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Volume 11(6); December 2006
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Original Articles
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A Study of the Body Weight Control and Dietary Habits According to the Obese Index in Male Middle School Students
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Shin Mi Son, Eun Sook Park
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Korean J Community Nutr 2006;11(6):683-694. Published online December 31, 2006
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- The purpose of this study was to determine the body weight control, food habits and nutrient intakes according to the obese index in male middle school students. This study was carried out through questionnaires and measurement by body fat analyzer (Inbody 4.0). The subjects were 275 male middle school students in Iksan, Chonbuk province. The average age, height, weight, and BMI of the subjects were 14.4 years old, 167.8 cm, 60.2 kg and 21.3 kg/m2, respectively. Seventeen point one percent of the subjects were the underweight group, 47.6% were the normalweight group, and 35.3% were the overweight group by the classification of the Korean Pediatrics Society standard. Body fat of underweight, normalweight, and overweight were 16.1%, 19.0%, and 26.6%, respectively. Thirty one point nine percent of underweight, 39.7% of normalweight, and 31.9% of overweight had misperceptions of their weight (p<0.001). Sixty two point two percent of the males were dissatisfied with their body weight, and 55.3% of the whole tried to reduce their body weights. Even though they were normalweight, half of them dissatisfied with their weight. The source of weight control method was friends and family, TV.radio, Internet, and school nutrition education, in order. The subjects exercised 3.4 days per week, 70.2 minutes per day, but it was not different significantly by the obese index. Forty percent of the subjects had meals fast, 58.5% of them have biased food habits even if they didn't differ by the obese index. Activity rate was different by the obese index significantly (p<0.05), the number of severe activity was most in underweight. In conclusion, nutrition education programs should contain the necessity of normalweight, and regularity of life habits and activities for energy expenditure in overweight students. It made them to recognize their weight correctly, establish healthy body images, and raise the ability to promote health and improve nutritional status.
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A Study on the Relationship between Time Spent on Lunch and Degree of Obesity,Eating Habits in Culinary College Male Students
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Sookhee Kim
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Korean J Community Nutr 2006;11(6):695-706. Published online December 31, 2006
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- This study was to investigate the relationship between time spent on lunch and degree of obesity, eating habits in culinary college male students. This survey was conducted using questionnaires for 106 male students in a Hongseung-located culinary college. Over 16 minutes of time spent on lunch group had significantly lower body weights, obesity degrees and body mass index (BMI) and tended to have lower body fat % than the other groups. It suggests that shorter time spent on lunch is related with lower body weight, obesity degree and BMI. Those who ate the meal prepared by mother had longer time spent on lunch. The shorter times spent on lunch group recognized their body shape was lean, the longer time spent on lunch group recognized the overweight or obesity significantly. The shorter time spent on lunch group tended to eat the cooked rice in the gug and recognized that they were not healthy. Those who had diseases in the past tended to have shorter time spent on lunch. The more they chewed cooked rice and then longer time spent on lunch they had, they recognized their eating speed was not significantly speedy. The shorter time spent on lunch they had, the fewer fruits and salty foods they ate significantly. This study suggests that more chewing time, slower eating speed and longer time spent on eatmg lunch is very related with lowering weight, BMI, body fat % and obesity degrees, so male college students should be educated to have correct eating habits.
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Moderate Alcohol Consumption Does Not Prevent the Hypertension among Korean: the 2001 Korean National Health and Nutrition Examination Survey
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Young Ok Kim
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Korean J Community Nutr 2006;11(6):707-713. Published online December 31, 2006
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- The purpose of this study was to test whether moderate alcohol consumption has any positive effect on lowering blood pressure among Koreans. Study subjects were Korean adults 20 years or older (n=5,234) who participated in the 2001 Korean National Health and Nutrition Examination Survey (KNHANES). Analysis of variance and analysis of covariance were used to construct univariate and multivariate models relating alcohol consumption to blood pressure for the analysis. After adjustment for possible covariates, drinkers (regardless of drinking level) had significantly higher systolic and diastolic blood pressure, compared with never-drinker for male subjects. Diastolic and systolic blood pressures were also significantly elevated with the drinking frequency and amount of alcohol intake among male subjects. For the female subjects, only diastolic blood pressure was significantly associated with the alcohol consumption at multivariate model, however, low level alcohol consumption did not show any sign of lowing effects on blood pressure. The result implies that moderate alcohol consumption did not have any positive effect on lowering blood pressure among Koreans for either sex.
