Korean Journal of Community Nutrition

[Korean]
Impact of a public health center nutrition education program on patients with type 2 diabetes in a primary care-based chronic disease management project: a pilot intervention study: Haerim Yang, Yoo Kyoung Park, Ji-hyun Lee, Hee-Sook Lim, Heejoon Baek, Hyejin Lee, Haeran Park, Pyunghwa Lee, Jooyoun Chung, Won Gyoung Kim; Korean J Community Nutr 2024;29(6):492-503. Published online December 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00018; Funded: Korea Health Promotion and Development Institute

Abstract PDF PubReader ePub: Objectives
We investigated the impact of an advanced “Nutrition Education Program” on patients with Diabetes mellitus, type 2 from public health centers enrolled in a primary health care-based chronic disease management project. This 12-week dietary management program was developed by the Korea Health Promotion and Development Institute. We assessed if this program improved glycemic control and other health indicators through dietary and nutritional improvements.
Methods
Seventeen patients with Diabetes mellitus type 2 were enrolled in the “Nutrition Education Program.” These patients were referred to public health centers for lifestyle management based on physician assessments at local clinics that were participating in a pilot project on primary health care-based chronic disease management. The participants attended the program comprising face-to-face basic, in-depth, and practical training sessions at the health center during the third, fifth, and seventh weeks, respectively. Anthropometric measurements, body composition analysis, blood biochemical characteristics, nutritional knowledge, and self-efficacy evaluation were performed before and after the program. Data were analyzed using SPSS ver. 28.0.
Results
The mean age of the participants was 62 years, and most participants were female (14, 82.4%). No significant changes in patients’ anthropometric measurements or body composition were observed after the training. However, significant reductions were observed in the blood biochemical characteristics, including glycated hemoglobin, total cholesterol, and low-density lipoprotein levels. Additionally, patients’ nutritional knowledge and self-efficacy scores increased significantly.
Conclusions
The “Nutrition Education Program” helped in improving glycemic control and other health indicators in patients with Diabetes mellitus type 2. Further research is required to objectively confirm the long-term and sustained effects of the program in a controlled study. Trial Registration Clinical Research Information Service Identifier: KCT0010010

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[English]
A pilot investigation of a combined food literacy and exercise program for college students: a one-group pre-post intervention study: Minjeong Jeong, Jinhyun Kim, Dahye Han, Eunjin Jang, Kyoungho Choi, Sohyun Park; Korean J Community Nutr 2024;29(6):455-466. Published online December 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00248; Funded: National Research Foundation of Korea

Abstract PDF PubReader ePub: Objectives
A campus-based intervention to enhance food literacy (FL) and establish exercise habits among college students was developed and the program’s effectiveness was evaluated.
Methods
The 13-session program was developed based on the transtheoretical model and social cognitive theory. Junior and senior students majoring in food and nutrition and physical education were asked to participate as mentors, with freshmen and sophomores from varied majors as mentees. The program encompassed food, nutrition, and exercise lessons including cooking sessions. Data were collected via pre- and post-program surveys using a questionnaire consisting of items on FL and nutrition behaviors and physical fitness measurements.
Results
Among 39 participants (35.9% male, 64.1% female), the overall FL score increased significantly from 64.1 to 70.6 post-program (P = 0.001). Significant increases were observed in the nutrition and safety (P < 0.001), cultural and relational (P = 0.023), and socio-ecological (P = 0.001) domains, as well as knowledge (P = 0.001), self-efficacy (P = 0.013), attitude (P < 0.001), and behavior (P = 0.005) items in three domains of FL. Additionally, meal duration increased significantly (P = 0.007) and sit-up performance among female showed a meaningful change (P = 0.046). Changes in dietary behaviors significantly progressed (P = 0.015) while that in exercise habits approached a marginal significance (P = 0.053) after the intervention.
Conclusion
The results reveal positive changes in FL and some modifications in eating habits, although the program had limited effects on physical activity and fitness measurements. These findings suggest that strategic approaches to foster exercise behavior changes in college students are required. This pilot program can serve as foundational data for improving and expanding multicomponent health promotion programs for this population.

