Korean Journal of Community Nutrition

[English]
Dietary Behavior Factors for Desirable Nutrient Intakes of the Oldest-old Population in Sunchang County: Mee Sook Lee; Korean J Community Nutr 2009;14(6):699-709. Published online December 31, 2009

Abstract PDF: In order to identify valuable factors for improving dietary quality of Korean rural elderly, the consumption frequency of food groups, dietary habits and health behaviors related to nutrient intakes of the elderly over 85 of Sunchang County were studied. The 171 subjects (61 males and 110 females) were chosen from Sunchang Province by stratified sampling. Among food groups, the consumption frequency of meat and fish groups influenced significantly on their nutrient intakes than the other groups. The subjects consuming more than 4 times per week of meat or fish had significantly higher nutrient intakes level than the other groups. The group consuming milk and milk products everday was higher in vitamin B2 intake level than the other groups. Among dietary habits, the groups with good appetite and regular mealtime compared with the groups with low appetite and irregular mealtime had significantly higher nutrient intake levels. The family type was the determining factor of nutrient intakes. The subjects living with family members consumed higher nutrient intakes than the subjects living alone. The smoking and the alcohol consumption themselves did not affect nutrient intakes, but the subjects having alcohol consumption frequently more than once a day had lower nutrient intakes than the others. The group with dentures did not differ significantly from the without denture group in nutrient intakes; however, those who had chewing problems showed the lower nutrient intakes compared to those who did not have chewing problems. The subjects with more than two kinds of clinical symptoms had lower nutrient intakes than the subjects with less than two kinds of clinical symptoms. These results indicate that the identifying factors for desirable nutrient intakes of rural elderly were characterized as appropriate consumption frequencies of meat and fish, good appetite, living with family, regular mealtime, chewing without difficulty, and low incidence of chronic disease.

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[English]
Study of Food Intakes and Eating Patterns among Preschool Children in Daegu Area: Nutrient Intakes and Dietary Habits Associated with Body Weight Status: Ju Young Seo, In Sook Lee, Bong Soon Choi; Korean J Community Nutr 2009;14(6):710-721. Published online December 31, 2009

Abstract PDF: This study was conducted to investigate the body weight status (by WLI: Weight-Length Index) and dietary habits and to assess the nutritional status among preschool children in the Daegu area. Dietary habits including dietary attitude and behavior were investigated using questionnaire answered by mothers of 680 subjects aged 4 to 6 years old (508 completed). Also, dietary intake survey using 24-hour recall method was performed by mothers of the children. According to WLI, the underweight, normal, overweight and obesity level of subjects were 9.1, 62.0, 19.5, and 9.4%, respectively. As well, the number of girls was higher than boys in underweight, overweight, and obese group. There were significantly different on overeating, eating fast, and preferring eating-out by body weight status, and overweight group got higher score than underweight or normal-weight group (p < 0.01, p < 0.001). As well, there was significantly different on not moving around during mealtime by body weight status, and underweight group have lower score than obese group (p < 0.001). From the 24-hour recall survey, it was found that intakes of all the nutrients were higher than the %KDRI except energy, calcium and folate. The energy intake of underweight group of 4~5-year old (1338.2 kcal) and 6-year old was lower than Koreans %DRI for those age group. Folate and dietary fiber intakes of obese group were significantly lower than underweight (p < 0.01, p < 0.05). For 4~5-year old, vitamin B(6) intakes of obese group were significantly higher than obese group (p < 0.05). For 6-year old, obese group showed that intake of vitamin B(1) was significantly higher than the other three groups, and intake of vitamin B(1) of overweight group was significantly higher than the other three groups. Taken together, these results indicate that there were significant differences in the nutrient intake level and dietary habits of preschool children by body weight status in Daegu area. Therefore, parents (family) and caregivers should be aware of the prevalence of obesity and nutritional status of preschool children, and start nutrition education as soon as possible.

