Korean Journal of Community Nutrition

Volume 14(3); June 2009

Original Articles

[English]
Nutritional Status of the Oldest-elderly Population in Sunchang County: Mee Sook Lee; Korean J Community Nutr 2009;14(3):255-265. Published online June 30, 2009

Abstract PDF: This study was investigated nutrient intakes and dietary evaluation index of the healthy subjects over 85 of Sunchang County to explore the improved dietary pattern for healthy aging of the elderly. The survey was conducted by personal interview to 161 elderly subjects (59 males and 102 females over 85) in 2006, and their daily dietary intake was assessed by 24-hr recalls and weighing one meal. The daily energy intakes of males were 1,335 +/-67 kcal, and those of females were 1,095 +/-38 kcal comprised of 66.8% and 68.4% of the EER for the age group of 75. The proportions of energy from carbohydrate : protein : lipid were 70.7 : 14.6 : 14.6 for males and 68.6 : 14.0 : 17.4 for females. The average protein intakes were 95.4% for males and 85.0% for females of RI, and the average calcium intakes were 54.3% for males and 43.6% for females of RI. The daily vitamin intakes were below 70% except vitamin A, vitamin B6, and vitamin E. The proportion of the relative risk groups of protein, phosphate, iron and vitamin A ranged 40-49% of RI over 75 year groups. The other nutrient intakes showed that there were over 50% risk groups. Especially for nutrients such as calcium, vitamin B1, vitamin B2, vitamin C, folate and niacin over 70% of the subjects were under risk. The median value of all nutrient intakes did not reach AI. The INQ of nutrients were over 0.8 except for folate and vitamin C. Calcium intakes were relatively low and needed attention. However, the ratio of calcium and phosphate showed 1 : 1.6, which appeared to be superior to the other districts. The DVS were higher as the dietary balance scores, KDDS were higher, and the groups with high KDDS had high intakes of nutrients compared to the groups with low KDDS. The high risk groups as judged by simple nutrition screening test had lower nutrient intakes than the groups of middle risk or low risk groups. The subjects in Sunchang area had relatively low intakes of several nutrients. However, judging from the desirable patterns of the energy proportion from three major nutrients, ratio of calcium and phosphate and INQ of nutrients there is a possibility that extended healthy aging might be related to the quality of nutrients and relative ratio between nutrients. To improve nutrient status of the elderly of the surveyed area further application involving KDDS and DVS appeared to be required.

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[English]
Evaluation of a Nutrition Education Program for Elementary School Children: Yun Ahn, Seo Yeon Ko, Kyung Won Kim; Korean J Community Nutr 2009;14(3):266-276. Published online June 30, 2009

Abstract PDF: The purpose of this study was to implement and evaluate the nutrition education program for elementary school children. Subjects were 5th graders (n = 142) of an elementary school in Seoul, and 138 children completed four sessions of nutrition education during March-April, 2008. One group pretest-posttest design was used to evaluate the program effectiveness. Anthropometric measurements and measurements on nutrition knowledge, eating attitudes and eating behavior were done before and after education. Data were analyzed using paired t-test, t-test and chi-sqaretest. After completing nutrition education, body mass index (from 19.3 to 18.9), fat mass (from 10.9 kg to 10.1 kg), percent body fat (from 25% to 23.3%) of subjects decreased significantly (p< 0.001). Percentages of overweight or obese children were 24.6% at pretest and decreased to 20.3% at posttest, although it did not reach statistical significance. Total score of nutrition knowledge increased significantly from 11.9 (59.5/100) at pretest to 14.7 (73.5/100) at posttest (p< 0.001). After nutrition education, percentages of correct answers increased significantly in 10 knowledge items out of 20 items. These included items such as desirable weight control, energy requirements for boys, food groups, snack, and function of fat and balanced meals (p< 0.001). Total score of eating attitudes increased significantly from 35.1 to 36.9 (p< 0.001). Attitude of applying nutrition knowledge to daily life (p< 0.001), interest toward nutrition and health (p< 0.001), attitude of moderating food intake (p< 0.01), and attitude toward eating habit and future health (p< 0.05) were significantly different between pretest and posttest. Total score of eating behaviors increased significantly from 46.7 (possible score: 20-60) to 49.5 by nutrition education (p< 0.001). Improvement in eight eating behaviors were noticed after nutrition education. These included eating meals slowly, eat protein foods (p< 0.001), eating breakfast, eating meals regularly, eating meals with diverse foods, having dairy foods, eating foods using plant oils (p< 0.01), and having grains (p< 0.05). Subjects evaluated quite positively in attractiveness of program, understanding of program contents, helpfulness of program in improving nutrition knowledge and meal management. Study results show that the nutrition education program was effective in improving nutrition knowledge, eating attitudes and changing eating behaviors of children. This program can be used in nutrition education of children at school or at public health centers

