Korean Journal of Community Nutrition

Volume 27(3); June 2022

Research Note

[Korean]
Using Service Design Tools in Community Nutrition Research: A Case Study in Developing Dietary Guidelines for Young Adults: Eunbin Jo, Jae Eun Shim, Hyun Joo Ryou, Kirang Kim, Su Jin Song, Hyun Ja Kim, Jeong Sun Ahn, Kwang-il Kwon, Hye Young Lee, Sohyun Park; Korean J Community Nutr 2022;27(3):177-191. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.177

Objectives
Recent epidemiological data reported that young adults in their 20 ~ 30s are a vulnerable population with unhealthy dietary practices and a few signs of deteriorated health indicators. However, there are no dietary guidelines that are specifically developed for the young adult population. This study introduces some data collection tools that are mostly used in the service design field, and demonstrates how these tools can be used in nutrition research for developing dietary guidelines for specific target groups.
Methods
To understand the context of food choices among young people, 39 people were enrolled to complete a probes booklet. Thematic analysis and word cloud were performed to capture the main themes from the probes and a persona was developed based on the findings.
Results
Data from the probes enabled us to grasp the various contextual meanings of eating practices among young people. Most participants understand what a healthy diet is and often have a willingness to practice it. However, there were very few participants who were following the practices. We created four types of persona for developing dietary guidelines: healthy eating, emotional eating, convenient eating, and trendy eating.
Conclusions
Probes and persona were used in order to understand the lives of young adults and develop targeted messages. We hope that this introduction will be helpful to researchers who are looking for new ways of understanding their target population in the field of community nutrition.

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Development of a campus-based intervention program to strengthen food literacy among university students: A qualitative formative study
Eunji Ko, Eunjin Jang, Jiwon Sim, Minjeong Jeong, Sohyun Park
Korean Journal of Community Nutrition.2023; 28(6): 495. CrossRef

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Research Articles

[Korean]
Dietary Behaviors Associated with Health Perception of Korean Adolescents from Multicultural Families: based on data from the 2017 ~ 2019 Korea Youth Risk Behavior Surveys: YueRong Hu, SuJin Song; Korean J Community Nutr 2022;27(3):192-204. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.192

Abstract PDF

Objectives
This study examined the association between dietary behaviors and perceived health status among Korean adolescents from multicultural families.
Methods
This cross-sectional study included 2,459 Korean adolescents from multicultural families (aged 13 ~ 18 years) who participated in the 2017 ~ 2019 Korea Youth Risk Behavior Surveys. Information on the sociodemographic variables, dietary behaviors, and lifestyle variables was selfreported using a web-based questionnaire. The dietary behaviors analyzed in this study were the breakfast and food intake frequencies, including fruit, vegetable, milk, fast food, carbonated drink, sweet drink, and high caffeine/energy drinks. The adolescents’ health perception was self-rated as healthy, average, or unhealthy. The dietary behaviors associated with health perception were examined using a multiple logistic regression after adjusting for the confounding variables.
Results
In this study population, 7.6% of adolescents perceived their health status as unhealthy, and 25.4% perceived it as average. The adolescents who were girls, middle school students, and in households with a low economic status showed significantly higher percentages of poor health perception (P-values < 0.001). Skipping breakfast was significantly associated with a negative health perception. Compared to the adolescents who consumed fruits every day, those who did not consume fruits during the previous week showed a higher odd ratio (OR) for a negative health perception [OR = 2.29, 95% confidence interval (CI) = 1.32–3.97]. The adolescents who frequently consumed carbonated drinks ( 5 times/week) perceived their health status as unhealthy relative to those who did not consume carbonated drinks (OR = 2.15, 95% CI = 1.25–3.71). Skipping breakfast was significantly associated with an increased OR for a negative health perception in girls but not in boys. Compared to adolescents with a normal weight, those with overweight/ obesity (OR = 1.75, 95% CI = 1.21–2.52) and underweight (OR = 2.19, 95% CI = 1.25–3.82) showed higher ORs for negative health perception. Positive associations of overweight/obesity and underweight with negative health perception were observed in boys but not in girls.
Conclusions
Dietary behaviors and weight status were associated with the health perception in Korean adolescents from multicultural families. These findings suggest that nutrition interventions on breakfast intake and healthy food choices for this population might effectively improve their weight and perceived health status.

