Korean Journal of Community Nutrition

Volume 10(4); August 2005

Original Articles

[English]
A Study of Mothers' Nutritional Knowledge on Weaning of Breast-fed Infants, the Age of 6 Months: Soon Ah Kang, Ho Jeung Shin, Yoong Ho Lim, Gye Ae Kim, Yean Hee Woo, Yong Hoon Jun, Soon Ki Kim; Korean J Community Nutr 2005;10(4):453-461. Published online August 31, 2005

Abstract PDF: This study was conducted to investigate the mothers' nutritional knowledge on weaning of 101 infants (8 for 4 mo, 44 for 5 mo, 45 for 6 mo, 4 for 7 mo) at a public health center of Incheon. Informations on the mothers' nutritional knowledge were obtained by questionnaires. In this survey 41.6% of infants were breast-feeding, 43.6% of them were bottle-feeding, and 14.9% of them were mixed feeding right after birth. The rate of breast-feeding right after birth was significantly higher in mothers of high school graduate than mothers of college/university graduate (p < 0.05). The infants of mothers graduated high school began to be weaned significantly earlier than the infants of mothers graduated college/university (p < 0.05). 95.1% of infants (n = 101) began to be weaned 4 to 6 months. 83.1% of infants were fed home-made weaning foods. 66.7% of infants were fed rice gruel, 18.5% of them were fruit juice, 6.2% of them were mixed grain, and 4.9% of them were commercially prepared weaning foods as their first supplementary foods. As main supplementary foods, 32.8% of infants were fed vegetable, 30.5% of them were rice gruel, and 27.7% of them were fruit juice. Mothers' nutritional knowledge related to weaning was significantly higher among mothers of college/university graduate than mothers of high school graduate (p < 0.05). 86.1% of mothers disagreed with the questionnaire in which breast-fed infants aged over 4 months needed to be fed iron sufficient food. For the improvement of nutritional status especially iron nutritional status of infants, nutritional education for mothers with weaning aged infants has to be increased and related programs have to be operated effectively.

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[English]
The Characteristics of Infants' Temperament, Maternal Feeding Behavior and Feeding Practices in Picky Eaters: Yoon Jung Kim, Sang Jin Chung, Young Shin Han, Yoonna Lee, Sang Il Lee, Ki Won Byun, Haymie Choi; Korean J Community Nutr 2005;10(4):462-470. Published online August 31, 2005

Abstract PDF: The purpose of this study was to determine the characteristics of infants' temperaments, maternal feeding behaviors and feeding practices in picky eaters. Participants were 83 infants (aged 12 - 24 months) from "A" hospital (Seoul) and "B" public health center (Kyunggido). Mothers completed questionnaires that assessed their own feeding behavior, feeding practices, infants' temperament and infants' feeding behavior. Picky eaters' demographics were not significantly different from non-picky eaters after adjusting sex and age. The average of thiamin, niacin and vitamin E intakes of picky eaters were below 75% Korean RDA, whereas vitamin A intakes exceed 120% RDA in both groups. Activity level of infants' temperament and disinhibition of maternal feeding behavior in picky eaters were significantly higher than those in non-picky eater. All constructs of infants feeding behavior were significantly associated with certain constructs of infants' temperament, maternal feeding practice and maternal feeding behavior. The pickiness of infants feeding behavior was positively correlated with activity level of infants' temperament, pickiness and disinhibition of maternal feeding behavior and negatively correlated with adaptability of infants' temperament. Findings suggest that maternal feeding behavior and feeding practices as well as infants' temperament should be addressed in nutrition education for picky eaters.