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[Korean]
Co-occurrence network and pattern of school lunch using big data and text-mining using data from the 2021–2023 school meal menu information on the NEIS open educational information portal: an exploratory study: Hyeyun Kang, Jimi Kim; Korean J Community Nutr 2024;29(6):514-527. Published online December 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00297; Funded: Changwon National University

Abstract PDF Supplementary Material PubReader ePub: Objectives
This study aimed to use big data from elementary, middle, and high school lunches to determine the primary food groups and menu items that contribute to lunch meals through text-mining and investigate the variations in food groups and menu composition patterns across different grade levels.
Methods
Between 2021 and 2023, a total of 7,892,456 lunch menus from 17 cities and provinces in South Korea were analyzed using big data from the National Education Information System (NEIS) system. After undergoing text preprocessing for text-mining, the collected menus were classified into 34 food groups based on primary ingredients and cooking methods, excluding the types of rice and kimchi. Subsequently, analyses of term frequency, term frequency-inverse document frequency (TF-IDF), centrality, and co-occurrence networks were performed on the food group and menu data.
Results
According to the TF-IDF, the most frequent food group across all grade levels was soup and seasoned vegetables, whereas milk was the most frequently provided menu. As the grade level increased, the frequency of grilled and fried food increased. In elementary schools, fruits exhibited the highest centrality, whereas soup had the highest centrality in middle and high schools. Co-occurrence frequency revealed that the soup-fruit combination was the most common in elementary schools, whereas soup and seasoned vegetables were most frequently paired in middle and high schools. The co-occurrence network of food groups and menus further indicated that menus regularly provided as standard meals and those frequently offered as special meals formed distinct communities.
Conclusion
This study investigated the food groups and menu provision patterns in school meals through text-mining techniques applied to large-scale school lunch. The findings may contribute in enhancing the quality of nutritional management, school foodservice, and menu composition of school meal programs.

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[English]
A systematic review and keyword network analysis of Korea Citation Index Journals (2004–2023): Yunkyoung Oh, Eunsil Her; Korean J Community Nutr 2024;29(6):445-454. Published online December 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00269; Funded: Changshin University

Abstract PDF PubReader ePub: Objectives
Obesity rates are rapidly rising in Korea. Weight control is highly involved in obesity treatment. This study aimed to explore research trends related to weight control through keyword network analysis. By focusing on journals indexed in the Korea Citation Index (KCI), this study highlights trends specific to Korea, offering insights that reflect the country’s unique cultural and policy contexts in weight control research.
Methods
This study collected keywords from weight control-related papers published in the KCI journal over the past 20 years. Keywords were cleaned through Textom (2024), and the relationships between key research issue frequency analysis, structural characteristics, and keywords were identified using Textom, UCINET6, and NetDraw.
Results
Over the past 20 years, 40 to 50 studies related to weight control have been conducted each year. The Korean Journal of Community Nutrition had the largest number of published articles. Keyword frequency analysis showed that ‘obesity’ had the highest frequency. And the analysis of degree centrality and betweenness centrality, the keyword ‘obesity’ ranked the highest. CONCOR analysis identified four clusters: preventive health care, health management, physical health, and personal development.
Conclusion
The results of this study showed that weight control research reflecting the characteristics of the times has been steadily progressing in relation to the rapidly increasing obesity in Korea, and when developing policies or setting research directions related to weight loss in the future, research should be conducted in a prospective manner by subdividing it according to groups and interests.

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[Korean]
Development and application of a dietary program to reduce sugar intake using a living lab approach in Korea: an intervention study: Jung-Hyun Kim, Min Sook Kyung, Seul Ki Choi; Korean J Community Nutr 2024;29(6):504-513. Published online December 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00318; Funded: Ministry of Food and Drug Safety of Korea

Abstract PDF PubReader ePub: Objectives
This study aimed to develop and apply a dietary program to reduce sugar intake among community residents using a Living Lab approach.
Methods
We developed and applied a community-based dietary program to reduce sugar intake. Participants were recruited from community organizations, including a children’s food service management center, elementary to high schools, a university, a family center, a community health center, and an elderly welfare center. The dietary program was conducted in two phases; start and next levels. The start level included a pre-assessment of dietary behaviors and participation in educational platforms, whereas the next level included activities using educational platforms, tailored mission and feedback, and pre- and post-surveys. Extension educators at each community organization implemented the dietary program following organization-specific guidelines. Changes in participants’ nutrition knowledge, dietary behaviors and perceptions, self-efficacy, intention to reduce sugar intake, and participants’ program satisfaction were analyzed using paired t-tests.
Results
In total, 1,238 and 339 individuals participated in the start and next level, respectively. Participants reported significantly lower scores on dietary behavior items regarding drinking more juice or soft drinks after program participation (P = 0.009) and craving sweet foods (P = 0.046). They reported a higher intention to take interest in sugar content in food (P = 0.009) and lower-sugar recipes (P = 0.019), eat less food with high sugar content (P = 0.020), and drink water or sparkling water instead of soft drinks (P = 0.042). Nutrition knowledge did not significantly change after program participation. Program satisfaction significantly increased from the start level to the next level (P<0.050).
Conclusion
This study showed the potential of using a Living Lab approach to implement community-wide dietary interventions. Further research is required to evaluate the effectiveness of the Living Lab approach in various community settings.