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The unequal weight of COVID-19 pandemic: national trends in body mass index among Korean adolescents by immigrant-origin and gender from 2013 to 2022
Nari Yoo, Yumin Hong, Yoonyoung Choi
International Journal of Adolescence and Youth.2024;[Epub] CrossRef

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[Korean]
[Republished study] Assessing Nutritional Status in Outpatients after Gastric Cancer Surgery: A Comparative Study of Five Nutritional Screening Tools: Jae Won Cho, Jiyoung Youn, Min-Gew Choi, Mi Young Rha, Jung Eun Lee; Korean J Community Nutr 2022;27(3):205-222. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.205

Abstract PDF

Objectives
This study examined the characteristics of patients according to nutritional status assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools.
Methods
A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 were included. The patients were categorized into malnutrition and normal status according to five nutritional screening tools one month after surgery. The Spearman partial correlation, Cohen’s Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each two screening tools were calculated.
Results
Malnutrition was observed in 86.24% of patients based on the PG-SGA and 85.82% based on the NUTRISCORE. When NRI or CONUT were applied, the proportions of malnutrition were < 30%. Patients with malnutrition had lower intakes of energy and protein than normal patients when assessed using the PG-SGA, NUTRISCORE, or NRI. Lower levels of albumin, hemoglobin, total lymphocyte count, and total cholesterol and longer postoperative hospital stays were observed among patients with malnutrition compared to normal patients when NRI, PNI, or CONUT were applied. Relatively high agreement for NUTRISCORE relative to PG-SGA was found; the sensitivity was 90.86%, and the AUC was 0.78. When NRI, PNI, and CONUT were compared, the sensitivities were 23.72% for PNI relative to NRI, 44.53% for CONUT relative to NRI, and 90.91% for CONUT relative to PNI. The AUCs were 0.95 for NRI relative to PNI and 0.91 for CONUT relative to PNI.
Conclusions
NUTRISCORE had a high sensitivity compared to PG-SGA, and CONUT had a high sensitivity compared to PNI. NRI had a high specificity compared to PNI. This relatively high sensitivity and specificity resulted in 77.00% agreement between PNI and CONUT and 77.94% agreement between NRI and PNI. Further cohort studies will be needed to determine if the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

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Report on the Current Trend of Commercial Enteral/Parenteral Nutrition in Outpatient
Hyun Ji Lee, Hyo Jung Park, Seon Young Chung, Myung Sook Min, Ok Soon Jeong, Ja Kyung Min
Journal of Korean Society of Health-System Pharmacists.2023; 40(2): 211. CrossRef

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[Korean]
The Relationship Between the Korean Adults Diet Evaluated Using Dietary Quality Indices and Metabolic Risk Factors: Based on the 2016 ~ 2019 Korea National Health and Nutrition Examination Survey: Chong-Yu Ding, Pil-Sook Park, Mi-Yeon Park; Korean J Community Nutr 2022;27(3):223-244. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.223

Abstract PDF

Objectives
This study was designed to investigate the relationship between metabolic risk factors, Index of Nutrition Quality, and the dietary quality index score of Korean adults.
Methods
The subjects were 18,652 Korean adults aged 19 years or older (7,899 males, 10,753 females) who participated in the 2016-2019 Korea National Health and Nutrition Examination Survey. Subjects were divided into normal, pre-metabolic syndrome, and metabolic syndrome (MetS) groups according to the number of their metabolic risk factors. Data were analyzed using the SPSS program.
Results
About 44.7% of men in the MetS group were at least college graduates (P < 0.001), whereas 52.0% of women in the MetS group were middle school graduates or lower (P < 0.001). The frequency of fruit and dairy products intake tended to decrease as the number of metabolic risk factors increased in both men and women (P for trend < 0.001). As the number of metabolic risk factors decreased, the frequency of grain intake tended to decrease in men (P for trend < 0.001) while the frequency of intake of red meat (P for trend = 0.001), poultry (P for trend < 0.001), and eggs (P for trend < 0.001) decreased in women. The total scores of Diet Quality Index-International (DQI-I) (men P < 0.001, women P < 0.01) and Korean Healthy Eating Index (KHEI) (men and women P < 0.001) were significantly lower in the MetS group compared to the other groups, and the total score of DQI-I and KHEI tended to decrease as the number of metabolic risk factors increased.
Conclusions
Dietary quality evaluation using various indices can provide more information on the dietary problems related to metabolic risk factors. Nutrients and foods that have been confirmed to be related to metabolic risk factors can be used to develop dietary guidelines for the nutritional management of metabolic diseases.