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[English]
Effect of School Breakfast Service on Attitudes Toward Breakfast and School Breakfast of Male Middle School Stu: Gajin Yi, Jihyun Yoon, Yun Jeong Choo, Sang Jin Chung, Young Hye Kwon; Korean J Community Nutr 2009;14(3):277-285. Published online June 30, 2009

Abstract PDF: This study was conducted to analyze the effect of male middle school students'eating school breakfast on their attitudes toward breakfast and school breakfast. In addition, the effect of school breakfast on breakfast-related eating behaviors and academic achievement was investigated. The study subjects were selected from a male middle school located in Gyeonggi-do, Republic of Korea. Breakfast was provided at the school for 7 weeks during the 2nd semester of the year 2006. Two sophomore classes were selected for the experimental study. All the students from one class (n = 34; School Breakfast Eaters) have eaten school breakfast while none of the students from the other class (n = 33; School Breakfast Non-eaters) have done so. About two weeks after the school breakfast service was terminated, questionnaires were distributed to the two classes and the responses were analyzed. The results showed that School Breakfast Eaters had more positive attitudes toward breakfast and school breakfast than School Breakfast Non-eaters. In addition, School Breakfast Eaters perceived the positive effect of eating breakfast on their school life more highly than School Breakfast Non-eaters. However there was no significant difference between the two groups in their breakfast eating behaviors in terms of breakfast skipping when the breakfast service was not available. No significant difference was found between the two groups with regards to math score variation before and after school breakfast service. In conclusion, school breakfast for 7 weeks had positive effects on male middle school students'attitudes toward breakfast and school breakfast, although the effect was not confirmed in their breakfast-related eating behaviors after the school breakfast service was terminated.

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[English]
Consumers' Purchasing Intentions of Organic Foods in relation to the Perceived Health Concerns, Healthy Eating Practices and Attitudes, and Food Choice Motives: Myeong Hwa Cha, Yoo Kyeong Kim; Korean J Community Nutr 2009;14(3):286-294. Published online June 30, 2009

Abstract PDF: This study investigated the correlations of five constructs - health concerns, healthy eating practices and attitudes, food choice motives, attitudes toward organic foods - in the formation of behavioral to the purchasing intentions of organic foods. An instrument encompassing health perception, attitudes, habits and personal traits was developed through the comprehensive reviews of the literature and the assured validity and internal reliability of the contents. The questionnaire was administered to the students of three universities at Daegu, Kyungpook province. A total of 288 questionnaires were collected for a response rate of 96.0%. The correlations of five constructs and purchasing intention were tested simultaneously using structural equation modeling. Healthy eating practices and attitudes toward organic foods were found to be the determinants which directly influence the intention to purchase organic foods. Health concerns didn't show direct relation to the purchasing intention of organic foods. The hypothesized path from the health concerns to the purchasing intentions was not supported. The results indicated that food choice motives and healthy eating attitudes should be managed to achieve higher behavioral intention to purchase organic foods.

