Korean Journal of Community Nutrition

Volume 15(4); August 2010

Original Articles

[English]
Evaluation of Food and Nutrient Intake by Food Frequency Questionnaire between Normal and Risk Groups according to the Bone Mineral Density of Female College Students Residing in Gangwon Area: Hye Ryeon Jeong, Sunju Yun, Mi Hyun Kim; Korean J Community Nutr 2010;15(4):429-444. Published online August 31, 2010

Abstract PDF: The purpose of this study was to examine the relationship between bone density and dietary intake for college women in their twenties. This study was performed on 160 female college students residing in Gangwon-do. It was conducted using ultrasound measurement of calcaneus bone density, anthropometric checkup and food-frequency questionnaires (FFQ) comprising 94 kinds of commonly consumed foods. Subjects were divided into two groups according to the T-score of bone density: a normal group (n = 113 persons, T-score > or = 1) and a risk group (n = 47, T-score < 1.0). The average age of the subjects was 20.17 years and there was no significant difference between the two groups. Body weight and body fat percentage of the normal group were significantly higher than those of the risk group. The mean daily energy intake of the normal group was significantly higher than that of the risk group. Also, protein, fat, vitamin A, niacin, vitamin B6, folate, calcium, phosphorus, sodium, potassium, iron and zinc intake for the normal group were significantly higher than for the risk group. For the intake of the commonly consumed foods (or dishes) listed in FFQ, the mean daily intake amount of loaf bread, rice cake, potatoes, spicy beef soup, cucumber, seasoned spinach perilla leaves, crown daisy, stir-fried mushroom, sea mustard, beef rib, ham, chicken, mackerel, common squid, drink type curd yogurt, oriental melon and chocolate in the normal group was significantly higher than in the risk group. While, the mean daily intake of ramyun (instant noodle) and carbonated beverage by the normal group was significantly lower than that of the risk group. In conclusion, 20 something female college students showed a higher rate (26.9%) of the bone mineral density risk group (osteopenia or osteoporosis). For the risk group, the levels of nutrient and food intake were lower than in the normal group. Therefore, the bone density risk group needs to increase their nutrient intake and diet quality by increasing the intake of various foods. In addition, they should decrease the intake of foods, which are negative for skeletal health such as instant noodles and carbonated beverages.

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[English]
A Study on the Prevalence of Chronic Diseases, Health-related Habits and Nutrients Intakes according to the Quality of Life in Korean Adults: Jee young Chung, Mi Young Lee, Mi Joung Kim; Korean J Community Nutr 2010;15(4):445-459. Published online August 31, 2010

Abstract PDF: This study was done to analyze the chronic diseases prevalence and dietary intake status according to the health related quality of life and to identify its significant properties. This study was conducted based on 2906 subjects ranging from 20~64 years old, out of 9704 total subjects from the 4th Korean National Health and Nutrition Survey in 2008. The average quality of life (QL) score was 0.915, where 983 subjects were below the average (low QL group) and 1923 subjects were above (high QL group). In the high QL group, there was more likely to be young, male, and with higher income and education. For high QL group, the self-related health score was high, and the subjective stress level was low. The prevalence of diabetes was significantly higher in the low QL group and anthropometric and biochemical measures were not shown differences between the two groups but waist circumference was significantly higher in the low QL group. The QL score was significantly negative correlated with the waist circumference and the body mass index. As for the recognition rate of Nutrition Guideline, there were no significant differences but high QL group had higher scores in "Eat a variety of foods", "Avoid too much Sodium", and "Enjoy meals and Eating a breakfast". Carbohydrate intake was significantly lower in the high QL group than in low QL group and the high QL group showed higher intake in legumes, meat and poultry, fruits, daily products and beverages. Overall results suggest that increased diabetes prevalence in people with low quality of life might be affected by the diets based on high carbohydrate, increased waist circumference, and lower rate of practice nutritional guideline.