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Cardiocerebrovascular Disease or Fatty Liver Incidence Associated with Pattern of Metabolic Risk Factors and Nutritional Status of Korean Adults: A Prospective Cohort Study
Pil Sook Park, Mei Sheng Li, Chong Yu Ding, Mi Yeon Park
Journal of Health Informatics and Statistics.2023; 48(2): 165. CrossRef
Assessment of Nutrient Intake and Dietary Quality of Korean Adults in Metabolic Syndrome Patients According to Taking Medical Care: Based on the 2017 Korea National Health and Nutrition Examination Survey
Juhee Lee, Kyungsuk Choi
Korean Journal of Community Nutrition.2022; 27(4): 321. CrossRef

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[Korean]
Dietary Iron Intake of Koreans Estimated using 2 Different Sources of Iron Contents are Comparable: Food & Nutrient Database and Iron Contents of Cooked Foods in the Korean Total Diet Study: Jeeyeon Lee, Sung Ok Kwon, Yoonjae Yeoh, Min Jeong Seo, Gae Ho Lee, Cho-il Kim; Korean J Community Nutr 2022;27(3):245-253. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.245

Abstract PDF

Objectives
This study was conducted to find out if the dietary iron intake of Koreans estimated by 2 different methods (iron content sources) using the food intake data from the Korea National Health and Nutrition Examination Survey (KNHANES) are comparable. One method was based on the KNHANES's Food & Nutrient Database (FND) derived mainly from the Korean Food Composition Table and the other used the iron content (IC) of food samples processed in the Korean Total Diet Study (KTDS).
Methods
Dietary intake data from the 2013-2016 KNHANES was used to select representative foods (RFs) in KTDS for iron analysis. Selection of the RFs and cooking methods for each RF (RF × cooking method pair) was performed according to the ‘Guidebook for Korean Total Diet Studies’ and resulted in a total of 132 RFs and 224 ‘RF × cooking method’ pairs. RFs were collected in 9 metropolitan cities nationwide once or twice (for those with seasonality) in 2018 and made into 6 composites each, based on the origin and season prior to cooking. Then, the RF composites prepared to a ‘table ready’ state for KTDS were analyzed by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Dietary iron intake of the Korean population was estimated using only RFs’ intake data based on the 2 sources of iron content, namely FND-KNHANES and IC-KTDS.
Results
RFs in KTDS covered 92.0% of total food intake of Koreans in the 2016-2018 KNHANES. Mean iron intake of Koreans was 7.77 mg/person/day by IC-KTDS vs 9.73 mg/person/day by FND-KNHANES. The major food groups contributing to iron intake were meats (21.7%), vegetables (20.5%), and grains & cereals (13.4%) as per IC-KTDS. On the other hand, the latter source (FND-KNHANES) resulted in a very different profile: grains & cereals (31.1%), vegetables (16.8%), and meats (15.3%). While the top iron source was beef, accounting for 8.6% in the former, it was polished rice (19.2%) in the latter. There was a 10-fold difference in the iron content of polished rice between 2 sources that iron intakes excluding the contribution by polished rice resulted in very similar values: 7.58 mg/person/day by IC-KTDS and 7.86 mg/person/day by FNDKNHANES.
Conclusions
This study revealed that the dietary iron intake estimated by 2 different methods were quite comparable, excluding one RF, namely polished rice. KTDS was thus proven to be a useful tool in estimating a ‘closer-to-real’ dietary intake of nutrients for Koreans and further research on various nutrients is warranted.

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Dietary sodium and potassium intake of Koreans estimated using 2 different sources of their contents in foods, Food & Nutrient Database and the Korean Total Diet Study: a comparative study
Jee Yeon Lee, Sung Ok Kwon, Soo Hyun Lee, Min Jeong Seo, Gae Ho Lee, Cho-il Kim
Korean Journal of Community Nutrition.2023; 28(3): 235. CrossRef

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