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[English]
A Comparison of Cluster and Factor Analysis to Derive Dietary Patterns in Korean Adults Using Data from the 2005 Korea National Health and Nutrition Examination Survey: Yoon Ju Song, Hee Young Paik, Hyojee Joung; Korean J Community Nutr 2009;14(6):722-733. Published online December 31, 2009

Abstract PDF: The purpose of this study was to explore dietary patterns and compare dietary patterns using cluster and factor analysis in Korean adults. This study analyzed data of 4,182 adult populations who aged 30 and more and had all of socio-demographic, anthropometric, and dietary data from 2005 Korean Health and Nutrition Examination Survey. Socio-demographic data was assessed by questionnaire and dietary data from 24-hour recall method was used. For cluster analysis, the percent of energy intake from each food group was used and 4 patterns were identified: "traditional", "bread, fruit & vegetable, milk", "noodle & egg", and "meat, fish, alcohol". The "traditional" pattern group was more likely to be old, less educated, living in a rural area and had higher percentage of energy intake from carbohydrates than other pattern groups. "Meat, fish, alcohol" group was more likely to be male and higher percentage of energy intake from fat. For factor analysis, mean amount of each food group was used and also 4 patterns were identified; "traditional", "modified", "bread, fruit, milk", and "noodle, egg, mushroom". People who showed higher factor score of "traditional" pattern were more likely to be elderly, less educated, and living in a rural area and higher proportion of energy intake from carbohydrates. In conclusion, three dietary patterns defined by cluster and factor analysis separately were similar and all dietary patterns were affected by socio-demographic factors and nutrient profile.

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[English]
Evaluation of Nutrition Education for Diabetes Mellitus Management of Older Adults: Hyun Joo Kang, Eun Mi Shin, Kyung Won Kim; Korean J Community Nutr 2009;14(6):734-745. Published online December 31, 2009

Abstract PDF: Diabetes mellitus is the prevalent disease among older adults. The purpose of this study was to implement and evaluate the nutrition education program for diabetes mellitus patients aged 60 and over. The one group pretest and posttest design was employed to evaluate the program effectiveness. Nutrition education program for diabetes mellitus patients was carried out at the public healthy center in Guri city. The 38 out of 63 patients completed education program. They received four sessions of group education during four weeks. Nutrition education materials (booklet, leaflet) for older adults were provided to participants. Data about blood glucose, blood pressure, nutrition and diabetes mellitus knowledge, dietary behavior, dietary intake by 24-hour recalls were collected before and after nutrition education to evaluate the program effectiveness. All data were statistically analyzed using SAS package (ver.8.2) and significant difference was evaluated by chi-square-test, paired t-test and Wilcoxon signed rank test. Study results showed that blood pressure and blood glucose were slightly decreased after nutrition education but they did not reach statistical significance. There were positive changes in nutrition knowledge and dietary behavior. The total score of nutrition and diabetes knowledge increased significantly (p < 0.001), and the total score of dietary behavior was improved (p < 0.05) after nutrition education. Dietary intakes of most of nutrients examined were not significantly different between preand post-test. Based on study results, it appears that nutrition education program for the aged diabetes mellitus patients might effectively increase nutrition knowledge, dietary behavior and diet quality. This nutrition education program can be used at the public health centers or senior centers for the management of diabetes mellitus for older adults.

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[English]
Development and Evaluation of a Nutrition Education Program on Sodium Reduction in Elementary School Students: Yun Young Jung, Eun Kyung Shin, Hye Jin Lee, Nan Hee Lee, Byung Yeol Chun, Moon Young Ann, Yeon Kyung Lee; Korean J Community Nutr 2009;14(6):746-755. Published online December 31, 2009

Abstract PDF: This study was to develop and evaluate a nutrition education program to reduce dietary sodium. The school children (218 boys, 226 girls), from 8 elementary schools in the city of Daegu, Korea, were involved in this study. This research was based on the data from two groups of elementary school children, the "education" group (n = 240), and "no-education" group (n = 204). Educational media and programs were developed to educate the education group for four weeks and were presented on the web (www.saltdown.com). After education, the preference for a non-salty taste in the education group increased 10%, compared with those who preferred a non-salty taste before education. There was a significant change away from a preference for a salty taste and a rise in the mean score for nutrition knowledge and dietary attitude in the education group compared to the no-education group (p < 0.05). This study indicates that school children can reduce their dependency on preference for a salty taste and change their high-salt dietary behavior after the education.