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[English]
A Study on the Physical Activity, Food Habit and Nutrient Intakes of Adults in Pusan: Hwa Jae Lim; Korean J Community Nutr 2010;15(4):460-474. Published online August 31, 2010

Abstract PDF: This study was performed to assess the physical activity, food habit and nutrient intakes by gender and age groups in 193 adults aged 20-59 years (84 men and 109 women) in Pusan. Data for physical activity and dietary survey was assessed by a questionnaire and 24hr recall method. The mean BMIs of men and women were 24.0 and 22.2 respectively and BMI of women in the 20-29 years group (20.9) was significantly lower than that of women in the 30-49 and 50-59 years group (22.7, 23.2) (p < 0.01). 56.0% for men and 44.0% for women exercised regularly. The mean exercise duration per once of men (69.7 minutes) was significantly higher than that of women (52.4minutes) (p < 0.01). The mean exercise duration per day was 36.0 minutes for men and 29.9 minutes for women. 67.9% for men and 78.0% for women often skipped meals and 68.4% for men and 69.4% for women skipped breakfast in the main. The mean energy intake of men was 2067.2 kcal and that of women was 1783.1 kcal comprised of 87.2% and 92.1% of the Estimated Energy Requirements (EER). The mineral intakes of men and women were over Recommended Intake (RI) and Adequate Intake (AI) except calcium and potassium. The mean calcium intake was 88.3% for men and 84.0% for women of RI. The mean potassium intake was 63.3% for men and 59.2% for women of AI. The mean vitamin intakes of men and women were over RI and AI except vitamin C and folic acid. The mean vitamin C intake was 92.5% for men and 85.6% for women of RI. The mean folic acid intake was 76.6% for men and 70.0% for women of RI. The mean energy, protein, sodium and zinc intakes of men were significantly higher than those of women (p < 0.01, p < 0.05, p < 0.05, p < 0.05). The mean vitamin B6, vitamin C and folic acid intakes of men in the 20-29 years group were significantly lower than those of men in the 30-49 and 50-59 years group (p < 0.01, p < 0.05, p < 0.05). For energy, proportions of subjects with intake levels less than 90% EER were 64.3% for men and 56.0% for women. For calcium, proportions of subjects with intake levels less than Estimated Average Requirement (EAR) were 52.4% for men and 59.6% for women. For folic acid, proportions of subjects with intake levels less than EAR were 78.6% for men and 83.5% for women. For iron and phosphorus, proportions of women (36.7%, 14.7%)with intake levels less than EAR were significantly higher than those of men (6.0%, 1.2%) (p < 0.01, p < 0.001). For men, age was positively correlated with intakes of potassium, vitamin B6, vitamin C and folic acid (p < 0.05, p < 0.05, p < 0.05, p < 0.01). For men, weight showed significantly negative correlations with intakes of carbohydrate, phosphorus, potassium, zinc, vitamin B6 and folic acid (p < 0.01, p < 0.05, p < 0.05, p < 0.05, p < 0.01) and BMI showed significantly negative correlations with protein, lipid, phosphorus, potassium, zinc, vitamin E and folic acid (p < 0.05, p < 0.05, p < 0.05, p < 0.05, p < 0.05, p < 0.05, p < 0.05) For men, exercise duration per once showed significantly positive correlations with intakes of calcium, phosphorus, potassium, zinc, vitamin B1, vitamin B2, niacin, vitamin C and folic acid (p < 0.01, p < 0.05, p < 0.01, p < 0.05, p < 0.05, p < 0.01, p < 0.01, p < 0.01, p < 0.05). Therefore, nutritional education for adult health management is needed by gender and age groups.

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[English]
Evaluation of Nutrition Education for Preschool Children Using Picture-Questionnaire: Saet Byol Hong, Hae Ryun Park, Gyeong Ah Go, Gye Ok Jeong, Kyung Hee Song; Korean J Community Nutr 2010;15(4):475-484. Published online August 31, 2010

Abstract PDF: The purpose of this study was to evaluate the effect of the nutrition education on preschool children's nutrition knowledge and behaviors. The study subjects were preschool children attending J kindergarten located in Wonju. Each of the control group and the education group consisted of 49 children and the education group was exposed to nutrition education while the control group did not. The nutrition education intervention lasted 9 weeks weekly basis. The t-test for the homogeneity of each group showed no meaningful difference at the beginning point of nutrition education. After nutrition education a test of nutrition knowledge using picture-questionnaire was carried out by the researcher for the subjects of education group and control group and the caretakers of the education group were offered self-administered questionnaire on the changes in children's dietary behaviors. The results of the study were as follows: 1. Nutrition education intervention showed a meaningful difference in children's understanding nutrition; the kinds and function of food, the relationship between food and body, the function of nutrients and enhanced their idea on hygiene compared to the control group (p < p.005). 2. However, nutrition education intervention made no statistically meaningful difference in children's dietary behaviors such as having breakfast, keeping balanced diet, washing hands before meals, saying "thanks" before and after meals, cleaning the table after meals, brushing teeth after meals and so on. Therefore, we found that it is hard to expect children to correct their dietary behaviors in such a short period of 9 weeks and nutrition education for preschool children should be offered to caretakers at the same time.

