Korean Journal of Community Nutrition

Volume 3(5); November 1998

Original Articles

[English]
The Longitudinal Study of Diet and Sexual Maturity as a Determinant of Obesity for Adolescents: Young Ok Kim, yoon Sun Choi; Korean J Community Nutr 1998;3(5):679-684. Published online November 30, 1998

Abstract PDF: This study was conducted to investigate the determinants of obesity during adolescnece. A total of 726 adolescents living in rural areas in Korea had been observed for four years from 1992 to 1996 regarding their diet, sexual maturity, blood profile and physical growth. Stepwise multiple regression analysis was used to identify priorities fo the importance between the factors influencing obesity. The average nutrient intake over the three year period was higher than that of the Korean Recommended Dietary Allowances. The prevalence of obesity for the subjects based on BMI was 9.5%. Results of the stepwise multiple regression analysis showed that blood components and sexual maturity were more significant factors for determining the obesity than the dietary factors. The result may suggest that to understand obesity in children it is necessary to develop on analytical model for the children rather than using the existing analytical model developed mostly for adult patients of obesity. The model should include a wide range of variables such as diet, sexual maturity and changes in blood.

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[English]
Changes of Plasma Cardiovascular Disease Risk Factors according to the Health Practice and Dietary Habits in Healthy Male University Studnets: Kyeong Sook yim; Korean J Community Nutr 1998;3(5):685-694. Published online November 30, 1998

Abstract PDF: This cross-sectional study was conducted to describe the changes of plasma cardiovascular disease(CVD) risk factors in Korea. Overnight fasting plasma levels of total cholesterol, high density lipoprotein(HDL)-cholesterol, triacylglycerol and glucose were analyzed. Blood pressure and anthropometric data were also measured. Health practice factors such as smoking status, alcohol consumption and frequency fo exercise were evaluated by a self-administered questionnaire. Questions regarding dietary habits and food preferences were also asked. Seventy eight percent of the subjects had more than one CVD risk factor. Plasma total cholesterol, triacylglycerol, and fasting blood glucose were significantly increased according to the subjects body mass index(kg/m2, BMI), whereas HDL-cholesterol, low density lipoprotein(LDL)-cholesterol and blood pressure showed no significant differences with BMI. Current smokers had significantly high plasma total cholesterol, LDL-cholesterol and triacylglycerol levels. Alcohol consumption significantly increased plasma total cholesterol and fasting blood sugar, but regular exercise had no effects on the plasma CVD risk factors. Overeating and frequency of fast food consumption were positively correlated with the CVD risk score, whereas intake of grains, meats and vegetables were negatively correlated with that score. A stepwise multiple regression analysis was performed to examine the effects of specific dietary factors on plasma lipid levels. For plasma total cholesterol level, the frequency of fast food intake explained 8% of the variance, followed by habitual overeating, frequency of grain intake and high cholesterol food intake(Model R2=22.4%). For plasma triacylglycerol level, preference of oily foods accounted for 7.5% of the variance, followed by eating breakfast, preference of fruit and frequency of grain intake(Model R2=22.0%). The findings suggest that intervention programs to reduce the risk of CVD should focus on health practice through reducing BMI, smoking cessation and moderate or no alcohol drinking. Moreover, desirable dietary habits such as eating breakfast, not overeating and reduced intake of fast food may improve CVD risk.

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[English]
The Associations of Percent Body Fat with Dietary Intake, Plasma Lipids, Lipoprotein(a), and PAI-1 in Middle Aged Korean Adults: Jean Chinock Kim Rim, Soon Ah Kang, Hiojung Wee; Korean J Community Nutr 1998;3(5):695-706. Published online November 30, 1998

