customer's selection right', the following study related with customers' meal patterns and perception of foodservice by menu selection attributes would be able to predict the chances for success of food court-style foodservice operations.

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[English]
Comparison of Foodservice Management Practices in the Employee Feeding Operations of Jeonnam and Chungchong Area: Hee Young Seo, Bok Mi Jung; Korean J Community Nutr 2004;9(2):191-203. Published online April 30, 2004

Abstract PDF: This study was performed to compare the foodservice management practices in the employee feeding operations of Jeonnam and Chungchong area. Questionnaires were developed and mailed to 160 dietitians with management in employee foodservice of Jeonnam and Chungchong area. Completed questionnaires were received from 124 dietitians with a response rate of 77.5%. The results of this study can be summarized as follows:. Age, work experience, concurrent position and work time of dietitians were significantly higher in the Chungchong area than those in the Jeonnam area. Times of meals and amount of meals served per day in the Chungchong area were significantly higher than those in the Jeonnam area. The type of menu by foodservice operation was high non-selective menu in both areas, especially non-selective menu was high in self-operated place whereas selective menu was high in contract management. Period of cycle menu was 10 - 15 days in Jeonnam area, but that was 7 days in Chungchong area and so cycle menu of both areas was significantly different (p <0.001). Most considerable factor in menu planning was preference in Jeonnam area and was cost in the Chungchong area. Food purchasing method was used mostly by automatic computerized order in the Jeonnam area whereas telephone or mail order was high in the Chungchong area.

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[English]
A Study on Dietary Behavior of Children According to the Their Preferences for Fast Food: Sung Sug Lee; Korean J Community Nutr 2004;9(2):204-213. Published online April 30, 2004

Abstract PDF: The purpose of this study was to examine the dietary behavior of children according to their preference for fast food. The study was carried out on 470, 6th grade students (boys : 236, girls : 234) in September, 2002. The results are summarized as follows : The mean body mass index was 18.72 kg/m2 for boys and 17.76 kg/m2 for girls. The subjective health disorder symptoms for the group preferring fast food was not significantly different than that of the other groups. The group preferring fast food consumed an inadequate volume of food, and they had an irregular and unbalanced diet. Their intake of green vegetables, vegetables, protein foods, and seaweed was significantly lower than that of the other groups. The food habit score for the group preferring fast food was lower than that of the other groups, and they had irregular meal times and had unbalanced diets. The group preferring fast food had a preference for sweet tastes, whilst members of the other group preferred a savory taste. The first choice for fast food by the group preferring fast food was hamburgers, the reason being that it tasted good. Results show that children who have a preference for fast food need to correct their dietary behavior. As a result, proper nutritional education and intervention is required in order to improve the consuming habits of children and their preference for fast food.

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[English]
A Study on Dining-Out Behaviors of Community for Marketing Strategy of Local Foodservice Industry: In Sook Lee, Bong Soon Choi; Korean J Community Nutr 2004;9(2):214-224. Published online April 30, 2004

Abstract PDF: The purpose of this study was to propose the marketing strategy for the local foodservice industry which can lead to successful business in keen competitive foodservice industry by adapting community residents' dining-out behaviors. A total of 350 adults (291 collected; 102 men and 188 women) was surveyed with a questionnaire about the frequency of dining-out, company when out to eat, proper price for one meal, reasons why one chooses a specific restaurant, and general information. Data was analyzed by SPSS/win 7.5. Over the 1/3 of residents (36.3%) ate out 1 - 2 times a week and slightly over the 1/4 of residents (26.4%) did so 1 - 2 times a month. Usually men did more dining out than women. Teachers/ professors' (52.6%) dined out 1 - 2 times a week. Respondents with 1 - 2 million won of monthly income (46.4%) ate out 1 - 2 times a week. Almost 3/4 of respondents chose Korean restaurant. The main factors affected selecting the specific restaurant were 'cleanliness of food and atmosphere of restaurant', and 'reasonable price'. More than 1/3 of respondents (38.9%) answered 5,000 - 8,000 won was reasonable price for eating-out. Respondents in 20's dined out with friends (70.4%) and friends (43.0%) chose the specific restaurant; on the other hand, the other age groups usually dined out accompanied by family (60.7 - 73.7%) and respected spouse or children's opinion when selecting a restaurant. Thus, the menu must be reevaluated from the customers' view point and nutritional status for the well-being of community residents.