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[English]
Trends in growth and nutritional status of Korean toddlers and preschoolers: a cross-sectional study using 2010–2021 Korea National Health and Nutrition Examination Survey data: Annisa Turridha, Jae Eun Shim; Korean J Community Nutr 2024;29(6):480-491. Published online December 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00241; Funded: Daejeon University

Abstract PDF PubReader ePub: Objectives
We aimed to analyze trends in growth and nutrient intake patterns in Korean toddlers and preschoolers and generate data for international comparisons of early childhood growth status.
Methods
Overall, 3,661 children aged 1–4 years were included. This study used the data from the 5th–8th Korea National Health and Nutrition Examination Survey. The weight-for-height, height-for-age, weight-for-age, and body mass index-for-age z-scores of the participants were calculated using the World Health Organization 2006 child growth z-score reference cutoff points. The 24-hour recall method was used to determine dietary intake, which was assessed according to the Dietary Reference Intake for Koreans. All statistical analyses were conducted and weighted according to a complex sample design.
Results
Most Korean toddlers and preschoolers demonstrated normal growth, with an increasing trend noted over the survey period. Concurrently, the prevalence of overweight decreased. The mean intake of energy from fat exhibited an upward trend, paralleling that of protein and fat. Conversely, the intake of several essential micronutrients declined. The prevalence of nutritional inadequacy showed significant variation throughout the survey period; the proportion of inadequacy in carbohydrate intake decreased, whereas those of iron, vitamin A, thiamin, niacin, and vitamin C increased.
Conclusion
South Korea is making significant progress in supporting toddlers and preschoolers, as evidenced by consistent increases in the proportion of children with normal growth and decreases in the prevalence of malnutrition. Future research should focus on exploring dietary patterns and analyzing specific food groups that are essential for promoting optimal growth and nutritional status in children.

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[English]
Nutritional content and healthiness in sweet and salty snacks and beverages popular in South Korea and the United States assessed by nutrition labels: a cross-sectional comparative study: Bo Jeong Gong, Segovia Lucas, Diewo Camara, Pauline E. Jolly, Chandrika Piyathilake, Taisun Hyun; Korean J Community Nutr 2024;29(6):467-479. Published online December 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00290; Funded: National Institute of Minority Health and Health Disparities

Abstract PDF PubReader ePub: Objectives
This study investigated the nutritional differences between sweet and salty snacks and beverages in South Korea (Korea) and the United States (US). Nutritional content and healthiness were determined using back- and front-of-package nutrition labeling (FoPNL) systems.
Methods
Three snack and three beverage categories popular in Korea and the US were selected. Statistical data were used to determine the top 10–15 best-selling products in each category in each country. The selected products included chips (n = 15), cookies (n = 10), chocolate (n = 13), carbonated drinks (n = 10), fruit juices/drinks (n = 10, 5/5), and energy drinks (n = 10). The study excluded products that were artificially sweetened. Nutritional information and percentages of fruit and vegetable content in each product were collected from brand websites and grocery stores in each country. The FoPNL system was used to assess the healthiness of the products, which included multiple traffic light labels, a Health Star Rating, and a Nutri-Score.
Results
Overall, Korean snacks contained significantly more protein, total fat, saturated fat, and cholesterol than US snacks. However, the US chips and carbonated drinks contained more sodium, while the US energy drinks contained more caffeine than Korean products. The serving size of US carbonated drinks was significantly larger than that of Korean drinks, whereas the serving size of US chips was smaller than that of Korean products. The FoPNL system classified the majority of products as ‘less healthy.’
Conclusion
Our results suggest that Korean and US food manufacturers should improve the nutritional quality and/or serving size of commonly consumed food products. Policymakers in both countries should work to improve the presentation of ingredient and nutrient information on nutritional labels to assist consumers in making healthier food choices.

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[Korean]
The needs and prioritization of nutrition and dietary support for individuals with disabilities: an exploratory study: Jong Eun Park, Yu Jin Kim, So Young Kim, Jong Hyock Park; Korean J Community Nutr 2024;29(5):431-443. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00009; Funded: Ministry of Education, Ministry of Education, Ministry of Science and ICT

Abstract PDF PubReader ePub: Objectives
Based on a survey of officers, social workers, and dietitians involved in managing nutrition and welfare policies or projects for vulnerable groups in local governments or private welfare institutions, this study aimed to assess the need for nutritional and dietary support policies and programs for persons with disabilities (PWD), as well as to identify appropriate support measures. Methods: An online survey was conducted from March 2 to 15, 2021. The survey included 20 questions exploring perspectives on the nutritional status of PWD, their need for nutritional and dietary support policies and programs, and the prioritization of appropriate support measures. A total of 132 responses were analyzed. Results: Approximately 68.9% of the respondents rated the nutritional status of PWD as “bad” or “very bad.” A substantial number identified “difficulty in purchasing ingredients, cooking, and preparing meals independently due to disability,” and “limited knowledge about nutrition and recipes necessary for maintaining a healthy and balanced diet” as the primary challenges in the dietary and nutritional management of this population. Additionally, 97.0% of the respondents deemed that the introduction of nutritional and dietary support policies and programs for PWD was “needed” or “very much needed.” Priority strategies to implement and strengthen these policies and systems included the “development of customized programs and services tailored to the needs and demands of the target population” and the “establishment of a dedicated department with specialized personnel.” Conclusion: Comprehensive nutritional and dietary support policies and programs should be actively implemented to ensure a healthy and stable diet for PWD, tailored to meet their actual needs and demands.