Abstract PDF: This study was designed to investigate the associations of the percent body fat dietary intake, plasma lipoprotein profile, lipoprotein(a), and plasminogen activator inhibitor-1(PAI-1) concentrations of 1982 Korean subjects(men : 1000 and women : 982) between the ages of 40 and 59 years. The dietary assessment consisted of twenty-four hour dietary records and food frequency questionnaires. The subjects were identified into one of the five rating groups of % body fat : lean, underweight, normal, overweight and obese groups. The biochemical assessment included measurements of plasma total cholesterol(TC), HDL-cholesterol(HDL-C), LDL-cholesterol(LDL-C), triglyceride(TG), lipoprotin(a)(Lp(a)), and PAI-1. With respect to the ratio of percent energy intake of carbohydrate : protein : fat of the normal group of the women was 62% : 17% : 20%, respectively. Women apparently had a higher intake of carbohydrates than men(52% : 17 : 20%) did. There was a linear relationship between energy intake and % body fat in both mean and women(with the exception of the underweight group of women). The relationship of % body fat of men to the protein and fat intake was higher than that of the carbohydrate intake. Of the men in the study, intakes of energy, protein and alcohol were positively correlated to % body fat. In women, energy, carbohydrate and protein intake were positively correlated to % body fat, however, the fat, cholesterol and alcohol intake did not show any correlation to the % body fat in women. This study showed that % body fat was positively correlated with plasma TC, LDL-C, PAI-1 levels, and TG, but the % body fat was negatively correlated with plasma HDL-C level in both men and women. These results indicated that the high energy intake of obese or overweight subjects might contribute to several of the biochemical indices fo coronary heart disease(CHD) risk. In conclusion, increased energy intake is associated with overweight or obesity in middle aged Korean people. There was no relationship between % energy intake of fat and % body fat in the study, in middle-aged Korean men and women. The plasma lipid profile and PAI-1 level thought to be the risk factors of CHD were positively associated with percent body fat in middle aged Korean people.

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[English]
Nutritional and Health Status of Korean Elderly Living in America: Hye Kyung Kim; Korean J Community Nutr 1998;3(5):707-714. Published online November 30, 1998

Abstract PDF: This cross-sectional study was designed to describe in nutritional and health status of the Korean elderly residing in America using demographic variables, dietary, anthropometric and functional status indicators, and to investigate possible relationships among these variables. Sixty elderly persons aged 61-91 years were assessed in their homes. Dietary intake was estimated by the 24-hour recall and brief dietary questionnaire. The following anthropometric measures were taken : weight, height, knee height, triceps skinfold, and midarm circumference. Functional status was measured by activities of daily living(ADLs), instrumental activities of daily living(IADLs) questionnaires, and a measure of psychosocial status as "happiness score"(a life satisfaction questionnaire). Intakes of energy, calcium, magnesium, folacin, vitamin B6, and zinc were low in this elderly sample. Females 75 years of age and older had extremely low energy intakes. A large percentage of subjects reported difficulty with both activities of daily living and instrumental activities of daily living. Subjects over 75 years of age reported more difficulty than younger subjects for most activities. Gender differnces were seen in anthropometric variables and energy intake. Happiness scores were similar in subjects, regardless of age or gender, however, happiness score was significantly correlated with the energy and protein intake(p<0.05). Several difficulties were encountered during the assessment of this elderly sample. The conditions in the home were unpredictable and often inadequate for the anthropometric measures in particular. Further research is needed to improve current methodologies so that they may be more adaptable to the conditions found in homes.

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[English]
The Effect of Milk Supplementation on Bone Density and Iron Status of Elderly: Sook mee Son, Yeh Na Chon; Korean J Community Nutr 1998;3(5):715-721. Published online November 30, 1998

Abstract PDF: This study was performed to investigate how milk supplementation can benefit the elderly by increasing bone density but possibly harming the iron status concomitantly. Forty one elderly subjects over 65 years of age(male : 9, female : 32) participated. All subjects were apparently healthy, home staying and attending meal service for lunch at the welfare center. They were from low income area of Puchon city. One cup of milk per day was served for 10 months. The mean intake of calcium was significantly increased for females after milk supplementation. Males showed significantly increased means of triceps skinfold thickness, suprailiac skinfold thickness and waist circumference. Females showed significantly increased measurements fo three kinds of skinfold thickness, waist circumference, and hip circumference. There were no significant change in the mean bone density of lumbar spine(L2~L4), femoral neck, ward's triangle and torchanter, but the proportion of osteopenia estimated by the T score of lumbar spine bone density was lowered from 50.0% to 34.6% for females. The mean Hb level was significantly for males. The proportion of anemia estimated by Hb(<12g/dl), Hct(<36%) and serum ferritin(<15mg/ml) were increased from 17.2% to 51.7%, from 20.7% to 44.8% and from 10.3% to 17.2%, respectively for females. It looks like milk supplementation can effect the intakes of several nutrients considered to be commonly deficient in the Korean diet fo elderly people, increase some anthropometric measurements, and decrease the proportion of osteopenia. However it can have adverse effects on iron status of females.