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[English]
Effects of Weight Control Program on Nutrient Intakes and Physical Fitness in Obese Korean Adult Women: Eun Ju Lee; Korean J Community Nutr 2009;14(6):756-766. Published online December 31, 2009

Abstract PDF: This study was conducted to investigate the effects of weight control program on nutrient intakes and physical fitness of Korean obese adult women. The subjects of this study were 33 obese adult women aged 30-65 years residing in Seoul. The weight control program for obese women included nutrition education, cognitive behavioral therapy and exercise for 12 weeks. There were significant decrease (p < 0.001) of blood pressure and atherogenic index of obese women after the weight control program. Energy intake was significantly decreased (p < 0.001) from 1556.9kcal to 1044.9kcal after 12 weeks of the weight control program. Also protein, fat and carbohydrate intakes were significantly decreased. The ratio of energy intakes per day for the subjects was carbohydrate 64% : protein 16% : fat 20%. The frequency of vegetables intakes was significantly increased (p < 0.05) and there were no significant differences in other food groups. After the weight control program, muscle endurance, flexibility, balance and explosive muscular strength of subject's physical fitness were significantly improved. These results suggest that the weight control program for obese women may contribute to nutrient intakes reduction and improvement of physical fitness.

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[English]
The Effect of Nutrition Plus Program among 0~5 Year Children in the Yeojoo Area: The Improvement in Nutritional Status of Children after Nutrition Supplement of Children and Nutrition Education in Parents/Guardians: Ok Jin Park, Min June Lee, Ji Hyang Kim, Sung Hee Min, Hyun Sook Lee; Korean J Community Nutr 2009;14(6):767-776. Published online December 31, 2009

Abstract PDF: This study evaluated the effect of nutritional improvement of 0~5 year children of financially poor families after nutrition supplement of children and nutrition education in parents/guardians. The subject selected among applicants for lowincome family financing of the government included 198 children (0~12 months:92, 1~5 years:106), and the average ages were 5.3 months and 2.4 years respectively. Food that includes each nutrient factor was provided to the subject for six months. Nutrition education was performed in two ways, through class and private education, once a month for both. Nutritional improvement was evaluated by body measurement and anemia prevalence rate. As to the survey on breastfeeding, complete breast-feeding accounted for 58.7%, weaning food 27.3%, and combined feeding 14.1% respectively, which shows that breast-feeding accounted for the largest percentage. The education program improved knowledge and attitude of the parents/guardians, which brings in positive effects on growth of children as well. The nutrition knowledge score was improved after nutrition education in 0~12 month children (8.5 +/- 1.75 to 8.9 +/- 1.69) and 1~5 year children (7.3 +/- 1.39 to 7.8 +/- 1.30). The nutrition attitude score was significantly improved in 0~12month children (52.0 +/- 6.99 to 53.5 +/- 5.21, p < 0.001) and 1~5year children (45.1 +/- 7.30 to 49.0 +/- 5.96, p < 0.001). In evaluation on nutritional improvement based on body measurements, it turned out that the wasting was reduced as for children in consideration of the height and weight according to the subject's age. The concentration of hemoglobin after the nutrient treatment for six months was significantly improved, and the anemia prevalence rate as well was reduced from 40.6% to 13.5%, which indicates the significant improvement. Based on the findings above, it turned out that providing quality food to children and nutrition education to the parents/guardians poorly fed in low-income families improved knowledge and attitude of the guardians and prevents anemia and improves growth, which brings in positive effects on growth of children. In the results regarding attitude and knowledge on nutrient/dietary life; however, the improvement level was relatively low when the extent before the education was too small, which indicates the need to revise and complement the contents and methods. In addition, as shown in the result of body measurement, long-term and consistent investigation is necessary since it is difficult to judge the effect on growth only based on short-term nutrient supplement.