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[English]
Outcome expectations, self-efficacy, eating environment, and eating behaviors by the stages of change in adequate sodium intake among university students: a cross-sectional study: Yeon Gyu Im, Kyung Won Kim; Korean J Community Nutr 2024;29(5):382-395. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00010; Funded: Seoul Women`s University

Abstract PDF PubReader ePub: Objectives
This study investigated whether outcome expectations, self-efficacy, eating environment, and eating behaviors differed according to the stages of change in adequate sodium intake among university students. Methods: The participants were students recruited from nine universities in Seoul, Korea. An online survey was conducted, and data from 351 participants were analyzed. Participants were classified into pre-action and action stages based on adequate sodium intake. Data were analyzed using t-test, χ2-test, analysis of covariance, and correlation analysis. Results: Participants in the action stage (22.8%) felt fewer disadvantages of eating sodium adequately compared to those in the pre-action stage (77.2%, P < 0.001) and perceived more self-efficacy for healthy eating behaviors (P < 0.001) and controlling sodium intake (P < 0.01). The participants in the action stage also showed more desirable eating behaviors than those in the pre-action stage, including general eating behaviors, behaviors related to sodium intake, and sodium checks (P < 0.001). The physical environment in the action stage was more supportive of adequate sodium intake (P < 0.05). Eating behaviors, self-efficacy, and outcome expectations were significantly correlated with the stages of change; however, some differences were noticed in the correlation of the subscales of variables with the stages of change when examined by sex. Conclusion: We observed differences in factors according to the stages of change in adequate sodium intake. For the pre-action stage, nutrition education can be planned to modify negative expectations of eating adequate sodium, foster self-efficacy, and practice general eating behaviors and behaviors to gradually reduce sodium intake. It is also necessary to alter the physical environment to reduce sodium intake. In the action stage, support and reinforcement are needed to continually practice and maintain desirable eating behaviors. Nutrition education for women may be planned using multiple paths, whereas a simple strategy may be useful for men.

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[Korean]
Food purchase patterns, food policy recognition, and food environment satisfaction among adults in Jeju, Korea, according to food security: a cross-sectional study: Sumin Kim, Youjeong Jang, Hyunji Ham, Hanbin Ko, Insuk Chai, Kyungho Ha; Korean J Community Nutr 2024;29(5):406-417. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00012; Funded: Jeju Special Self-Governing Province

Abstract PDF Supplementary Material PubReader ePub: Objectives
Recently, food insecurity has been a major public health issue along with the food crisis caused by COVID-19, climate change, and the polarization of food supply due to socioeconomic disparities. Food insecurity is known to be related to the food choices and environment of the consumer. Therefore, this study aimed to evaluate the food security statuses of adults in Jeju and investigate their food purchase patterns, food policy recognition, and food environment satisfaction.
Methods
Based on data from the 2022 Jeju Food Survey, 346 adults aged ≥19 years in Jeju were classified into food security and insecurity groups (quantitatively and qualitatively) using the questionnaire. Food purchase patterns, including purchasing frequency, items, and reasons, were surveyed for local and eco-friendly foods. The recognition and necessity of several food policies and satisfaction with diet and food environment (availability, accessibility, affordability, accommodation, and acceptability) were measured using the Likert scale.
Results
Among the total participants, 47.4% were in the food insecurity group. The frequency of purchasing local and eco-friendly foods did not significantly differ by food security status. The insecurity group exhibited a higher recognition rate of basic rights to food (36.0%) than the security group (24.7%, P = 0.023). The recognition and necessity of specific food policies did not significantly differ by food security status, except for the policy of promoting food communities, for which the food security group exhibited higher recognition than the food insecurity group did (P = 0.004). The food insecurity group exhibited significantly lower scores regarding satisfaction toward diet and food environment factors (P < 0.05 for all).
Conclusions
Overall, the food security group reported higher satisfaction with their diet and food environment than the food insecurity group. Further in-depth studies to investigate the determinants of food insecurity and effective promotional strategies for food policies are needed.