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Mothers' Perceptions on Preschool Children's Food Preference, Efforts in Improving Food Intake and Their Beliefs in Food Selection
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Young Hye Jeong, Jin Sook Yoon, Dong Yean Park
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Korean J Community Nutr 2006;11(6):714-724. Published online December 31, 2006
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- In an attempt to investigate mothers' perceptions of factors affecting preschool children's food preferences, their policy improving food intake and belief in food selection, in-depth interviews with 30 mothers who had preschool children were conducted in Daegu and Busan. The interviews were tape-recorded and the contents of interviews were analysed by researchers. Most mothers and children liked meats. It was found that children usually disliked vegetables such as onions, carrots, and green onions. Mothers perceived that many factors affected their children's food preferences: mothers' and fathers' food preferences, food offering at meals, mothers' food intake during pregnancy, children's food intake during weaning period, heredity, peer pressure, and advertisements on television. Mothers made efforts to improve childrens food intakes in many ways: change of cooking method, emphasizing function of nutrients and food for health, conciliation and enforcement, and comparison to other children. The most affecting belief for mothers in food selection was family members' food preference. Health, balance in nutrient intake, degree of food processes, food additives, chemicals, convenience, diversity, and economy were also important beliefs to select food. Convenience was especially the primary belief in choosing and preparing children's snacks. Mothers offered frozen dumplings and meat, instant noodles, tuna, and ham for snacks for convenience. These results showed that mothers understood many aspects affecting children's food preference, tried to improve children's food intakes, and had several beliefs in food selection. We concluded that it is necessary to give information for mothers to make healthy snacks in a short time and chance to learn cooking skills.
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An Assessment of Socioeconomic Status and Physical Health Status of the Middle-aged Adults in Gangwha County
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Eun Mi Kim, Yoon jung Choi, Oh Jun Kweon
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Korean J Community Nutr 2006;11(6):725-739. Published online December 31, 2006
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- This is study was performed to assess socioeconomic status and physical health status of middle-aged men (40's~60's) in Ganghwa country. We interviewed 1,267 middle-aged men (602 male, 665 female) by trained interviewers using structured questionnaires including demographic information, general health status, and anthropometric measurements. And all the data were analyzed by chi-square test, Student's t-test and one-way ANOVA using SPSS 12.0 version at p<0.05. These results were that males were higher than females in educational levels (p=0.000) and most of them decreased according to age in educational levels (p=0.000) and family income (p=0.000), and prevalence of chronic diseases (p=0.000): stomach-duodenum disease, fracture, arthritis, or hypertension. They took to the health information on TV and radio and their health managing methods were exercise and walking and resting and diet regulation. Body Mass Index (BMI) was decreased in older males (p=0.024) but increased in older females (p=0.001). In females, obesity prevalence of 40's, 50's and 60's was 31.3%, 49.7% and 48.0%, respectively. Waist circumference was the highest in 50's males (p=0.015), but hip circumference was the highest in 50's females (p=0.015). Waist-hip ratio (WHR) increased in older males (p=0.028) and females (p=0.000). In spite of the subjects were engaged in agriculture and fishery and had desirable lifestyles, obesity rate especially abdominal obesity, was the serious problem. Socioeconomic status, especially education and income were related to SRH (p=0.006, p=0.000), chronic disease (p=0.000) and BMI (p=0.028, p=0.000). Therefore, it is necessary that the public health policy and nutrition education programs to alter lifestyles and to improve health preservation and health promotion in the farming and fishing communities.