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[English]
A Study on Food Habits, Nutrient Intakes and Nutritional Quality of Preschool Children in Seoul: Keum Jee Kang; Korean J Community Nutr 2005;10(4):471-483. Published online August 31, 2005

Abstract PDF: The purpose of this study was to investigate food habits, nutrients intakes and nutritional quality of the preschool children living in Seoul. The study was performed by analyzing a questionnaire answered by the mothers of 233 subjects aged 2 to 6 years old. A three-day dietary intakes survey, using a 24 hour recall method was used by both the mothers and teachers of the children in day care centers. Twenty eight, 65.9 and 21.8% of preschool children were underweight, normal and overweight or obese, respectively. It was found that 19.8% of preschool children replied that they skipped breakfast sometimes. The major reasons for skipping breakfast were 'snacks'(38.3%) and 'no appetite' (32.6%). The proportion of subjects having unbalanced meals was 61.6%. From the 24-recall survey, it was found that all nutrients intakes were higher than those of the Korean RDA except zinc. The proportions of carbohydrate, protein and fat from total calories were 56,1, 17.2 and 30.7%. The P/M/S ratio was 0.62 : 0.86 : 1. Nutrient adquacy (NAR), mean of nutrient adequacy ratio (MAR) and index of nutritional quality (INQ) were considered adequate. In conclusion, the dietary intakes of children aged 2 to 6 were assumed adequate judging from nutrient intakes, although some attention should be paid to fat intake in this age group.

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[English]
Adolescents' Nutrient Intake Determined by Plate Waste at School Food Services: Kyung Eun Lee; Korean J Community Nutr 2005;10(4):484-492. Published online August 31, 2005

Abstract PDF: The purposes of the study were to analyze nutrients of the menus served and to evaluate students' nutrient consumption at school food services. Three middle schools (boys, girls, and co-ed schools) were located in Seoul and Kyunggi Province. A weighed plate method was employed to measure plate wastes and consumption of the menus served. Data was collected for 3 consecutive days at each school. Nutrient analyses for the served and consumed menus were performed using CAN-PRO. On average the students consumed 67% of the menus they were served. By menu category, the students consumed more than 90% of the rice and one-dish foods they were served. Kimchis (54%) and soups/stews (55%) were the menu categories with the lowest consumption rates. The menus served at the boys and coed schools did not meet 1/3 of the recommended daily allowances (RDA) for calcium, iron, and vitamin B2. Due to the plate wastes, the actual consumption of the boys school students did not meet the 1/3 RDA for calories, calcium, iron, vitamin A, vitamin B1, vitamin B2, and niacin. The menus served at the girls school exceeded the 1/3 RDA for all nutrients, but the actual consumption did not meet the 1/3 RDA for calcium, iron, and vitamin B2. During the 3-day periods, the served and consumed menus provided 27% and 24% of energy from fat, which exceeded the recommended proportion of 20%. To improve nutrition management at school food services, dietitians should understand factors that influence students' consumption and implement nutrition education programs that emphasize balanced diets.

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Clinical Trial

[English]
A Study on Relation among Habitual Isoflavone Intake, Blood Pressure, and Serum Lipid Parameters in Korean Men and Women over 20 Years Old: Mi Kyeong Choi, Mi Hyun Kim, Chung Ja Sung, Won Young Lee, Jung Duck Park; Korean J Community Nutr 2005;10(4):493-500. Published online August 31, 2005