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[English]
Development and Effects' Analysis of Nutrition Education Program for Diabetes Mellitus at Community Health Center: Focused on Individual Daily Energy Requirements and Food Exchange Units: Ji Yoon Oh, Sook Bae Kim; Korean J Community Nutr 2010;15(4):485-497. Published online August 31, 2010

Abstract PDF: The purpose of this study was to investigate effects of the developed nutrition education program focused on individual daily energy requirements and food exchange units using Food Exchange System for diabetes mellitus at a community health center. Developed the nutrition education program, four weeks' nutrition education including provided twice individual meal as diet therapy (2 hour/lesson/week, 4 week), was provided to 20 diabetic elderly (12 male, 8 female, 50-75 yrs): 1st lesson "Introduction: management of diabetes mellitus", 2nd lesson "6 Food groups and sources of 6 food groups", 3rd lesson "Individual daily energy requirements and food exchange units", and 4th lesson "Food choice for diabetes mellitus". For effects' analysis of the developed program, we assessed the changes in anthropometric characteristics; biochemical characteristics and nutrient intakes using 24 hr recall method. Effects of the developed nutrition education program were as follows: weight was significantly decreased, blood urea nitrogen (BUN) and glycosylated hemoglobin (HbA1c) were significantly decreased, and distribution of subjects in BUN and HbA1c was significantly changed. In protein : fat : carbohydrate (PFC) ratio, it was significantly changed from 15.98 : 16.30 : 66.69 to 17.51 : 18.94 : 64.10. In evaluation of nutrient intakes by Dietary Reference Intakes for Koreans (KDRI), protein, fiber, fat, vitamin E, niacin, folic acid, calcium and zinc were shown significantly positive changes in distribution of subjects according to intake level. The index of nutrition quality (INQ), nutrition adequacy ratio (NAR) and mean nutrition adequacy ratio (MAR) were significantly increased. In conclusion, the developed 4 weeks' nutrition education program focused on individual daily energy requirements and food exchange units using Food Exchange System for diabetes mellitus at community health center may improve the symptom of diabetes mellitus.

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[English]
A Study on the Stress and the Dietary Habits of Elementary School Children by Mother's Employment Status: Seunghee Oh, Whajin Hyun, Hongmie Lee, Haeryun Park, Hyunjin Lim, Kyunghee Song; Korean J Community Nutr 2010;15(4):498-506. Published online August 31, 2010

Abstract PDF: The purpose of this study is to determine the stress and the dietary habits of elementary school children and assess the associations with mother's employment status. The subjects were 423 students of 5th and 6th grade students (210 boys and 213 girls) in Seoul and Gyeonggi-Do. Two hundred fifty-two mothers had some kinds of job and 171 mothers were housewives. The students had stress the most from their studies/schoolwork (M = 2.37), while the least from "teacher/school" (M=1.51). The average stress score of the subjects was 1.76. The average score of dietary habits was 3.43. More specifically, the statement "not skipping breakfast" had the highest score (M = 4.04) and the statement "not substituting cereals, breads or drink milk for any meal" had the lowest score. Students with employed mothers had higher stress level than students with unemployed mothers. Students with employed mothers who have blue color job showed the lower dietary habits score than those with employed mothers who had other types of job. Students of employed mothers who go to school at dawn showed the lowest dietary habits score. In both employed and unemployed mothers, the stress score of students negatively correlated with the score of dietary habits. It was important for the mother to be at home when the students go to school and return. Based on this study, mothers should be aware of the stress level of their children get depending on their employment status. They should also provide their children to have good dietary habits and nutritional education regularly.

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[English]
Recognition of Elementary School Students for The Country-of-Origin Labeling at School Foodservice in Seoul: So Yeon Kim, Sanghyun Park, Nami Joo; Korean J Community Nutr 2010;15(4):507-512. Published online August 31, 2010

Abstract PDF: This study was conducted to offer basic data that give effective ways to inform the country-of-origin labeling, where the ingredients they are serving are from, at school foodservice and to reconsider the importance of the labeling origin based on the survey by the elementary school students. 96.0% of the elementary school students agreed to the regulation about the country-of-origin labeling and the older students were influenced more by media and also supported the labeling. About the tendency of ingesting food from the country the students didn't like, 69% of them disagreed to eat. In the ways to label the country-of-origin labeling at school foodservice, elementary school students recognized easily the indication of origin designed by menu items, letter type. 76% of elementary school students checked the country-of-origin labeling posted at restaurants. When the students eat out, 68% of them were unwilling to have the food using the ingredients from the country they don't like. The country-of-origin for main ingredients such as beef, pork, chicken and other meat products, rice, kimchi had high importance scores. We found that the students think about the country-of-origin for main ingredients is important. Consequently, education and public relations of the country-of-origin labeling for elementary school students would be required.