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Development of Nutrition Education Materials for Healthy Aging
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Yun Ahn, Kyung A Kim, Hyunjoo Kang, Kyungwon Kim
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Korean J Community Nutr 2006;11(6):740-749. Published online December 31, 2006
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- The objective of this study was to develop nutrition education materials for older adults, 'nutritional management for healthy aging'. A booklet and four leaflets were developed based on lesson plans. Topics of the lesson plans included eating habit assessment, Korean food guide pyramid, meal planning, eating sensibly and weight management. The titles of the leaflets were 'Eating right for healthy aging', 'Eat calcium-rich foods', 'Enjoy fruits & vegetables' and 'Weight management'. Illustrations and icons appropriate to the texts were designed using Illustrator 9.0 and Photoshop 6.0. Booklet (letter size, 5 chapters, 44 pages) and leaflets (B4 size, 6 sections) focused on modifying undesirable eating habits, providing practical tips for desirable behaviors, and behavioral modification such as recording in a food diary, goal setting and increasing self-efficacy. The drafts were pilot-tested by interviews with older adults(n=10), and minor changes were made. The characteristics of revised materials are as follows; i) materials focused on providing desirable eating behaviors for healthy aging, ii) messages were simple and specific, iii) large fonts(13 pt) were used and materials included interesting pictures and illustrations, iv) materials provided tips for balanced diets and recipes for older adults, v) materials included sections for participation of learners including assessment of nutritional risk factors and obesity, meal planning and games. The revised materials are self-explanatory and can be used by older adults and in nutrition education for older adults.
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TQM Performance and Job Satisfaction of Dietitians in Institutional Foodservices
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Ki won Cho, Ji young Yoon
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Korean J Community Nutr 2006;11(6):750-760. Published online December 31, 2006
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- This study was designed to investigate the correlation between perceived TQM performance and job satisfaction of dietitians. The objective of the study is to help the management of foodservice by providing a direction which will elevate perceived TQM performance of dietitians and presenting plans which will ensure effective foodservice management. The survey sample was dietitians (n=308) who were charged with foodservice management. The questionnaires requested information about demographics self-perception of TQM importance and performance levels, and job satisfaction. According to the TQM importance and performance analysis, the level of performance was typically high in TQM items recognized as important by dietitians and low in areas where the recognized level of importance was low. Analysis was conducted on the job satisfaction according to demographic characteristics. The level of satisfaction in terms of salary and promotion increased relatively for those working in the industries and those who were older, married, and full-time employees with longer careers. The lesser the number of working hours, the higher their satisfaction levels were. Canonical correlation analysis between TQM performance and job satisfaction indicated higher canonical correlation (canonical correlations coefficient: 0.59). In conclusion, TQM performance-job satisfaction showed higher canonical correlation. When information exchange via network is made possible and more external customer recognition is gained, it increases the level of job satisfaction. The above results suggest that further research on the scope of TQM performance is thoroughly needed and continual training is necessary for foodservice managers.
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Evaluation of Menus Using Antioxidant-Rich Foods at a Congregate Meal Program for the Korean Elderly
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Seon Joo Park, Hae Jeung Lee, Haymie Choi
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Korean J Community Nutr 2006;11(6):761-770. Published online December 31, 2006
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- The purpose of this study was to plan a 5-day menu using antioxidant-rich foods (vitamin A, vitamin C, vitamin E, phytochemicals) for a congregate meal program for the elderly and to evaluate the satisfaction of menus. The elderly participated in the congregate meal program at Guro Elderly Welfare Facility during October, 2003 (120 persons/day). The elderly liked yungyangbab, cooked rice with sweet potato and pumpkin, soybean paste soup with chinese cabbage, pan-fried cuttlefish patty with chopped soybean sprout, pan-fried beef patty with tofu and ginseng, fresh vegetable salad and most of desserts. The leftovers of menus were negatively correlated with satisfaction of menus. The 5-day menu contained over 1/3 of KDRIs (Dietary Reference Intakes for Koreans) except fiber, calcium, vitamin K and vitamin E. In conclusion, menus using antioxidant-rich foods for a congregate meal program for the elderly will improve nutrient intakes and satisfaction of the meal program. It may help to prevent chronic diseases and improve healthy lives of the Korean elderly.