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[English]
Assessment of Physical Activity, Activity Coefficient of Preschool Children and Actual Condition of Daycare Center Outdoor Play: Jae Hee Kim, Eun Kyung Kim; Korean J Community Nutr 2009;14(6):777-788. Published online December 31, 2009

Abstract PDF: The purpose of this study was to assess physical activities and activity coefficient of preschool children and was to give some concrete information to activate outdoor play and to probe the suggestions to activate outdoor play. 42 preschool children (17 boys and 25 girls) were included. Body weight and height were measured and one-day activity diaries were collected by interviewing with their parents and kindergarten teachers. To measure physical activity during outdoor play, this study was researched the current conditions and content of outdoor play activity in daycare centers, and teacher's perceptions of that outdoor play. The average age of the subjects was 5.0 years. Average height, weight, body fat and body muscle of subjects were 108.9 cm, 18.9 kg, 17.7% and 26.8%, respectively. The subjects spent about 10 hours 39 minutes sleeping; 4 hours 16 minutes personal hygiene and computer working. They spent 88.2% of 24 hours (one day) in "very light activities" and 11.3% in "light activities". Activity coefficient (1.34) of weekday was significantly higher than that of weekend (1.21). And in this study, it was found that most of daycare centers (87.7%) have outdoor play space, 95.2% of them were garden. The teachers recognized that have a outdoor play frequency everyday (48%), three or four times (46%) in a week but they have three or four times (38%), one or two times (30%) because of various indoor program. Also, they recognized that have a outdoor play expending time 21- 30 minutes (48%), 31-40 minutes (26%) but they have 21-30 minutes (64%). They answered that have frequency and expending time less than their recognition of outdoor play. Most of daycare center teachers perceived outdoor play to be as important as indoor play, and the teachers believed outdoor play supports children's physical, cognitive, social, and language development. The results of this study may be used to utilize as a basic data for estimate physical activity for preschool children and developed that exercise program to increase physical activity of daycare center outdoor play.

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[English]
Effects of Frequent Eating-out and Breakfast Skipping on Body Mass Index and Nutrients Intake of Working Male Adults: Analysis of 2001 Korea National Health and Nutrition Survey Data: Joung Won Lee; Korean J Community Nutr 2009;14(6):789-797. Published online December 31, 2009

Abstract PDF: In order to investigate the effects of frequent eating-out and breakfast skipping of working men on body mass index and nutrients intake status, working male adults aged 20 or over were selected (n = 1883) from the data of 2001 Korea national health and nutrition survey. The subjects were divided into 4 groups according to the eating-out frequency(high: once or more daily, low: less than once daily) and breakfast eating or not. Four groups were high eating-out with breakfast eating (n = 609), high eating-out with breakfast skipping (n = 192), low eating-out with breakfast eating (n = 877), and low eatingout with breakfast skipping (n = 205). High eating-out group showed higher body mass index (BMI) than low eating-out group, but the difference of BMI was disappeared when adjusted with age, residence region and family income. However high eating-out group in case of breakfast eating, compared with the low eating-out, showed higher intakes or densities of energy, fat, fat-energy% and higher ratio of energy-fat overintake, and also showed higher mean nutritional adequacy ratio and lower ratio of nutrients intake deficiency. Calcium, iron, vitamin A and C intakes were not affected by eating-out frequency, but were lowered by breakfast skipping. Breakfast skipping also decreased intake frequency of unprocessed cereals and increased those of ramyon and carbonated and alcoholic beverages. From the results frequent eating-out with breakfast eating caused increased intakes of energy and fat, but did not cause BMI increase. Breakfast skipping, but not eating-out, had negative influences on mineral and vitamin intakes. Accordingly good eating-out as well as breakfast eating should be exceedingly emphasized at nutrition education for the working males.