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[English]
A Study on Dietary Patterns, Dietary Behaviors and Life Styles before and after Breast Cancer Surgery: Kyung Ja Chang, Sei Hyun Ahn; Korean J Community Nutr 1998;3(5):722-728. Published online November 30, 1998

Abstract PDF: The purpose of this study was to compare dietary patterns, dietary behaviors and life styles before and after breast cancer surgery in Korea. The subjects were 220 females who underwent surgery for stage I-III breast cancer at general hospitals. Food intake, eating habits, snacks, eating-out, use of nutritional supplements and healthy foods, and drinking and smoking habits were studied using a questionnaire. SAS program was used for statistical analysis of the data. The results are as follows : 1) Most subjects were housewives aged more than 40 years. 2) After breast cancer surgery, intakes of fruits and vegetables were increased and those of meat, salty and spicy foods were decreased. 3) There was a significant difference in takes of caffeine beverages, snacks, fast foods and instant foods before and after breast cancer surgery. 4) There was a significant difference in meal regularity and skipping breakfast before and after breast cancer surgery. 5) The frequency of eating-out was decreased and low-fat foods, such as Japanese foods, were preferred after breast cancer surgery. 6) Nutritional supplements and natural healthy foods were used more after breast cancer surgery. 7) Most subjects were non-smokers and drank little alcohol and the rate of regular drinking significantly decreased after breast cancer surgery. Therefore, there was a significant difference in dietary patterns and behaviors resulting form breast cancer. Further more, dietary factors may be a contributing factor in the incidence at breast cancer in Korea.

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[English]
Evaluation and Categorization of Commercially Prepared Enteral Nutrition Formulas: Dong yeon Kim, Hee Jae Suh; Korean J Community Nutr 1998;3(5):729-738. Published online November 30, 1998

Abstract PDF: In order to investigate the types of enteral nutrition formulas currently used in hospitals and evaluate and categorize the commercially prepared enteral nutrition formulas formulas available in the domestic market, we asked dietitians working in 6 hospitals in Seoul to complete the questionnaire and obtained compositional characteristics of 12 commercially prepared enteral nutrition formulas. The average proportion of patients receiving the commercially prepared enteral nutrition formulas(60.6%) was greater than that of patients receiving the in-hospital preparations(31.9%). In the group of patients receiving the in-hospital prepared formulas, the enteral feeding was mainly administered orally, whereas, in the group of patients receiving the commercially prepared formulas, tube feeding was the primary route of formula administration. In both groups, however, a greater proportion of patients received the formulas as total replacements of their meals and for the purpose of dietary supplementation. On the basis of major criteria for evaluation of the commercially prepared enteral nutrition formulas, the 6 products out of the 9 nutritionally complete products formulated for the purpose of dietary supplementation were grouped into the same category(standard protein, caloric density of 1kcal/ml, and tube/oral), so they were considered therapeutically comparable. However, the remaining 3 products were different in protein content(high protein) or route of administration(tube only). Of the 3 nutritonally complete products formulated specifically for the purpose of dietary therapy, 2 products were formulated for patients with renal disease, and the one product was formulated for diabetic patients. Therefore, the data in this study showed that the commercially prepared enteral nutriton formulas became an important part of the enteral nutrition for hospitalized patients in Korea, but the domestic market has not yet generated a wide variety of the formulas, not providing many choices for clinicians to manage the diets for their patients. The results of this study would be helpful for clinicians in choosing appropriate products for their patients, for manufactures in developing new products, and for regulatory authorities to establish the regulation for the broad group fo heterogeneous products that are marketed and will be developed as medical foods. In addition, the process of maintaining the categories for evaluation of the commercially prepared enteral nutrition formulas should be dynamic because new products may not reasonably fit any of the existing categories.