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[English]
Health-related quality of life and nutrient intake of the elderly with type 2 diabetes according to comorbidity burden: a cross-sectional study: Yejung Choi, Kyong Park; Korean J Community Nutr 2024;29(5):418-430. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00014; Funded: Yeungnam University, National Research Foundation of Korea

Abstract PDF PubReader ePub: Objectives
This study aimed to explore the cross-sectional association between health-related quality of life (HRQoL) according to the number of comorbidities in older adults with type 2 diabetes mellitus (T2DM) using the Euro Quality of Life-5 Dimensions (EQ-5D) index. Methods: This study included 3,553 participants aged ≥ 65 years from the 2008–2020 Korea National Health and Nutrition Examination Survey. Dietary data were collected through 24-hour recall interviews by trained researchers, and demographic and lifestyle information via self-administered questionnaires. HRQoL was measured using a modified EQ-5D scale. Multivariable linear regression analyzed the associations between EQ-5D scores, nutrients and comorbidity, controlling for sociodemographic and health variables. Results: Most participants reported ‘no problems’ in the EQ-5D scores, although approximately 17% to 47% of participants reported ‘some problems’ or ‘extreme problems,’ depending on the dimension. As comorbidities increased, significant declines were observed across all dimensions, particularly in mobility, usual activities, pain/discomfort, and anxiety/ depression. Nutrient intake analysis revealed that participants with three or more comorbidities consumed less carbohydrates, but more fat. Conclusion: Our findings demonstrate that among older adults with T2DM, a higher number of comorbidities is associated with decreased HRQoL. Additionally, there are differences in nutrient intake patterns among those with more comorbidities, specifically decreased carbohydrate intake and increased fat intake. These results emphasize the need for comprehensive and tailored management strategies that consider both diabetes and the co-occurring health conditions. By addressing the complex healthcare needs of individuals with multiple comorbidities, it is possible to enhance their HRQoL and overall well-being.

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[English]
Eating habits and dietary supplement utilization according to food-related lifestyle among Korean adults: a cross-sectional study: EunJung Lee, Jin A Jang, Ji-Myung Kim; Korean J Community Nutr 2024;29(4):253-264. Published online August 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00017; Funded: Hankyong National University

Abstract PDF PubReader ePub: Objectives
This study investigated the association between eating habits and the utilization of dietary supplements (DSs) according to food-related lifestyle (FRL) among Korean adults. Methods: This study included a total of 300 participants (150 men and 150 women) in their 20s to 60s living in Seoul and Gyeonggi Province. We identified two groups by factor and cluster analysis: an ‘active pursuit’ group and a ‘passive pursuit’ group. Differences in eating habits and DS utilization between the two groups were analyzed by chi-square test and t-test. Logistic regression analysis was used to analyze the effect of variables on DS consumption according to FRL. Results: There were significant differences between the two groups in terms of age, alcohol drinking frequency, total dietary score, change in DS consumption after coronavirus disease 2019, and current DS consumption (P < 0.05). The proportion who perceived many health benefits of DSs was higher in the ‘active pursuit’ group than in the ‘passive pursuit’ group (P = 0.003). The most commonly consumed type of DSs was multivitamins & minerals for the ‘active pursuit’ group, and omega-3 fatty acids for the ‘passive pursuit’ group. The ‘an active pursuit’ group consumed DSs 2.93 times more (95% confidence interval [CI]: 1.44–5.97) compared to the ‘passive pursuit’ group, after adjusting for confounders. In the ‘active pursuit’ group, the health pursuit (odds ratio [OR] = 6.54, 95% CI: 1.44– 29.61) and rational consumption pursuit factors (OR = 0.26, 95% CI: 0.08–0.83) were associated with DS consumption, whereas only the health pursuit factor had a significant association (OR = 5.37, 95% CI: 2.08–13.88) within the ‘passive pursuit’ group. However, total dietary score and DSs consumption did not show a relationship. Conclusions: By understanding the consumption characteristics of DSs according to FRL, this can serve as basic data necessary for promoting health through the utilization of DSs and healthy behaviors.

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[English]
Analysis of health behavior changes among residents in depopulation areas in Korea: a cross-sectional study based on Community Health Survey data from 2010 to 2019: Miyong Yon; Korean J Community Nutr 2024;29(4):348-357. Published online August 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00001; Funded: Korea Disease Control and Prevention Agency