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[English]
Factors Influencing Job Satisfaction of Dietitians(Nutrition Teachers) of School Foodservice in Daejeon/Chungnam Province: Wang Mi Shin, Jang Il Han, Seong Ai Kim; Korean J Community Nutr 2009;14(6):798-806. Published online December 31, 2009

Abstract PDF: The objective of this study was to investigate how to improve job satisfaction for dietitians and nutrition teachers by identifying influencing factors in Daejeon and Chungnam Province, South Korea. A survey was conducted among school foodservice dietitians and nutrition teachers from selected primary, middle and high school in the area. This survey consisted of general characteristics, status of their job, job satisfaction, work satisfaction and work performance. In this study we found current state of general characteristics and status of their job according to frequency analysis and the level of work satisfaction, work performance and job satisfaction using descriptive statistics. The t-test, ANOVA and Duncan-test were also conducted in order to searching for tendency of job satisfaction according to the general characteristics and the status of their job. Pearson's correlation was carried out in order to find correlation with job satisfaction. Also, factors, which influenced job satisfaction according to regression analysis, were drawn. We describe the difference of job satisfaction between irregular dietitians and nutrition teachers as well. Besides we discussed the improvement of dietitians' (nutrition teachers') work environment to raise their job satisfaction through this study.

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[English]
A Study on Brand Personality and Employee's Self: Image Congruity and Job Satisfaction: Especially for Family Restaurant: Ki Young Kim, Mi Ae Ko; Korean J Community Nutr 2009;14(6):807-816. Published online December 31, 2009

Abstract PDF: This day's research analyzed the difference between brand personality, self - image congruity, job satisfaction and their influences towards employees of family restaurants in order to suggest a plan which would induce researcher's interest as well as influencing diversification of management strategies toward dining-out business. The purpose of this research is to analyse the difference between brand personality, self - image congruity, job satisfaction and their influences towards employees of family restaurants. The survey questionnaires were distributed to 300 employees of family restaurants in Seoul from August 1th until August 30th 2009, and 257 of them were used for analysis. The top seven company's were chosen by base on data from 2009 Annual Dinner of the Korea. Statistics handling of this research used SPSS WIN 17.0 statistics package program, which performed frequency analysis, factor analysis, regrssion anlysis. The research result shows, first of all, the relationship between company's brand personality and personal self - image congruity, it shows that the company's brand personality has higher on 'ability/capability, loyalty/ fidelity, and strong' the personal self - image congruity appeared higher. The relationship between company's brand personality and social self-image congruity, it shows that the company's brand personality has higher on 'ability/ capability and loyalty/fidelity' the social self-image congruity appeared higher. Second of all, in a relation between the self-image congruity and job satisfaction, the personal self-image congruity has shown positive impact on job satisfaction. Third of all, in a relationship between the company's brand personality and job satisfaction, if 'interest or loyalty/fidelity' shows higher on brand personality, than job satisfaction has shown higher.

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[English]
Factors Related to Sanitary Management Performance Based on HACCP System in School Foodservice: Seoul, Gyeonggi, Kangwon and Choongchung Areas in Korea: Gyoung Mi Kim, Sim Yeol Lee; Korean J Community Nutr 2009;14(6):817-830. Published online December 31, 2009