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[English]
A Comparison of the Dietary Habit and Nutrient Intakes of Korean Farmers according to Different Family Patterns and Farming Types: Seung Gyo Rhie, Yaungja Park; Korean J Community Nutr 1998;3(5):739-747. Published online November 30, 1998

Abstract PDF: The purpose of this study was to compare the dietary habit and nutrient intakes of Korean farmers according to their different family patterns and farming types. Food and nutrient intakes were obtained by food frequency method. The subjects(male 35%, female 65% : mean age, 48+/-11 years) were compared 46% of nuclear family, 59% of 3-4 person of family size ; 50% of middle-scale farming ; 54% of rice farming. Sixteen percent were over 60 years old group. In aspects of dietary habit, farmers of medium size farming and 10-20 years of farming experience frequently skipped meals. But their appetite was better than small farm famers. Dinner irregularity was more frequent in their group of 3-4 person families. The numbers of food intake were significantly different according to family pattern. Nuclear family groups consumed more kinds of foods. The mean energy intake was 2000Kcal/day, with PFC ratio of 19 : 16 : 65. The energy and nutrient intakes showed the same tendency as the food variety. Intakes of calcium and iron were lower than the Korean RDA. Families with over 5 people consumed higher amounts of protein and minerals. Intakes of thiamin, niacin, and vitamin E were better in large families and large-scale farming groups. As compared with the PMS ratio, the level of monounsaturated fatty acids as higher than saturated FA. The lipid intake was also better in large families and large-scale farming. The results suggest that dietary habit and nutrient intakes were different by family pattern and farming types.

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[English]
The Changes and Suggestions in Korean Dietary Guideline: Young Nam Lee, Eul Sang Kim; Korean J Community Nutr 1998;3(5):748-758. Published online November 30, 1998

Abstract PDF: The Recommended Dietary Allowances(RDAs, Nutrient standards), dietary guidelines, and food guides, each define aspects for a healthy diet in different ways. The RDA and food guide for Koreans were first established in 1962 by the Food and Nutrition Committee of the Korea FAO Association. The committee released the RDA and suggested ways to intake the recommended nutrients. Every five years, the committee has added more data and released revisions. The latest edition of the RDA is the 6th revision. In the beginning, the concept of basic food groups was emphasized as basic data for planning means based on RDA. In the 5th revision, the basic food groups and dietary guideline for public health from the Ministry of Health and Welfairs(December, 1990) suggests that, 1) Eat a variety of foods with a recommended fat intake equaling or less than 20% of total calories ; 2) Maintain ideal body weight and prevent obesity ; 3) Eat foods low in salt. Salt intake should not exceed 10g ; 4) Do not drink too much ; 5) Eat regularly and enjoy meals. After these guidelines were established, the first nutritonal education efforts guidelines were developed in 1984. Despite broad possibilities for application, they had limited use, mainly as a nutritional assessment and food balance sheet preparation. They were not well utilized in public nutritional education and nutritonal policy through the media because of the weakness of the government's food and nutriton policy. Also a lack of administrative support and dietitians in the health department and administrative organizations was partly to blame. In regard to public health and nutrition status, life expectancy has increased 10 years since the 70's and the elderly population increased threefold in 1995 compared to 1960. The common causes of death in 1996 by 19 Chapters classification, were first disease of the circulatory system ; the second, neoplasms ; the third, external causes fo mortality ; the forth, diseases of the digestive system ; and the fifth, respiratory system diseases, In food intake, grain and complex starch intake has decreased while fruit and animal foods have considerably increased. Therefore, energy from carbohydrates has decreased while energy from protein and fat has increased. Energy intakes from protein, fat and carbohydrates were respectively 12.5, 7.2 and 80.3% in 1969 but 16.1, 19.1 and 64.8% in 1995. 62.9% of the householes had the fat energy less than 20%, while 37.1% had the fat energy above 20%. The only intakes of vitamin A and calcium were below RDA levles. Therefore, nationwide attention should be focused on public nutriton education and public activities with supplementation of the RDAs, according to the food guide and the dietary guideline.

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