Abstract PDF PubReader ePub: Objectives
The total population of Korea began to decline in 2019; in particular, the population in rural areas has been rapidly decreasing and is aging. Therefore, the government has designated depopulation areas and is seeking ways to support them. To assess whether health disparities exist between areas with population decline and those without, this study used community health survey data to observe temporal changes in health behaviors between the two types of areas. Methods: The analysis used Community Health Survey data from 2010 to 2019, and regional classification was divided by depopulation areas designated by the Ministry of the Interior and Safety. Trends in health behavior and chronic disease prevalence between depopulation and non-depopulation areas were analyzed. All analyses were conducted using complex sample analysis procedures in SAS 9.4 software. Results: The smoking rate steadily decreased in both depopulation and non-depopulation areas, whereas the high-risk drinking rate increased slightly. The walking practice rate did not improve in depopulation areas compared to non-depopulation areas. Furthermore, nutritional labeling usage rate was consistently lower in depopulation areas than in non-depopulation areas, with the gap being the largest. The prevalence of obesity, diabetes, and hypertension showed that the gap between depopulation and non-depopulation areas is continuously increasing. Conclusions: Health behaviors in depopulation areas have not improved, and the prevalence of chronic diseases is increasing rapidly. Therefore, the demand for health care services that support healthy lifestyle practices and chronic disease management in these areas is expected to increase.

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[English]
Sex differences in health-related quality of life among older Korean adults with type 2 diabetes mellitus: a cross-sectional study: Hyeonji Jeong, Kyong Park; Korean J Community Nutr 2024;29(4):336-347. Published online August 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00003; Funded: Yeungnam University, National Research Foundation of Korea

Abstract PDF PubReader ePub: Objectives
This cross-sectional study examined sex differences in Health-Related Quality of Life (HRQoL) among seniors with Type 2 Diabetes Mellitus (T2DM).
Methods
Data from the Korea National Health and Nutrition Examination Survey (2008–2020) were analyzed. The EuroQol-5 Dimensions (EQ-5D), a measure of HRQoL, was used. It comprises five dimensions: mobility, self-care, usual activity, pain/discomfort, and anxiety/depression, each with three levels.
Results
Analysis of 3,826 older adults with T2DM showed a significant increasing trend in the EQ-5D Index from the 4th survey phase onwards (P for trend < 0.001 for both men and women). Men consistently reported higher EQ-5D levels than women across all survey years. Women’s EQ-5D levels remained lower than men’s, maintaining a decade-old disparity (P < 0.05). Men scored significantly higher (P < 0.05) in most EQ-5D domains, except for self-care and anxiety/depression, resulting in a higher total EQ-5D Index (P = 0.001). Increased comorbidities were strongly associated with lower EQ-5D levels in both sexes. Additionally, there was a negative correlation between the EQ-5D Index and refined grain intake for both sexes (P for trend < 0.001), with high-EQ-5D groups consuming fewer refined grains. Women in the high-EQ-5D group consumed more nuts, vegetables, and meat compared to men (P for trend < 0.05).
Conclusions
Our study highlights the sex disparities in HRQoL among older adults with T2DM. The findings suggest the need for tailored treatment guidelines aimed at improving the HRQoL of elderly T2DM patients, with a focus on their sex-specific characteristics. Implementing these tailored guidelines could enhance the HRQoL of older women with T2DM and promote more equitable healthcare outcomes. This underscores the importance of considering sex differences to comprehensively improve the well-being of this population.

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[English]
Changes in the importance and performance of low-sodium management among childcare center cooks in Yongin, South Korea, after salinometer support programs: a descriptive study: Jiwoo Min, Youngmi Lee, Yunhee Chang, Yujin Lee; Korean J Community Nutr 2024;29(4):304-317. Published online August 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00004; Funded: Ministry of Food and Drug Safety

Abstract PDF PubReader ePub: Objectives
This study aimed to evaluate the importance and performance of sodium reduction practices among childcare center cooks in the Yongin area before and after a 3-month salinometer support program.
Methods
In total, 313 cooks employed in childcare centers in Yongin were surveyed before and after participating in a salinometer support program. The survey included questions on general information, sodium-related dietary habits, and perceived importance and performance levels of sodium reduction approaches in the purchasing, cooking, and serving areas. The centers were divided into childcare centers registered as group-feeding facilities (FS group, n = 68) and those not registered as such (non-FS group, n = 245). The differences between the two groups were analyzed.
Results
The overall importance levels increased significantly after the program in both the FS-group (P < 0.001) and non-FS group (P = 0.005). The overall performance levels also increased significantly in both groups (P < 0.001 for all). Consequently, the significant difference between the importance and performance levels disappeared in both groups after the program. However, unlike the FS group, which showed no significant differences between the importance and performance levels after the program in all three areas, the non-FS group still demonstrated lower performance levels than importance levels in the purchasing (P = 0.011) and serving (P = 0.034) areas after the program.
Conclusions
The use of salinometers significantly enhanced the performance and importance of low-sodium management practices among cooks in childcare centers, especially in the FS group. The continuous monitoring of salinity measurements and tailored education specialized for the FS and non-FS groups are recommended.