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[English]
Nutrition Label Use, Self-Efficacy, Snacking and Eating Behavior of Middle School Students in Kyunggi Area: Seo Yeon Ko, Kyung Won Kim; Korean J Community Nutr 2010;15(4):513-524. Published online August 31, 2010

Abstract PDF: This study was designed to examine nutrition label use, self-efficacy, snacking and eating behaviors of middle school students, and to investigate if these characteristics were different by nutrition label use. A cross-sectional survey was conducted to 348 middle school students in Kyunggi, Korea. About a third of subjects read nutrition labels when they purchased snacks/packaged foods. Most nutrition label users were interested in reading information on calories, fat and trans-fat. Self-efficacy of eating/selecting snacks or general nutrition behavior was moderate (mean score: 44.4 out of 60), with significantly higher score in nutrition label users compared to nonusers (p < 0.001). Nutrition label users felt more confident in 9 items out of 15 items of self-efficacy, such as "taking fruits instead of cookies/candy for snack" (p < 0.001), "choosing milk instead of soft drink" (p < 0.01), "not having snacks after dinner" and "avoiding processed foods for snacks" (p < 0.05). Subjects had snacks 1.3 times a day, and nutrition label nonusers consumed snacks more frequently than the counterparts (p < 0.01). About 55% of nutrition label users and 64.7% of nonusers mainly purchased snacks for themselves (p < 0.05). Commonly purchased snacks by adolescents were ice cream, cookies/chips, breads and ramen. Major considerations in purchasing snacks were taste (46.9%) and price (34.6%). In selecting snacks, the influence of friends and parents was greater than the other sources. Based on eating frequency of snacks, nutrition label users were more likely to consume healthy snacks, such as fruit juices, vegetables, milk, yogurt, and potato/sweet potato than nonusers (p < 0.05). Eating behaviors measured by 15 items scored 33.6 out of 45. Nutrition label users showed better eating behaviors, such as "eating meals slowly", "eating foods cooked with plant oil", and "eating out less frequently" (p < 0.05). Study results showed that majority of adolescents did not read nutrition labels, selected snacks for themselves and had somewhat unhealthy foods for snacks. This study also showed the differences in self-efficacy, snacking and eating behaviors between nutrition label users and nonusers. In nutrition education, it is necessary to stress the importance and skills for reading nutrition labels. It is also needed to help adolescents to select healthy snacks and have desirable eating behaviors, as well as increasing self-efficacy.

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[English]
A Study on Vegetable Intakes and Dietary Habits of Middle School Students in Chungnam: Hyun Sun Cho, Myung Hee Kim, Mi Kyeong Choi; Korean J Community Nutr 2010;15(4):525-535. Published online August 31, 2010

Abstract PDF: The purpose of this study was to provide basic data for nutritional education for juveniles' desirable vegetable intake by analyzing their vegetable intake, dietary habit and nutrient intakes according to gender of middle school students in Chungnam. The average age of the subjects was 15.0, height was 162.5 cm, weight was 53.5 kg and their average BMI was 20.1 kg/m2. The frequency of eating supper in girls was lower than that in boys. Many respondents answered that a meal-time was 10~20 minutes. Without gender difference, more than 90% respondents thought that vegetables were good for health. As for the preference of vegetable, subjects responded, "I am in the middle", "I like them", "I dislike them", "I like them very much", and "I dislike them very much" in order, without gender difference. The frequent eaten leaf vegetable was Chinese cabbage, the frequent eaten fruit vegetable was cucumber, and the frequent eaten root vegetable was radish. The favorite leaf vegetable was lettuce, the favorite fruit vegetable was corn, and the favorite root vegetable was sweet potato. The preference degrees of taro and ginger were very low. The reasons why they liked a vegetable were that it was delicious and they ate it at home often. In addition, the reason why they disliked vegetables was that they are untasty in flavor or texture and it showed that many students had a prejudice that vegetables were untasty. The intakes of plant protein, dietary fiber, ash and INQs of dietary fiber, calcium, vitamin C, folate, vitamin E in the group with high preference of vegetables were significantly higher than those of low preference group. The study results indicate that intake frequency and preference of root vegetables in juveniles are low and the major reasons of these results are taste and eating experience of vegetables. In addition, the intake amounts of dietary fiber and folate are poor in the subjects with low preference of vegetables. Therefore, families and schools should make efforts that juveniles can recognize the importance of vegetable intake and select various vegetables properly through the development of cooking methods and systematic nutrition education.