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[English]
Healthy Eating Habits Related to Normal Weight Maintenance among Female University Students: Seolhyang Baek; Korean J Community Nutr 2009;14(3):295-305. Published online June 30, 2009

Abstract PDF: In order to investigate how to maintain normal weight under independent living conditions, twenty female university students were enrolled and asked to complete a questionnaire over a 10- day study period. T-test, Spearman's correlation and multiple regression analysis were applied to describe characteristics of weight maintainers'habits on a daily basis. The results were as follows: They always comsumed small or moderate-sized meals. 2~3 co-eaters usually had dinner together at home while not watching TV. They also showed healthy eating behaviors such as no snacking, very little amounts of soft drinks, coffee and alcohol consumption. The always normal weight maintainers, however, were not physically active at all. When being with co-eater(s), they ate larger-sized dinners (beta = 0.585, R2= 30.6), and the more co-eaters they had at the dinner table, the greater BMI they got (beta = 0.547, R2= 29.9). As a result of this study, encouraging young adult people to exercise on a regular basis is required, even though they seem to succeed in maintaining normal weight without being active physically. Further study is necessary to investigate how co-eaters would influence the amount of food eaten.

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[English]
A Study on Differences of Sanitation Education and Sanitation Knowledge Between Dietitians in School Foodservice And Managers in Commercial Foodservice: Sang Hyun Park, Hyeon A Jung, Hyun Joo Bae, Nami Joo; Korean J Community Nutr 2009;14(3):306-315. Published online June 30, 2009

Abstract PDF: The purpose of this study was to compare the status of sanitation education and sanitation knowledge in school foodservice with commercial foodservice. The survey sample was institutional foodservice directors (n = 88) in A office of education and commercial foodservice directors (n = 81) in B foodservice industry. The questionnaire requested information about demographic information, situation of sanitation education, contents of sanitation education practice, importance of sanitation education, and sanitation knowledge. Data were analyzed using frequencies, means, chi-square test, and t-test. Over half (52.1%) of the respondents were institutional foodservice directors, 47.9% of the respondents were commercial foodservice directors. The majority of institutional foodservice directors were 25-29 years of age (38.6%), over 10 years of working experience (63.6%) and commercial foodservice directors were 25-29 years of age (53.1%), 5-10 years of working experience (35.0%). 66.3% of the respondents were educated food safety once a month, but 8.6% of commercial foodservices were never educated. The majority of the respondents used printing materials (73.3%) or lecture (74.8%). The importance level of institutional foodservice directors about sanitation education was significantly higher than commercial foodservice directors. The average score of institutional foodservice directors'sanitation knowledge was 87.05/100.00. The commercial foodservice directors'sanitation knowledge 67.74 was significantly lower than institutional foodservice directors (p< 0.05). Therefore, there should be a systematic education program designed for commercial foodservice directors.

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[English]
The Perception of Nutrition Teacher's Competency and Duty: Hae Young Lee, Eun Ju Lee; Korean J Community Nutr 2009;14(3):316-326. Published online June 30, 2009

Abstract PDF: The purposes of this study were to identify the significance of a nutrition teacher, to analyze the importance of competence as a nutrition teacher and to evaluate the importance and difficulty for duties of nutrition teachers. The questionnaire was distributed to 554 preliminary teachers and a total of 468 usable data were collected with 84.5% of response rate from August to October 2006. The statistical data analysis was completed by using SPSS Win (ver. 10.0) for descriptive analysis, t-test, ANOVA and chi-sqare-test. The results were as follows: Preliminary nutrition teachers expected that conversion of a school dietitian into a nutrition teacher could lead to systematic and constant nutrition education and come into synergic effect by doing meal service with nutrition education. For a teacher's competence, all three paradigms were perceived as important. It was evaluated to be high for a knowledge factor in the empirical. analytic paradigm, a personality factor in the practical.interpretive paradigm and an attitude factor in the critical.emancipatory paradigm. And 'a knowledge for nutrition and sanitation (4.59)'and 'an ability to raise a selfmanagement capacity for right food habit and dietary life (4.59)'were showed as most important in a nutrition teacher. It appeared that both important and difficult duties of nutrition teachers were nutrition education, nutrition counseling and sanitation quality of nutrition education; the most necessary solution was to develop a reference and program for nutrition education (37.4%). In conclusion, the systematic supports of district offices of education and associated institutions as well as sustained efforts of preliminary nutrition teachers for themselves should lead to establish a successful system of nutrition teachers.