Abstract PDF: There is some evidence that soy isoflavone has beneficial effects on the concentration of blood lipids. In this study, we investigated habitual isoflavone intake levels and the relation among dietary isoflavone intake, blood pressure, and blood lipids of adult men (n = 149) and women (n = 205). Anthropometric measurements including blood pressure, dietary intake assessment using 24-hour recall method, and biochemical assessment using blood were conducted. The average age, height, weight, and BMI were 54.7 years, 168.5 cm, 67.3 kg, and 24.5 kg/m2 for men and 53.9 years, 153.8 cm, 59.2 kg, and 25.0 kg/m2 for women, respectively. The mean daily intakes of total food and energy were 1219.1 g and 1740.9 kcal for men and 1071.3 g and 1432.6 kcal for women, respectively. The mean daily isoflavones (daidzein + genistein) intake of men and women were 20.0 mg and 14.2 mg, respectively. Blood pressure of the subjects was 128.3/75.5 mmHg for men and 124.1/73.7 mmHg for women. Serum lipids of men and women were 180.2 and 184.9 mg/dL for total cholesterol, 160.8 and 137.6 mg/dL for triglyceride, 41.5 and 44.7 mg/dL for HDL-cholesterol, 106.6 and 112.7 mg/dL for LDL-cholesterol, and 3.5 and 3.3 for atherogenic index, respectively. Serum triglyceride and atherogenic index of men were significantly higher than those of women. In men, isoflavone intake and the level of total serum cholesterol were negatively (p < 0.05) correlated, after adjusted age. In women, there were significant correlations between isoflavone intake and blood pressure (systolic and diastolic), after adjusted age (p < 0.05). Based on these results, we concluded that higher isoflavone intake seemed to be related to a better lipid profile in men and lower blood pressure in women. But more epidemiological studies and controlled clinical trials would help to confirm the optimal amount required for the prevention and treatment of cardiovascular disease.

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Original Articles

[English]
A Study on the Food Habit and Seasonal Difference of Nutrient Intake of Adult Working Women: Hwa Jae Lim; Korean J Community Nutr 2005;10(4):501-512. Published online August 31, 2005

Abstract PDF: To assess the food habits and the seasonal differnces of nutrient intakes and diet qualities of adult working women aged 30 - 49y in Busan, dietary survey was conducted in summer and in winter by a questionnaire and two-day food record. Anthropometric assessment was also investigated in two seasons. 91.8% of those skipped breakfast in the main. 44.3% had irregular meals. The mean daily energy intake was 1725.8 kcal with 63.3% of energy intake being supplied by carbohydrates, 14.7% by protein, 22.3% by fat in summer and 1598.4 kcal with 62.1% of energy intake being supplied by carbohydrates, 15.6% by protein, 22.1% by fat in winter. Over 70% of iron intake came from plant origin in two seasons. The mean intakes of energy, calcium, iron and vitamin A in summer and energy, calcium, iron, vitamin A and vitamin B2 in winter were below Recommended Dietary Allowance (RDA) for Koreans. As well as insufficiency in iron, the bioavailability of iron is considered to have been low because most of iron intake came from plant origin in two seasons. For calcium and iron in summer and calcium, iron, vitamin A and vitamin B2 in winter, proportions of subjects with intake levels less than 75% of RDA were over 40% in summer and over 50% in winter, respectively. The nutrient adequacy ratios (NAR) were below 0.75 for calcium and iron in summer and calcium, iron, vitamin A and vitamin B2 in winter. NARs of iron (p < 0.05), vitamin A (p < 0.01) and vitamin B2 (p < 0.001) in winter were significantly lower than those in summer. The mean adequacy ratios (MAR), an index of overall dietary quality were 0.85 in summer and 0.80 in winter. The MAR in winter was significantly lower than that in summer (p < 0.05). The indexes of nutritional quality (INQ) were below 1 for calcium and iron in summer and calcium, iron, vitamin A and vitamin B2 in winter. The intake (p < 0.05) and NAR (p < 0.05) of vitamin B2 showed positive significant correlations with height in winter. In conclusion, nutrient intake and diet quality of adult working women were different between the summer and the winter. So nutritional education programs for summer and winter are needed for adult working women.

