Korean Journal of Community Nutrition

Volume 14(5); October 2009

Original Article

[English]
A Study on Middle School Students of Gwangju, Chonnam in Terms of Dietary Life, Dietary Related Self-efficacy According to Body Mass Index: Hyun Hwa Kim, Hee Kyong Ro; Korean J Community Nutr 2009;14(5):483-494. Published online October 31, 2009

Abstract PDF: In order to give basic data to teenager's healthcare, we investigated the food habits according to BMI (Body Mass Index), life style, dietary related self-efficacy and food intake through conducting a research surveying 732 middle school students of the Kwang-ju and Chonnam areas. The results of this study were compared groups in under weight (UW), normal weight (NW), and overweight (OW) groups according to BMI levels. In the male students, height was significantly differently in the UW group as 158.2 +/- 0.7 cm compared to other NW and OW groups respectively as 163.7 +/- 0.6 cm and 162.6 +/- 0.7 cm but in the female students there was no significantly difference within groups. Weight was significantly different between the groups in the male students, whereas there were minor differences in the female students. The average of BMI was 20.7 +/- 0.1 on the male students and 20.6 +/- 0.1 on the female students which were all within the average, and their obesity was increased as the school grade was higher. Under less than 30,000 won of pocket money was dominating, and most of the students were in a nuclear family. In all male and female students, the inactive hours like watching TV and using computers had no differences between groups. The difference between groups was minor on breakfast time and most of the students thought their problems on unbalanced diet. There was significant difference in the OW group in female students as they thought their problems on unbalanced diets. The frequency of snack was significantly low in the OW group of male students but there were no differences in snack and eating-out food. All students chose fruits as snack food and Korean-style food as eating out food. The OW group in male students were significantly low in the dietary related self-efficacy when they were with their families and feeling depressed but there were no differences in female students between groups. When all students were getting higher BMI, they evaluated themselves badly in their self-dietary habits. Also the more male students had non-physical activity time, the less they had the dietary related self-efficacy and the more female students had physical activity time, the higher they had the dietary related self-efficacy. In conclusion, the OW group had good habits in physical activities for weekends, meal times, frequency of snack consumption but it showed undesirable when they were low in dietary related self-efficacy. Therefore we will provide the systematic nutrition education to them through this study.

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Evaluation Studies

[English]
The Evaluation Study on Eating Behavior and Dietary Quality of Elderly People Residing in Samcheok According to Age Group: Mi Hyun Kim, Jae Cheol Lee, Yun Jung Bae; Korean J Community Nutr 2009;14(5):495-508. Published online October 31, 2009

Abstract PDF: The purpose of this study was to evaluate the eating behaviors and dietary quality of various aged adults. This study conducted through questionnaire and dietary survey by 24-hr recall to 850 adults residing in Samcheok. Subjects were divided into four groups according to the age in male and female, which included 20~29 yrs group (male n = 94, female n = 66), 30~49 yrs group (male n = 201, female n = 216), 50~64 yrs group (male n = 88, female n = 96), and >or = 65 yrs group (n = 46, female n = 43). In male, 20~29 yrs group had a larger proportion of subjects who skipped breakfast, lunch and dinner compared to other groups (p<0.001, p<0.05, p<0.01). The daily food and energy intakes in > or = 50 yrs group were significantly lower than those of < 50 yrs. Protein and fat intakes of 20~29 yrs group were significantly higher than those of the other groups. But ND (Nutrient Density) of minerals as like calcium, iron and plant iron in 20~29 yrs group were significantly lower than those of other groups. The KDDS (Korean's Dietary Diversity Score) of 20~29 yrs group, 30~49 yrs group, 50~64 yrs group and > or = 65 yrs group in male were 4.1, 3.8, 3.7 and 3.5 respectively and there was significant difference (p < 0.001). In female, skipping breakfast and dinner were significantly higher in 20~29 yrs group than in other groups (p<0.001, p<0.001). And the use of nutrient supplementation was higher in 30~49 yrs group than that of other groups (p<0.05). The daily energy intakes was higher in 20~49 yrs group than that of >or = 65 yrs group. The ND (Nutrient Density) of animal protein, vitamins A and B1 in 20~29 yrs group were significantly lower than those of other groups. The KDDS of 20~29 yrs group, 30~49 yrs group, 50~64 yrs group and > or = 65 yrs group in female were 4.0, 3.9, 3.9 and 3.6 respectively and >or = 65 yrs group was significant lower than other groups. According to these results, >or = 65 yrs and 20~29 yrs group had more dietary habit problems and poor nutrition status than 30~64 yrs group. The results of this study revealed that nutritional management and education for adequate meals should be emphasized in adults and elderly.