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[English]
A Case Study on Quality Improvement of the Food Services for Patients: Focused on Satisfaction Offered Menu and Differentiated Service: Seung Lim Lee, Yu Kyung Chang; Korean J Community Nutr 2004;9(2):225-232. Published online April 30, 2004

Abstract PDF: The objective of this study is to investigate how patients satisfaction are affected by satisfaction with the patient menu and differentiated service resulting from QI activities and to evaluate the efficiency of QI activities. In order to improve satisfaction with menus through QI activities, this study strengthened meal round, examined the quantity of food waste produced by patients, diversified one-dish menus and used seasonal food as much as possible to reflect patients' tastes to the maximum. With regard to cooking, additionally, it strengthened sampling and standardized recipes to maintain the constancy of taste and cooking/seasoning. From July 2003, dining time was changed from 08 : 00 to 07 : 30 for breakfast and from 17 : 30 to 18 : 00 for dinner. Statistical data analyses were completed using the SPSS 11.0 program. The results can be summarized as follows: The goal of QI was to improve food service by raising the score of "Satisfaction with Offered Menus" from 3.49 before QI to 3.55 after QI and differentiating nutrition service at the VIP ward. The score of "Satisfaction with offered menus" after QI was 3.56, and services related to the VIP ward were 7 dishes per meal, meal round once per day and the use of a napkin for a spoon in setting the table. In addition a variety of dishes were used in order to heighten the visual effect. Among the 10 items included on the patient satisfaction questionnaire, 8 items showed higher scores before QI. "Taste of meals" (p <0.05), "Satisfaction with offered menus" (p <0.05), "Kindness of meal serving assistants" (p <0.05) and "Cleanliness of clothes & features" (p <0.05) of VIP ward were significantly higher than those of a general ward.

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[English]
Importance, Support and Application for Contract Foodservice Management Company's Infra-System in the Viewpoint of Headquarters and Branch Office: Il Sun Yang, Moon Kyung Park, Kyung Soo Han, In Sook Chae, So Hyun Park, Hae Young Lee; Korean J Community Nutr 2004;9(2):233-240. Published online April 30, 2004

Abstract PDF: This study was design to grope the suggestions leading synergic effects by bridging the gap between headquarters and branch office, and so to identify the infra-system of contract foodservice management company (CFMC) necessary for operating any kind of branch office including school, hospital and business and industry (B&I). Among 8 categories consisted of infra-system in CFMC, 'C8. Evaluation & analysis for branch office's operation' was the most important category in the headquarter's viewpoint, while 'C3. Sanitation management system' was the most important category in branch office's viewpoint. In support and application, 'C3. Sanitation management system' was the highest category in both headquarters and branch offices including school, hospital and B&I. As a result of analysis on gap between main and branch office in importance, support and application in 8 categories, the efforts of communication and community of perception for infrastructure were needed, because 'C4. Education & training for human resource management (HRM) system' and 'C8. Evaluation & analysis for branch office's operation' in importance, 'C2. Menu management system', 'C4. Education & training for HRM system', 'C6. Facility & utility support system' and 'C8. Evaluation & analysis for branch office's operation' in support had a gap. Correlation analysis to grasp the relation between importance of infra-system and headquarters' support or branch office's application showed that headquarters's importance and support were correlated positively in 'C3. Sanitation management system', 'C6. Facility & utility support system', 'C7. Customer satisfaction management system' and 'C8. Evaluation & analysis for branch office's operation' and branch office's importance and application were correlated positively in 'C1. Procurement & food processing system', 'C5. Management Information system', 'C7. Customer satisfaction management system' and 'C8. Evaluation & analysis for branch office's operation'. Lastly, 'C6. Facility & utility support system' in the branch office of school and hospital and 'C2. Menu management system' in the branch office of B&I were high in importance, low in support and application, therefore intensive support for these categories was needed. In conclusion, continuous check and improvement for categories, which were identified as an urgent problems to be solved in this study, among infra-structure qualifying for CFMC,would enable contract foodservice industry that has grown quantitatively till now to grow qualitatively.

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