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[English]
The Use of Iron Supplements of Pregnant Women and Pregnancy Outcome: Ji Hyun Cho, Hong Seok Ahn, Hyun Sook Bae; Korean J Community Nutr 2009;14(3):327-339. Published online June 30, 2009

Abstract PDF: It is known that Korean pregnant women take iron supplements at a higher than the recommended level. This study was designed to provide data on current iron intake levels both from food sources and supplement to better guide iron supplement use during pregnancy. We also explored associations of iron supplement intake levels with varioussociocultural factors and pregnancy outcomes. Dietary intakes of 510 pregnant women were assessed by a validated 102- item food frequency questionnaire, and information on types and amounts of nutritional supplement intakes were also attained. While dietary intake levels of most nutrients exceeded the KDRIs (Korea Dietary Reference Intakes: EAR: Estimated Average Requirements), folate fell short of the KDRIs. A total of 428 women (83.9%) reported to take iron supplement. The pregnant women were divided into the three groups (group I: Fe supplement intake < or = EAR, group II: EAR< Fe supplement intake < or = 3 times of EAR, group III: 3 times of EAR< Fe supplement intake). The mean dietary intake of iron was 24% of the total iron intake for pregnant women. Iron intake from food was not significantly different among I, II, and III. In case of iron intake from supplements, the most frequent dose (34.1%) was 90-100 mg/day, and the mean iron supplement intake was 362% of the EAR. The study findings showed that those with higher levels of iron supplements had better meal quality measured by NAR (Nutrient Adequacy Ratio) and INQ (Index of Nutrient Quality). In addition iron supplement intake levels were significantly related to age (20s: 66.5 +/- 38.6 mg/day, 30s: 77.3 +/- 47.8 mg/ day, p< 0.0116) and experience of childbirth (1st pregnancy: 70.9 +/- 41.2 mg/day, 2nd pregnancy: 64.5 +/- 39.5 mg/day, > or = 3rd pregnancy: 94.4 +/- 63.8 mg/day, p< 0.005). However, no significant difference was found between iron supplement intake levels and various pregnancy outcomes including birth weight, birth height, gestational age, weight gain during pregnancy, and jaundice. It is worrisome that iron intake by supplement use greatly exceeded the EAR, suggesting the need of appropriate guidelines for iron supplement intake during pregnancy. Thus iron overdose from supplements in pregnancy should be considered as a serious condition.

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[English]
Reliability of Nutritional Screening Using DETERMINE Checklist for Elderly in Korean Rural Areas by Season: Hyun Kyung Moon, Jung Eun Kong; Korean J Community Nutr 2009;14(3):340-353. Published online June 30, 2009

Abstract PDF: It is very important to screen the elderly for nutritional risk, because nutritional status is a critical factor to maintain their health. Some nutrition checklists used in Korea for the elderly are from other countries. Reliability of those checklist in Korea is not studied enough. This survey was done for the elderly over 65-years-old who live in Hongcheon, An-dong, Dam-yang and Yeon-gi in Korea (subject; summer: 146, winter: 145) to study the reliability of DETERMINE checklist which is adopted widely in Korea. Using the score of DETERMINE checklist, the elderly were divided as high, middle and low risk groups. For nutritional assessment for those elderly, dietary assessment using 24 recall, anthropometry, biochemical assessment and health condition were used. Results for the checklist showed that percentage below EAR for energy intake and protein intake in winter were higher in the high risk group than other groups. The intakes of phosphorus and iron and most vitamins were below the DRI. The percentage of subjects with intake below DRI was highest in the high risk group. Sensitivity, specificity, and positive predictive values using the DETERMINE were calculated using 6 point as a cut-off point. Subjects were divided into two groups by MAR (MAR< 0.75:undernutrition, MAR< 0.75 : normal). Sensitivity recorded 49.4% and 34.3%, specificity did 61.9% and 65.4 and Positive predictive value did 62.1% and 46.0% each for summer and winter. Results of screening using DETERMINE Checklist were not matched with dietary assessment but not with anthropometric and biochemical measurement. In conclusion DETERMINE 'Checklist' is shown be a good screening tool for finding out risk groups for dietary intake in the elderly, It needs to verify reliability and validity through large-scale survey.

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