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Iron Nutritional Status by ALAD Genotype and Intervention Study for Rural Area Residents
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Hee Seon Kim, Min Kyung Kim, Sohee Kim, Sung Soo Lee, Byung Kook Lee
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Korean J Community Nutr 2006;11(6):771-778. Published online December 31, 2006
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- Previous studies have suggested that delta-aminolevulinic acid dehydratase (ALAD) phenotype differently affect mineral metabolism. The objective of this study was to determine the effectiveness of 6-month iron supplementation as syrup of NaFeEDTA in improvement of iron status according to ALAD genotype. One hundred thirty adult women living in rural areas of Asan were provided NaFeEDTA syrup once a week for 6 months at the dose of 64mg Fe/week. Three hundred control subjects were observed during the study period. Fasting blood was obtained for analyzing hemoglobin (Hb) and zinc protophorphyrin (ZPP) and serum was analyzed for ferritin, iron and total iron capacity (TIBC) levels before and after iron supplementation. Ninety percent of ALAD 1-1 (ALAD1) and 10% of ALAD 1-2 (ALAD2) genotype were observed in the control group. However, in the intervention group, 98% showed ALAD1 while only 2% was ALAD2, which is significantly lower proportions of ALAD2 compared to the control group (p<0.01). The iron status of intervention group significantly improved except for ferritin and TIBC regardless of ALAD genotype, while the control group did not show any changes in iron status except for ZPP. ZPP concentration of the control group significantly increased in both ALAD1 and 2 while the intervention group showed significantly decreased ZPP after supplementation in ALAD1. Iron supplementation in the form of NaFeEDTA seems to be effective in reduction of ZPP levels although ALAD2 did not show significant changes due to the small number. However, it is difficult to make a conclusion from these results, and more specified further investigation is needed with more participants.
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Development of Nutrition Screening Index for Hospitalized Patients
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Suan Kim, Soyeon Kim, Cheongmin Sohn
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Korean J Community Nutr 2006;11(6):779-784. Published online December 31, 2006
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- Several studies about hospital malnutrition have been reported that about more than 40% of hospitalized patients are having nutritional risk factors and hospital malnutrition presents a high prevalence. People in a more severe nutritional status ended up with a longer length of hospital stay and higher hospital cost. Nutrition screening tools identify individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutritional support. For the early detection and treatment of malnourished hospital patients, few valid screening instruments for Koreans exist. Therefore, the aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult patients at risk of malnutrition using medical electrical record data. Two hundred and one patients of the university affiliated medical center were assessed on nutritional status and classified as well nourished, moderately or severely malnourished by a Patient-Generated subjective global assessment (PG-SGA) being chosen as the 'gold standard' for defining malnutrition. The combination of nutrition screening questions with the highest sensitivity and specificity at prediction PG-SGA was termed the nutrition screening index (NSI). Odd ratio, and binary logistic regression were used to predict the best nutritional status predictors. Based on regression coefficient score, albumin less than 3.5 g/dl, body mass index (BMI) less than 18.5 kg/m2, total lymphocyte count less than 900 and age over 65 were determined as the best set of NSI. By using best nutritional predictors receiver operating characteristic curve with the area under the curve, sensitivity and 1-specificity were analyzed to determine the best optimal cut-off point to decide normal or abnormal in nutritional status. Therefore simple and beneficial NSI was developed for identifying patients with severe malnutrition. Using NSI, nutritional information of the severe malnutrition patient should be shared with physicians and they should be cared for by clinical dietitians to improve their nutritional status.