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Original Articles

[English]
Effects of Weight Control Program on Food Habits, Eating Behaviors and Life Habits in Obese Elementary School Children: Kyung Hee Kim; Korean J Community Nutr 2009;14(5):509-520. Published online October 31, 2009

Abstract PDF: This study was conducted to investigate the effects of weight control program on food habits, eating behaviors and life habits in obese elementary school children. The program consisted of nutritional education, physical exercise and behavioral therapy was conformed for 10 weeks. Participants of the study involved 41 obese children and their parents. There was significant difference in waist circumference (p<0.05) and children's body fat % significantly decreased from 35.8% to 33.0% (p<0.01) after program. There was significant increase (p<0.05) in HDL-cholesterol, 47.8 (mg/dL) to 53.6 (mg/dL) after weight control program. Food habits and eating behaviors of obese children were showed positively changes but there were no significant differences after program. Regularity of having breakfast and amount of meal under the stress condition were not significantly different after program. The levels of physical activity of obese children were significantly increased from 1.40(hr) to 1.74(hr) per day (p<0.05). But there were no significant changes in spending hours of watching television and playing computer games. Food habits, eating behavior and physical activity showed significant correlations to weight control. These results suggest that the body weight control program for obese children including nutrition education, physical exercise and behavioral therapy may be effective to improve their food habits, eating behaviors and life habits. Nevertheless we need a more concentrating program to improve life habits such as physical activity and watching television.

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[English]
Study of Food Intakes and Eating Patterns among Preschool Children in Daegu Area: Assessment of Dietary Pattern and Dietary Diversity: Ju Young Seo, In Sook Lee, Bong Soon Choi; Korean J Community Nutr 2009;14(5):521-530. Published online October 31, 2009

Abstract PDF: This study was conducted to assess dietary pattern and dietary diversity of preschool children by investigating their food consumption. To accomplish this, dietary intake survey (24 hour-recall food diary) was administered to 508 children aged between 4 to 6 years old from 4 kindergartens in the Daegu area (415 were completed). By using CAN pro 3.0 for professionals, the dietary patterns and dietary diversity scores of each food group were examined by age and sex. Data were analyzed with SPSS 12.0, and chi-square t-test and Anova test, and Duncan's multiple range test used for verifying significance. For 4~5- year-old group, boys had significantly more fruit and meats than girls (p<0.05), but girls had more dairy food than boys with no ignificance. For 6-year-old group, boys had significantly more foods, milk and dairy foods than girls (p<0.05), and also boys had more vegetables and fruit than girls with no significance. For DDS (Dietary Diversity Score), the score of 6-year-old group was significantly higher than that of younger children (p<0.05) and the older the age was, the higher the score was. Dietary Pattern (GMVFD) was verified by 8 types, and the ratio of taking all five food groups (GMVFD = 11111) of the 6-year-old group was 48.8%. Children with older ages had more various foods than younger ones (p<0.05). In addition, the ratio of taking less than the minimal intake of dairy foods of girls (48.1%) was higher than that of boys (41.3%). As results, unbalanced diet, overeating and not eating unbalanced diet were revealed as the problematic dietary habits among preschool children, and those habits may change positively with knowledge on nutrition grow on. Therefore, nutritional characteristics and importance of preschool children should be taught to parents and caregivers, and it must be practical and ready to use in cooking for these children to healthy dietary habits.

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[English]
A Survey on Preferences for Vegetable Cooking Methods and Vegetable-aversion-related Factors among Elementary School Students in Kwangju and Chonnam Regions: Yu Kyong Ahn, Hee Kyong Ro; Korean J Community Nutr 2009;14(5):531-544. Published online October 31, 2009