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[English]
Assessment of Food Consumption, Dietary Diversity and Dietary Pattern during the Summer in Middle Aged Adults and Older Adults Living in Gugoksoondam Logevity Area, Korea: Miyong Yon, Mee Sook Lee, Se In Oh, Sang Chul Park, Chung Shil Kwak; Korean J Community Nutr 2010;15(4):536-549. Published online August 31, 2010

Abstract PDF: The purpose of this study was to investigate food intake, dietary diversity and dietary pattern during the summer in middle aged and older adults living in Gugoksundam (Gurye, Goksung, Sunchang and Damyang counties), Jeonla Province located in southern part of Korea and known as one of the representative Korean longevity areas. Food intake and dietary diversity were assessed by using the data from 2 day-24 hour recall of 1,051 subjects (394 males and 711 females) aged 45 years and older (45-93 years in male, 45-105 years in female). The average ages of males and females were 70.7 years and 71.1 years, respectively. Average total daily food intake was significantly decreased with aging in both genders, and the average animal food intake ratio to total food intake was ranged 10~14% in 3 different age groups, 45~64 years, 65~74 years and 75 years and older. The contribution of each food group, in weight, to total food intake showed the descending order of grains, fruits, vegetables and alcohols in males, and grains, fruits, potatoes and meats in females. On daily intake amount of each food item, rice, watermelon, soju, kimchi, and potato were ranked on top 5 in descending order in males, and rice, watermelon, potato, kimchi and ylmukimchi in females. On intake frequency, rice, kimchi, onion, green pepper and potato were ranked on top 5 in descending order in both genders. Dietary variety score (DVS) and dietary diversity score (DDS) for the assessment of dietary diversity and balance were significantly decreased with aging in both genders. In food group intake pattern (DMGFV), 01101 type without consumption of dairy and fruits was the most prevalent, and only 3.6% of male and 3.9% of female subjects showed 11111 type, consumed all the 5 food groups a day. Dietary pattern of subjects was analyzed by cluster analysis with 18 food groups intake. Overall dietary pattern was classified into two clusters, one was more desirable and the other was less desirable. The percentage of subjects with more desirable dietary pattern was about 15% in male and 32% in female. In conclusion, most of our subjects living in Gugoksundam area were taking very simple diet with low amount of dairy products and fruits. These results indicate that nutrition intervention and education for older people living in rural areas should be focused on various food intake including dairy products and fruits.

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[English]
Utilization Status and Efforts to Increase Usage of Traditional Foods in School Lunch according to Dietitians' Preference: Gi Deuk Ahn, Kyung Hee Song, Hong Mie Lee; Korean J Community Nutr 2010;15(4):550-559. Published online August 31, 2010

Abstract PDF: The study was conducted to assess school dietitians' preferences for traditional foods, to determine the association with their perception and usage status, and to develop the strategies to increase its utilization of traditional foods in school lunches. The information was obtained by the self-administered questionnaire from the subjects, which were 198 dietitians in schools located in Seoul and Gyeonggi-do. According to the preference for traditional foods, subjects were distributed into three groups (High = 54, Medium = 128, Low = 16). The significances of differences between groups were determined using SPSS 12.0 at p < 0.05. Compared to the dietitians with lower (medium and low) preferences, those with high preferences answered that they had better knowledge (p < 0.001) for traditional foods, and served them more in school lunches (p < 0.01). Also, more dieticians in the high preference group not only felt that they need to train school administrators (p < 0.01) as well as themselves (p < 0.05), but also were currently providing students with the nutrition education on traditional foods (p < 0.05). The results presented the evidence suggesting that having dietitians with higher preference for traditional foods can offer an effective strategy to increase the opportunities for schoolchildren to be exposed to traditional foods. Development of the standard recipes for use in school lunches by the government or the association was answered as the best strategy to increase the use of traditional foods, regardless of the dietitians' preferences.

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