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[English]
The Dietary Habits of the Nonagenarian Population in Longevity Belt in Korea: Mee Sook Lee; Korean J Community Nutr 2005;10(4):513-524. Published online August 31, 2005

Abstract PDF: The dietary habits and eating behaviors of nonagenarian subjects over 90 years old in Korean representative longevity belts of Damyang, Gokseong, Kurye, Sunchang were evaluated. The subjects of the study were 91 elderly people (26 males and 65 females) over 90 years old and their dietary habits, food preferences and meal patterns were collected by individual interview. The percentage of subjects, who answered "very good" or "good" for their health status, was 65.9%. In this study, 55% of subjects were without chronic diseases, and there was no significance difference in gender. Many subjects had performed regular exercise and outdoor activity. The rate of eating together with their family was 79.1%. Most of subjects (91.2%) had a regular mealtime consuming three meals a day, and they had good appetite and pleasure of eating. The higher preference of food group was fruits (95.6%), legumes (94.5%), mushrooms (93.4%) and vegetables (92.3%), but the amount of intakes is higher in vegetables than the others. Eating with family, regular exercise and self-rated good health are improved their nutrient intakes. Most frequently consumed meal pattern was rice plus soup and side dishes. The side dish consumed frequently was Namul (blanch and seasoned vegetables). From this study, the nonagenarian populations in longevity belt in Korea have good dietary habits such as regular mealtime, constant amount of meal and eat with pleasure. They are taking Korean traditional meal pattern, providing enriched antioxidant vegetable foods. Also, it can be concluded that the amount and quality of diet in the long-lived elderly are responsible for the Korean traditional family system.

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[English]
Effect of 12-week Low Calorie Diet and Behavior Modification on the Anthropomeric Indices and Biochemical Nutritional Status of Obese Woman: Sook Mee Son, Hee Jun Kim; Korean J Community Nutr 2005;10(4):525-535. Published online August 31, 2005

Abstract PDF: This study was conducted to investigate the effect of a 3 week low calorie diet (LCD) and a 9 week of behavior modification (BM) program on the weight loss, mineral and vitamin status in 22 obese women. The subject were healthy, obese (PIBW > 120%) women aged 20 - 50 Yr and not taking any medications known to influence body composition, mineral or vitamin metabolism During the LCD program, subjects were provided commercial liquid formulas with 125 kcal per pack and were instructed to have a formula for replacement of one meal and at least one regular meal per day within the range of daily 800 - 1200 kcal intake. During the BM program the subjects weekly attended the group nutrition counseling session to encourage themselves to modify their eating behavior and spontaneously restrict their energy intakes. The BM program focused on stimulus control, control of portion sizes and modification of binge eating and other adverse habits. The initial mean energy intake of subjects was 2016.9 +/- 129.8 kcal (100.8% of RDA) and dropped to 1276.5 +/- 435.7 kcal at the end of a 3 week of LCD program and elevated to 1762 +/- 329.3 kcal at the end of a 9 week of BM program. Carbohydrate, protein and fat intakes were significantly decreased at the end of the LCD but carbohydrate was the only macro nutrient that showed significant decrease (p < 0.05) at the end of the BM program compared to baseline. Calcium and iron intakes decreased significantly (p < 0.01, respectively) with no significant changes in other micronutrients at the end of the LCD. The mean weight of the subjects decreased from 73.8 +/- 8.0 kg to 69.2 +/- 7.7 kg with LCD and ended up with 67.7 +/- 7.1 kg after 9 weeks of BM. The 3 weeks of LCD reduced most of the anthropometric indices such as BMI, PIBW, fat weight, wast-to-hip ratio and subscapular and suprailiac skinfold thickness. The 9 weeks of behavior modification showed slight change or maintenance of each anthropometric measurements. Weight loss and decreased WHR with the diet program induced significantly decreased systolic blood pressure. SGOT, SGPT and serum insulin levels with improved serum lipid profiles. Biochemical parameters related to iron status such as hemoglobin, hematocrit were significantly decreased (p < 0.01) at the end of the LCD. But their mean values were within normal range. The mean serum 25 (OH) vitamin D3 level significantly increased after whole diet program. Serum folate level significantly decreased after 12 weeks of diet program. In conclusion 3 weeks of LCD brought 4.6 kg reduction in body weight without risk of iron, zinc or vitamin D deficiency and 9 weeks of the BM was effective to maintain nutritional status with slightly more weight reduction (1.5 kg). However calcium intake and serum folate should be monitored during the LCD and BM because of increased risk of deficiencies..