Abstract PDF: This study was conducted to survey multiple factors of aversion to vegetables and preferences for vegetable-related recipes in school meal services among elementary school children in order to help develop various menus and recipes for school meal services. Questionnaire survey was carried out with the study subjects, who were 401 children in 6th grade attending elementary schools in Chonnam and Kwangju metropolitan regions. Results from the survey can be summarized as follows: 65.1% of respondents answered they try to eat vegetables and other namul side dishes served in school meal service for health. As for the frequency of taking vegetables and namul side dishes out of daily meals, 47.4% of respondents chose 'once or twice'. The reasons for aversion to vegetables in boys were taste and cooking method, while girls were taste and feeling between teeth. In boys there were no differences between regions of Kwangju and Chonnam but the tendency of aversion to vegetables was significantly high in girls. As for the aspects of vegetable aversion of subjects, 46.9% of respondents took up 'black & purple' in the unfavorable color of vegetables. 49.1% in 'bitterness' and 39.2% in 'greasiness''were in terms of the aversive taste of vegetables. The aversive vegetable recipes were 58.6% in 'raw &seasoned' and the unfavorable feeling of vegetables were 53.1% in 'squashiness'. There were differences between regions of Kwangju and Chonnam with boys in color and cooking method in girls. Results from the survey on their preferences for vegetable recipes showed that leafy vegetables like crown daisy (raw/slightly seasoned) and pak choi (broth/pot stew) fell to the most aversive category, while bean sprouts (broth/pot stew) were chosen as the most favorable one. Among root begetables bell-flowers were found to belong to the least preferred recipe, while potatoes were proven to be most preferable in terms of recipes. As for fruit vegetables and other vegetables, all respondents didn't like 'fatsia shoots' vegetable and it's cooking method and they preferred 'green pumpkins (broth/pot stew)'. In respect of mushrooms, enoki mushroom (broth/pot stew) was found most preferred and had high tendency of preferences in boys and girls in Kwangju compared with Chonnam region. The study results indicated that respondents did not show big differences in factors influencing them to be averse to vegetables and their preferences for vegetable recipes depending on regions. In order to have high preference and intake in children's diets, it needs to study in reform of menu about using namul or vegetables mixed with meats and fruits that children preferred or applying roasted and fried other less than namul.

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[English]
Possibility Analysis of a Rice Based Bread by Analyzing Customers' Needs of Menus for School Foodservice: So Jung Lee, Min A Lee, Il Sun Yang, Hae Young Lee; Korean J Community Nutr 2009;14(5):545-555. Published online October 31, 2009

Abstract PDF: School foodservice customers are likely to be tired of repeated cycle menus and their satisfaction for meals offered in school is inclined to be low. The menu variety is an important factor in increasing customer satisfaction. The purpose of this study was to investigate customer perspectives for applying rice based bread menus in order to add menu variety and promote using rice processed products in school foodservice. The questionnaire was distributed to 760 parent samples in elementary schools and 520 student samples in middle/high schools and a total of 665 and 387 usable data were collected, respectively. Food habits such as preference for cooking method, menu preference, food allergy and nutritional perspectives for menu and customer perception for rice based bread like quality, reliability, price, and purchasing convenience were investigated using 7 Likert scale. Also expected menu types applying rice based bread and offering frequency of rice bread menu were examined. Preference level for bread-based meals were moderate and students' preferences were slightly higher than parents. Menu types applying rice bread expected by middle/high school students were western food (49.4%), spaghetti (28.4%), set menu (13.7%), noodle (17.6%), Korean food (11.1%), Chinese food (10.9%) and porridge (4.5%). The most occupied rate was once in a week for expected offering frequency. Most respondents perceived that rice bread was more nutritive and qualitative than the wheat based one.

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[English]
A Survey on Use of Environment-Friendly Agricultural Products for School Food Service by Dietitians in Chungnam Province: Yang Soon Lee, Nam Oak Lee, Sung Hee Ko; Korean J Community Nutr 2009;14(5):556-564. Published online October 31, 2009

Abstract PDF: The purpose of this study is to analyze the school dietitian's cognition, practical use of environment-friendly agricultural products to provide fundamental information for the qualitative improvement in the school food service. The results of the study are as follows: 1. It was clearly recognized that the subsidy for the school food service is generally insufficient, the amount of additional appropriate subsidy for the school food service was different according to type of school and roughly 300~600 won in each of foods needs to be supported. 2. The environmentfriendly agricultural products that were often used in the school food service were vegetables and grains. 3. In the analysis of cognition and problems toward using environment-friendly agricultural products, the dietitians recognized that environment-friendly agricultural products should be appropriately used. A reason that environmentfriendly agricultural products were better than general agricultural products was composed of a use of less additive, good ingredient, and good outer condition. 4. In the analysis of countermeasure on increasing environment-friendly agricultural products in the school meal service, the response to that more additional subsidy was necessary for the school food service. The highest and the most positive effects after using environment-friendly agricultural products were students' health improvement and improvement in parents' satisfaction with the school food service.