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[English]
Effects of a nutrition education program on metabolic syndrome risk factors in middle-aged Korean adults: an intervention study: Minji Kang, Young-Hee Park, Subeen Kim, Eunyoung Tak, Hyun Wook Baik, Hee Young Paik, Hyojee Joung; Korean J Community Nutr 2024;29(4):265-277. Published online August 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00005; Funded: National Academy of Agricultural Science, Rural Development Administration

Abstract PDF PubReader ePub: Objectives
This study was conducted to evaluate the effects of a nutrition education program on metabolic syndrome in middle-aged Korean adults.
Methods
A total of 411 Korean adults 30–59 years of age were allocated randomly into three groups: the nutrition education group for promoting Han-sik consumption (HG), the nutrition education group for eating balanced diet (EG), and the control group (CG). The HG and EG received four face-to-face nutrition education sessions over 16 weeks to improve nutritional problems based on the individual’ usual diet. Effectiveness of the program was evaluated with the differences of self-reported dietary behaviors, dietary intakes, anthropometric measurements and biochemical indices between the baseline and the end of the nutrition education program. The changes within groups were analyzed using paired t-test and McNemar test and effectiveness among three groups was analyzed by repeated analysis of variance.
Results
After the nutrition education, the percentages of participants who achieved the recommended food group consumption in the Korean Food Guidance Systems significantly increased in HG (P = 0.022). Body weight (P = 0.007), body mass index (P = 0.002), and triglycerides (P = 0.002) significantly decreased in HG. Waist circumference and diastolic blood pressure decreased in all three groups (P < 0.05).
Conclusions
This study found that tailored nutrition education program for middle aged Korean adults showed beneficial effects on improving dietary behaviors and metabolic syndrome risk factors. Further studies are needed to assess the long-term effects of the nutrition education programs on metabolic syndrome risks.

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[Korean]
Nutritional status of North Koreans and related perceptions among South Korean adults: Youngmin Nam, Jihyun Yoon; Korean J Community Nutr 2024;29(4):288-303. Published online August 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00006; Funded: Seoul National University

Abstract PDF PubReader ePub: Objectives
North Koreans have been facing chronic food shortages and malnutrition. This study examined the nutritional status of North Koreans and the perceptions of South Korean adults regarding their nutritional status.
Methods
The nutritional status was examined using nutritional indicators for the general population, children, and reproductive-aged women in North Korea. An online survey was conducted among 1,000 South Korean adults aged 19–69 years to investigate their perceptions regarding the nutritional status of North Koreans.
Results
Although the nutritional status of children in North Korea has consistently improved, significant progress in the general population and reproductive-aged women in the country remains elusive. The prevalence of malnutrition among North Korean children has decreased to a level that is not considered severe based on international standards, although it shows a substantial difference from that among South Korean children. The prevalence of undernourishment and food insecurity in North Korea remains over 40%. South Korean adults perceive the nutritional status of North Koreans as being more severe than it is in reality. Notably, a significant inconsistency exists between the perceived and actual nutritional status of North Korean children, with over 95% of South Korean adults perceiving North Korean children’s malnutrition as being more severe than it actually is. Moreover, South Korean adults in their 20s to 40s tended to perceive the nutritional status of North Koreans as being more severe than those in their 50s to 60s did.
Conclusions
The nutritional status of North Koreans is a matter of concern. The disparity between South Koreans’ perceptions of the nutritional status of North Koreans and the actual status highlights the need for accurate information dissemination to effectively address malnutrition in North Korea. These efforts could be instrumental in enhancing public awareness and fostering social consensus on food aid and nutritional support programs for North Korea.

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[English]
Serum branch chain amino acids and aromatic amino acids ratio and metabolic risks in Koreans with normal-weight or obesity: a cross-sectional study: Ji-Sook Park, Kainat Ahmed, Jung-Eun Yim; Korean J Community Nutr 2024;29(3):212-221. Published online June 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.3.212; Funded: Changwon National University

Abstract PDF PubReader ePub: Objectives
Metabolic disease is strongly associated with future insulin resistance, and its prevalence is increasing worldwide. Thus, identifying early biomarkers of metabolic-related disease based on serum profiling is useful to control future metabolic disease. Our study aimed to assess the association of serum branched chain amino acids (BCAAs) and aromatic amino acids (AAAs) ratio and metabolic disease according to body mass index (BMI) status among Korean adults.
Methods
This cross-sectional study included 78 adults aged 20–59 years in Korea. We compared serum amino acid (AA) levels between adults with normal-weight and adults with obesity and investigated biomarkers of metabolic disease. We examined serum AA levels, blood profile, and body composition. We also evaluated the association between serum AAs and metabolic-related disease.
Results
The height, weight, BMI, waist circumference, hip circumference, waist-hip-ratio, body fat mass, body fat percent, skeletal muscle mass, systolic blood pressure, and diastolic blood pressure were higher in the group with obesity compared to normal weight group. The group with obesity showed significantly higher levels of BCAA, AAA, and BCAA and AAA ratio. Further, BCAA and AAA ratio were significantly positively correlated with triglyceride, body weight, and skeletal muscle mass. The evaluation of metabolic disease risks revealed an association between the ratios of BCAAs and AAAs, hypertension, and metabolic syndrome.
Conclusions
Our study is showed the associations between BCAA and AAA ratio, obesity, and obesity-related diseases using various analytical approaches. The elevated BCAA and AAA ratio could be early biomarkers for predicting future metabolic diseases in Korean population.