Abstract PDF: The purpose of this study was to analysis the sanitary management performance based on HACCP system for school foodservice. This study was carried out from September 2008 until December 2008 and is targeted towards schools' dietitians that work at schools with school foodservice. 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. When school foodservices were put through sanitation management achievement level analysis applied by the HACCP system, results displayed that management of temperature (3.96 points), time (4.08 points), and cross-contamination (4.07 points) were all below the average achievement level. HACCP system's achievement level based on the TQM showed that areas for strategy development, leadership, information and analysis had low achievement levels. Achievement levels for CCP are quality check, delivery/distribution process, sterilization/cleansing of food's contact surface. As a result of multiple regression analysis of the factors that influenced sanitation management achievement level of school foodservice HACCP system; sanitary job standard showed 35.6% and CCP achievement levels showed 26.8% explanatory rate. In particular, Kangwondo's number of foodservice provided to per cook was small. Also, the better the processing management was assessed, the higher the sanitary job standard achievement level became resulting to a explanatory rate of 39.5%. Elementary schools showed a higher explanatory rate of 37.0% than middle and high schools. CCP achievement levels in middle and high schools with self-operated foodservice had a 28.0% variable explanatory rate, which was the highest. The better the drainage system, leadership and assessments turned out to be, the higher the CCP achievement levels became. In summary, to revitalize HACCP system that is based on the TQM, it is considered that proper database of HACCP system for school foodservice's sanitation management be constructed and more emphasis should be put on strategy development to improve customers' satisfactory level. In addition, improvements in achievement levels of time, temperature, and cross-contamination for sanitary job standard and CCP achievement level are essential.

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[English]
Association of Nutritional Status with Obesity by Body Mass Index and Waist Circumference among Hypertensive Elderly Patients: Kyung Hee Seo, Hye Jin Lee, Bu Dol Lim, Yun Jung Choi, Hyunmee Oh, Jin Sook Yoon; Korean J Community Nutr 2009;14(6):831-845. Published online December 31, 2009

Abstract PDF: Hypertension and obesity are important modifiable risk factors for cardiovascular disease, the leading cause of death in Korea. Therefore, we assessed the association between dietary pattern and obesity in hypertensive patients to formulate health promotion strategies for the older population. Dietary information was collected from hypertensive patients visiting community health education and information center by using 24 hour recall method. The 2005 DRIs for Koreans was used to evaluate the dietary adequacy. When subjects were categorized by body mass index (BMI) as normal, overweight and obese, no significant difference in energy intake was found among groups. Dietary intakes of folate, and vitamin C in obese hypertensive patients were significantly lower than in normal weight patients (p < 0.05). When we compare the nutritional status by waist circumferences, dietary intakes of zinc, vitamin A, thiamin, vitamin C and folate were significantly lower in the obese group. Vegetable intake was significantly lower in the obese group according to BMI as well as waist circumference. Energy intake from carbohydrate was significantly higher in obese hypertensive patients (p < 0.05). Obese hypertensive patients had a higher risk of nutritional inadequacy compared to normal weight patients. Our results indicated the need for developing interventions that encourage greater consumption of vegetables while cutting down salt intake with wise selection of staple foods, for obese hypertensive patients.

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[English]
A Survey on the Foodservice Management System of the Child Care Centers in Chungnam Asan Area: Eun Seung Song, Eun Gyung Kim; Korean J Community Nutr 2009;14(6):846-860. Published online December 31, 2009

Abstract PDF: We investigated the foodservice management practices in various operation types of childcare centers in Asan, Chungnam Province, with the intention of improving the quality of foodservice and providing the basic information for establishing more effective and efficient foodservice model system. Self-completed questionnaires were collected from the directors of 174 child care centers. The statistical analysis was completed using SPSS Ver. 12.0 program. The followings are about the results of this study. Approximately 94.8% of the directors were women with the average age of 40.3. All of the investigated facilities executed foodservice; the facilities of 96.2% had been self-operated, 1.9% was contract-managed and the remaining 1.9% served delivered meal from outside. Only 20.0% of the investigated centers employed a dietitian. In most of the centers, meals were prepared in a conventional manner and approximately 85.3% of the centers are serving only snacks twice a day as a supplementary due to financial difficulties. Menu planner of the facilities, which have no dietitian was the director (35.8%) or the cook (25.7%). In most centers, the directors purchased the food materials (67.5%). Material inspection was done by the director (54.9%) or the cook (40.5%). However, home care centers did not inspect the food material. These results indicate that food service management guidelines need to be established by the facility type with the government control and financial support. Especially, dietitian employment and the efficient foodservice model system establishment are questions that confront us.

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