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[English]
Appropriate Size and Dish Combination of Nutritional-Balanced Lunch Boxes Delivered to Children Under the Government-Funded Meal Service Program in Korea: Kana Asano, Jihyun Yoon, Borham Yoon; Korean J Community Nutr 2009;14(5):565-575. Published online October 31, 2009

Abstract PDF: The purpose of this study was to propose the appropriate sizes and dish combination for nutritional-balanced lunch boxes delivered to children under the government-funded meal service program in Korea. The study was based on the 3 : 1 : 2 Meal Box Magic, a nutrition education method developed in Japan. A total of 290 lunch menus, comprising of 10 day menus from 29 organizations having delivered lunch boxes to children during summer vacation of 2008, were analyzed and used as the base data for lunch box combination. Dishes of the menus were classified into 6 groups: Rice group, Protein side dish group (including meat, fish, egg, and bean dishes), Vegetable side dish group, Kimchi group (including kimchi and jangajji), Soup, stew group, and the other group. Nutrient analysis was conducted for 100 ml of these dishes by CAN Pro 3.0 utilizing volume and weight conversion data used for analysis of the Korea Health and Nutrition Examination Survey and those from the Nutrient Composition of Food for Consumers. All the possible combinations of 5 dishes, comprising of 3 dishes from Rice group, Protein side dish group, and Kimchi group, respectively, and 2 dishes from Vegetable side dish group, were made using the frequently served dishes from the respective dish group. Nutrient analysis of each combination was conducted based on the assumption that a lunch box was 600 ml and filled up to 80% by dishes using the volume ratio of 3 : 1 : 1.5 : 0.5 for Rice group : Protein side dish group : Vegetable side dish group : Kimchi group. The mean and standard deviation of energy and nutrients of all combinations calculated by weighting the serving frequency of each dish selected for the combinations were 621 +/- 81 kcal for Energy, 22.1 +/- 5.0 g for Protein, 120 +/- 45 mg for Calcium, 4.1 +/- 1.1 mg for Iron, 201 +/- 130microgram RE for Vitamin A, 0.34 +/- 0.10 mg for Thiamin, 0.27 +/- 0.10 mg for Riboflavin, and 24.3 +/- 9.6 mg for Vitamin C. The energy percentages from Carbohydrate, Protein and Fat were 66%, 14% and 20%. The analysis results met the nutrition standard of lunch boxes for male elementary students in grades 4 through 6 under the government-funded meal service program regarding calories, nutrients except calcium and riboflavin, and macronutrient distribution ranges. Accordingly appropriate box sizes were suggested for different age and sex groups to meet the respective nutrition standards. In addition, milk or dairy products were suggested to accompany lunch boxes to supplement calcium and riboflavin intake. The method of selecting box sizes and making dish combination suggested in this study could be useful for the organizations preparing lunch boxes under the government-funded children's meal service program where nutrition professionals are not available.

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[English]
Analysis of the School Foodservice Facilities & Sanitary Education (Seoul, Gyeonggi, Kangwon and Choongchung Areas in Korea): Gyoung Mi Kim, Sim Yeol Lee; Korean J Community Nutr 2009;14(5):576-589. Published online October 31, 2009

Abstract PDF: The purpose of this study was to analyze the status of school foodservice facilities, utilities and equipment & sanitary education in provinces, This study was carried out from September 2008 until December 2008 and is targeted towards schools' dietitians that work at schools with school foodservice. 1,623 schools participated in this research and Kangwondo, Choongchungdo including the metropolitan area with frequent occurrence of food bone disease were the targets of this research. The regional distribution of this research is as follows; 377 schools in Seoul, 648 schools in Gyeonggido, 160 schools in Kangwondo, 438 schools in Choongchungdo equaling 1,623 schools in total. And out of the total 1,623 schools, 815 (50.2%) were elementary schools and 808 (48.8%) were middle and high schools (p<0.001). Most of the elementary schools, excluding 4 schools, were self-operated. In the case with middle and high schools, 81.5% (513 schools) were selfoperated and 18.4% (295 schools) were contracted. When dealing with the sanitation management of school foodservice in Kangwondo and Seoul, elementary schools were less equipped with equipment and facilities than middle and high schools which proved that they were in need of improvements (p<0.01). Schools with self-operated foodservice, in particular, were in need of preparation zone improvements. 52.3%~88.0% of stainless equipment such as utensils, spoons/chopsticks, subsidiary food tray, and food trays were sterilized by dryers. Work tables, vegetable slicers, and mincers were chemically sterilized and plastic materials were sterilized by ultraviolet rays. Data from newspapers, Internet and TV are collected beforehand and then an annual hygiene educations plan for employees are put together. Hygiene education for employees are carried out monthly through oral method.