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[English]
Osteoporosis Prevalence of Radius and Tibia and Related Factors Using Multiple Bone Sites Quantitative Ultrasound Measurement of the Korean Health and Genome Study Cohort Women: Seon Joo Park, Younjhin Ahn, Hae Sook Min, Kyoung Soo Oh, Chan Park, Nam Han Cho, Kuchan Kimm; Korean J Community Nutr 2005;10(4):536-545. Published online August 31, 2005

Abstract PDF: This study was conducted to investigate osteopenia and osteoporosis prevalence of radius and tibia using Quantitative Ultrasound (QUS) and to identify affecting factors of osteoporosis. A total of 4,340 women aged 40 - 69 years, living in Ansung (rural) and Ansan (mid-sized) area, and free of illnesses affecting bone metabolism participated in the community-based cohort study. Among them 4,059 subjects measured radius bone density and 4,089 measured tibia. The T-score threshold, defined as < -1.0 and < or = -2.5, was used to identify subjects with osteopenia and osteoporosis by WHO criteria. The crude prevalence of osteoporosis in radius and tibia was 8.4% and 23.3% respectively; after adjustment for age, it changed 6.3% and 18.8%. In simple logistic regression analysis, the prevalence of osteoporosis increased by aging, non-marital status, low education, low income. Otherwise, high intakes of Ca/P, thiamin, riboflavin, vitamin B6, and vitamin E were decreased osteoporosis prevalence. Compared to the normal BMI (body mass index) group (18.5 < or = BMI < 23), the odds ratio (ORs) of the low BMI group (BMI < 18.5), and high BMI groups (BMI 25 - 30, BMI > or = 30) were significantly increased. The OR of osteoporosis decreased across increasing quartiles of intakes of Ca, P and Ca/P. Therefore, maintaining normal BMI and increasing Ca intake and Ca/P ratio may have a beneficial effect on bone health of Korean women.

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[English]
Relationship between Levels of Dietitians' Management Activities and Job Satisfaction in Elementary School Foodservice Operations: Yun Jeong Choo, Jung Hee Lee, Jihyun Yoon, Si Hyun Ryu; Korean J Community Nutr 2005;10(4):546-554. Published online August 31, 2005

Abstract PDF: The purpose of this study was to identify the relationship between the levels of foodservice management activities and job satisfaction of the dietitians in elementary schools. Out of 130 questionnaires distributed to elementary school dietitians in In-cheon, 127 were returned and analyzed (98% response rate). The questionnaire included two multipleitem scales for measuring foodservice management activities and job satisfaction, respectively. All the items in the scales were coded 1 to 5 for 'certainly no', 'no', 'neutral', 'yes', and 'certainly yes' and grouped by using factor analyses. Most of the responding dietitians were working for schools in urban areas and have independently managed on-site kitchens. The 19 items on food service management activities were grouped into 6 factors and the mean scores of the levels of Personnel Hygiene Management, Education & Training, Sanitation & Safety Management, Menu Quality Management, Service Management, and Environment Management were 4.76, 4.26, 4.24, 4.05, 3.61 and 3.39, respectively. The 23 items on job satisfaction were grouped into 4 factors and the mean scores of the satisfaction levels of Systematic Environment, Job Duty, Job Condition, and Physical Environment were 3.38, 2.83, 2.53, and 2.08, respectively. Overall, the levels of food service management activities and job satisfaction were positively associated with a correlation coefficient of 0.254 (p < 0.01). In particular, satisfaction levels on job duty itself and systematic environment were positively associated with the levels of overall management activities. The results suggest that improving dietitians' job satisfaction could increase the levels of management activities of school foodservice dietitians, resulting in quality improvement of school food service.

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