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[English]
Total sugar intake and its contributed foods by age groups in Koreans using the 8th (2019–2021) Korea National Health and Nutrition Examination Survey: a cross-sectional study: Hyejin Yu, Sang-Jin Chung; Korean J Community Nutr 2024;29(3):222-233. Published online June 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.3.222; Funded: Yangyoung Foundation

Abstract PDF PubReader ePub: Objectives
This study was conducted to investigate the status of total sugar intake and contributing foods in Korea according to age groups.
Methods
This study used 24-hour dietary recall data from the 8th Korea National Health and Nutrition Examination Survey (2019–2021) to investigate the nutritional and total sugar intake status among Koreans. A total of 18,338 research participants (≥3 years old) were included in this study. To analyze the types of foods contributing to total sugar intake, these foods were categorized into 15 types. Moreover, we examined the total sugar intake and ranked the most consumed foods by age groups (3–11 years, 12–18 years, 19–34 years, 35–49 years, 50–64 years, over 65 years). A survey procedure was employed for statistical analysis.
Results
The energy intake ratio from total sugars was approximately 12%–15%, which was within the recommended range. However, the proportion of individuals consuming total sugar exceeding 20% of their total caloric intake is nearly 20%, raising concerns about excessive sugar consumption. Furthermore, the percentage of participants whose intake of sugar from processed foods exceeded 10% of their total calories was highest in the 12–18 age group at 37.1%, followed by the 3–11 age group at 35.2%, and the 19–34 age group at 34.0%. Carbonated drinks, cola, and cider were the primary foods consumed by children and adolescents (3–18 years old) and young adults (19–34 years old). For middle-aged and older adults, mixed coffee with sugar and cream was a prominent contributor to sugar intake.
Conclusions
This study investigated sugar consumption patterns among Koreans, finding the principal foods contributing to this intake. Identifying these contributors is pivotal, given their potential impact on public health.

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[Korean]
Intake of energy and macronutrients according to household income among elementary, middle, and high school students before and during the COVID-19 pandemic: a cross-sectional study: Chae-Eun Jeong, Heejin Lee, Jung Eun Lee; Korean J Community Nutr 2024;29(3):234-252. Published online June 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.3.234; Funded: Institute for Future Strategy, Seoul National University

Abstract PDF PubReader ePub

Objectives
This study examined the intake of energy and macronutrients among elementary, middle, and high school students according to household income before the COVID-19 pandemic (2016–2019), during the social distancing period (2020–2021), and after the social distancing measures were lifted (2022).
Methods
We included 5,217 students aged 5–18 from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted between 2016 and 2022. Dietary intake was assessed using one-day 24-hour dietary recalls. We estimated the least squares means (LS-means) of intake according to household income for each period using a weighted linear regression model, adjusted for age and sex. Differences in LS-means between the periods were analyzed using the t-test.
Results
During the social distancing period, the LS-means of energy intake among students decreased significantly by 143.2 kcal/day compared to pre-pandemic levels (P < 0.001). Students from low-income households experienced a more pronounced decrease in energy intake (−379.1 kcal/day, P < 0.001) and macronutrient intake compared to those from other income groups. Energy intake at school significantly declined for all income groups during the social distancing period compared to before the pandemic. No significant changes in home energy intake were observed among low-income students, whereas there was an increase for students from higher-income groups. Before the pandemic, 8.5% of students from low-income households reported insufficient food due to economic difficulties; this figure rose to 21.3% during the pandemic.
Conclusions
During the pandemic, students from low-income families experienced significantly lower intake of energy and macronutrients compared to pre-pandemic levels. The most substantial reductions were noted among low-income students, largely due to the lack of compensation for decreased school-based intake with increased intake at home.

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Changes in Ultra-Processed Food Consumption among Adolescents before and after the COVID-19 Pandemic : Using Data from the 7th (2018~2019) and 8th (2020~2021) Korea National Health and Nutrition Examination Survey
Hyun-Jin Hwang, Yoo Kyeong Kim
Korean Journal of Human Ecology.2024; 33(6): 981. CrossRef

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