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[English]
Effects of Body Composition and Nutrients Intake on the Calcaneal Broadband Ultrasound Attenuation in College Students: Eun Joo Jea, Kwang Eui Byoun, Jung Eun Youn, Byung Kook Lee, Hee Seon Kim; Korean J Community Nutr 2009;14(5):590-599. Published online October 31, 2009

Abstract PDF: The purpose of this study was to analyze the relationship of nutritional status measured by the body composition and dietary nutrients intakes with calcaneal broadband ultrasound attenuation in college students. Total of 886 (462 male and 424 female) students who received health examination in May 2007 participated in this research.Participants bone status was measured by a quantitative ultrasound method and t-score was calculated via WHO guideline. For body composition measurements, body fat, height and weight were measured and BMI was calculated. Dietary data were collected by a 24-hour recall method. Based on Asia-Pacific standard of WHO, BMI was divided into 3 groups; UW (BMI<18.5), NW + OW (18.5< or =BMI<25) and Obese group (25< or =BMI). Among male students, 2.4% belong to the UW group, 45.0% to the NW+OW group and 52.6% belong to the obese group, while 10.4% of female students belong to the UW group, 71.9% to the NW + OW group and 17.7% of female students belong to the Obese group. Differences among male and female students were statistically significant (p<0.001). Students with higher BMI showed significantly higher bone health status. Male students did not show any significant differences in nutrients intakes by BMI groups while female students showed the higher intakes of energy, protein, pyridoxin, phosphorus, iron and zinc among NW + OW group than other groups (p < 0.05). The qualitative and quantitative evaluation of diet by BMI groups did not show any significant differences in both male and female students. The result of the multiple regression analyses showed that the body fat and bone status was negatively related while energy intake was positively related with the bone status. These results revealed that bone health status was positively affected by BMI but not by body fat. In conclusion, among those who are at their twenties, the period when the bone density becomes maximized, body fat may negatively affect bone health unlike during other life cycle stages.

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[English]
The Use of Likert Scale in Community Nutrition Research: Analysis of the Articles Published in Korean Journal of Community Nutrition: Si Hyun Ryu, Jihyun Yoon; Korean J Community Nutr 2009;14(5):600-607. Published online October 31, 2009

Abstract PDF: The purpose of this study was to examine if Likert scales had been properly utilized in community nutrition research. A total of 527 research articles published in the 32 issues of Korean Journal of Community Nutrition from the volume 5, issue 1 in 2000 to the volume 10, issue 2 in 2005 were screened and 55 articles were found to have utilized one or more Likert scales for the studies. Therefore, 109 Likert scales used in the 55 studies were reviewed regarding the name, statement and response items, reliability and validity check, and analysis method. The scales were mostly referred as Likert scales (60%) or Likert-type scales (27%). Some scales were found to be referred as Likert scales although they were Likert-type scales when judged based on the information given in the respective articles. However some scales couldn't be judged for the rightness of the names because the information given for the scales in the articles was not enough. About 23% of the scales consisted of items less than 6 or more than 30, and therefore found to be inappropriate. The percentage of the scales listing all the statement items in the articles was only 25%. Most of the scales (85%) included 5 response items, and the rest included 4 (7%), 7 (6%), or 3 (2%). The percentages of the scales including appropriate center and end items were only 2% and 22%, respectively. Less than half of the scales (41%) were found to have been checked for reliability and only one scale was reported to have been checked for validity. In some scales (6%), the responses were scored improperly for analysis. The responses to the scales were frequently found to have been analyzed by parametric statistics such as mean, ANOVA, t-test, and Pearson's correlation, which might be a problem depending on the size and distribution of study samples. In conclusion, there is much room for improvement in the use of Likert scales in community nutrition research.

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