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A Study on Nutritional Status after Gastrectomy of Gastric Cancer Patients in Jeonbuk Province
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Mi Jin Jeong, Chan Young Kim, Sook Bae Kim
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Korean J Community Nutr 2006;11(6):785-792. Published online December 31, 2006
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- The purpose of this study was to investigate the nutritional status before and after gastrectomy of gastric cancer patients in Jeonbuk Province. The subjects were 136 patients with gastrectomy of gastric cancer. We assessed the nutritional status before and after an operation by general characteristics (age, clinicopathological stage, type of operation, method of reconstruction), anthropometric characteristics (height, weight, skeletal muscle mass, body fat mass, body mass index (BMI), percent body fat, arm muscle circumference AMC, arm circumference AC) and biochemical characteristics (hemoglobin Hb, hematocrit Hct, mean corpuscular volume MCV, mean corpuscular hemoglobin MCH, total lymphocyte count TLC, serum albumin, serum transferrin). Mean ages were 60.0 yrs in males and 58.8 yrs in females. Age, clinicopathological stage, types of operation and reconstruction methods were not significantly different between males and females. Weight, skeletal muscle mass, body fat mass, BMI, percent body fat, AMC and AC significantly deteriorated by gastrectomy. There were severe weight losses in males and females after gastrectomy. Hemoglobin, Hct, MCV, MCH, TLC, albumin and transferrin significantly deteriorated by gastrectomy. After gastrectomy, subjects who were assessed as malnounrished in Hb and Hct were increased in male and those who were assessed as malnounrished in Hb were increased in females. These results suggest that a nutrition intervention, specially for energy, protein and iron, is necessary to improve the nutritional status of gastric cancer patients with gastrectomy.
Randomized Controlled Trial
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The Effect of 6 Month Alphacalcidol Treatment or Nutrition Education on the Nutrient Intakes, Bone Mineral Density and Bone Markers in Continuous Ambulatory Peritoneal Dialysis Patients
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Sook Mee Son, Jin Kyung Park
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Korean J Community Nutr 2006;11(6):793-807. Published online December 31, 2006
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- This study was performed to estimate the effect of alphacalcidol supplementation or nutrition education on the nutrient intakes, bone mineral density and bone markers in continuous ambulatory peritoneal dialysis (CAPD) patients. The 90 CAPD subjects were randomly assigned to 3 groups (alphacalcidol group: AG, nutrition education group: NG, and control group: CG). Alphacalcidol supplementation(0.5 microgram/day) was carried out for 8 months. Nutrition counseling was performed according to the patient's individual question for the first 6 months and scheduled nutrition education with individual counseling was carried out for the last 2 months. In baseline data, there were no significant differences in age, sex, family number, education years and monthly income except the NG showed significantly less duration of CAPD (p <0.05) compared to other two groups. After intervention all three groups showed tendency of lower intakes. NG revealed less decrease in protein, especially in animal protein, calcium from Ca-P binder, dietary calcium, dietary iron and niacin. NG showed significantly more increase in dry weight (p <0.05) and AG in waist circumference (p <0.001) after intervention. The groups did not show significant differences in the changes of biochemical indices related to bone metabolism. NG revealed more increase in trochanter BMD (p <0.05) compared to other two groups. It seems that nutrition education is more effective in preventing deterioration or improving the bone and general nutrition status.
Original Article
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Estimated Iron Intakes from Simulated Fortification to Selected Grain Products in the Korea Food Supply
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Hae Rang Chung, Min Ji Hong, Rafael Perez Escamilla, Se Young Oh
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Korean J Community Nutr 2006;11(6):808-813. Published online December 31, 2006
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- Until now, South Korea does not have either fortification or enrichment program as intervention tools, although the addition of micronutrients to foods is for the most part not regulated. The aim of this study was to determine which scenario would most effectively reduce the proportion of the population with low iron intake while not putting other population groups at risk of excessive intakes. In order to investigate potential dietary consequences of iron fortification, we analyzed 2 day dietary record data (n=3,955) from the 2001 National Nutrition Surveys. The Proportion of the population consuming dietary iron less than the estimated average requirement (EAR) ranged from 12.4~87.5% depending upon gender and age group. Iron fortification at the level of 100% of Recommended Intake (RI) per 100g to breads and instant or dried noodles was estimated to result in a 15% decrease of proportion of those with iron less than EAR, while putting 1.4 % of the population greater than the Upper Limit (UL). Iron fortification appeared to be the most effective for the 15~19 year old age group, showing 39% reduction of iron intake insufficiency. The results suggest that carefully designed fortification or enrichment to staple foods may contribute to increase dietary iron intakes of Koreans, especially for the young population with a high prevalence of iron inadequacy. As the estimation in this study was based solely upon dietary intake data, iron intake from supplements should be considered in further studies.