Korean Journal of Community Nutrition

[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

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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[English]
Regional differences in protein intake and protein sources of Korean older adults and their association with metabolic syndrome using the 2016–2019 Korea National Health and Nutrition Examination Surveys: a cross-sectional study: You-Sin Lee, Yoonna Lee; Korean J Community Nutr 2024;29(3):173-188. Published online June 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.3.173

Abstract PDF PubReader ePub: Objectives
The study aim was to analyze the regional differences in dietary protein intake and protein sources of Korean older adults and their association with metabolic syndrome.
Methods
Study participants were 1,721 older adults aged 65 and over who participated in 2016–2019 Korea National Health and Nutrition Examination Survey. Using 24-hour recall dietary intake data, protein intake and their food sources were examined. The association between protein intake and metabolic syndrome, obesity, and abdominal obesity were analyzed by multiple logistic regression.
Results
Total protein and animal protein intakes were higher in urban area (60.0 g, 24.4 g, respectively) than in rural area (54.6 g, 19.6 g, respectively). With increase of protein intake level, animal to total protein proportion was increased in both areas. Total protein and plant protein intake was negatively associated with the risk of obesity, abdominal obesity in both areas. Animal protein intake was negatively associated with the risk of obesity in both areas, and with abdominal obesity only in urban area. In urban area, plant protein intake was also negatively associated with the risks of metabolic syndrome, elevated triglyceride, and reduced high density lipoprotein-cholesterol. In urban area, the risk of metabolic syndrome was decreased when their protein intake was more than 0.91 g/kg and was lowest when their protein intake was more than 1.5 g/kg (P for trend < 0.001).
Conclusions
Korean older adults showed inadequate protein intake and those in rural area showed lower animal protein intake than in urban area. The risk of obesity and metabolic syndrome was decreased with the increase of protein intake level. These findings may help develop effective nutrition support strategy for older adults to reduce regional health disparity.

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[English]
Factors influencing consumers’ continuance intention in online grocery shopping: a cross-sectional study using application behavior reasoning theory: Binglin Liu, Min A Lee; Korean J Community Nutr 2024;29(3):199-211. Published online June 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.3.199

Abstract PDF PubReader ePub: Objectives
Online grocery shopping has gained traction with the digital transformation of retail. This study constructs a behavioral model combining values, attitudes, and reasons for behavior—specifically, facilitators and resistance—to provide a more novel discussion and further understand the relative influences of the various factors affecting continuance intention in online grocery shopping.
Methods
Data were collected through an online questionnaire from consumers who had engaged in online grocery shopping during the past month in Seoul, Korea. All collected data were analyzed using descriptive analysis, and model validation was performed using partial least squares structural equation modeling.
Results
Continuance intention is primarily driven by facilitative factors (compatibility, relative advantage, and ubiquity). Attitude can also positively influence continuance intention. Although resistance factors (price, tradition, and risk) do not significantly affect continuance intention, they negatively affect attitude. Values significantly influence consumers’ reasoning processes but not their attitude.
Conclusions
These findings explain the key influences on consumers’ online grocery shopping behavior in Seoul and provide additional discussion and literature on consumer behavior and market management. To expand the online grocery market, consumers should be made aware of the potential benefits of the online channel; the barriers they encounter should be reduced. This will help sustain online grocery shopping behavior. Furthermore, its positive impact on attitude will further strengthen consumers’ continuance intention.

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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

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]
Relationship of sodium index with the obesity indicators of university students in Daegu, South Korea: a cross-sectional study: Young-Won Jang, Jian Ma, Yeon-Kyung Lee; Korean J Community Nutr 2024;29(3):189-198. Published online June 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.3.189

Abstract PDF PubReader ePub: Objectives
The sodium index is an index that converts the estimated sodium intake calculated using a verified and reliable sodium estimation formula. This study aimed to determine the relationship between the sodium index and obesity indicators and the potential impact of excessive sodium consumption on obesity.
Methods
Obesity indicators, such as body mass index (BMI), body fat percentage, waist-to-hip ratio (WHR), and visceral fat levels, were analyzed in 120 university students (60 men and 60 women). The sodium index was calculated by indexing the estimated sodium intake according to age, sex, BMI, salt-eating habits, and salt-eating behaviors. The relationship between sodium index and obesity indicators was analyzed using multiple logistic regression.
Results
The estimated sodium intake was 3,907.1 mg, with 76.7% of the participants categorized under the “careful” level of sodium index and 10.8% under the “moderate” level. As the sodium index increased, the BMI, body fat percentage, WHR, and visceral fat levels significantly increased. All obesity indicators significantly increased in patients with a “severe” sodium index than in those with a “moderate” sodium index. In addition, a strong positive correlation was identified between obesity indicators and sodium index. When the “severe” sodium index was compared with the “moderate” sodium index, the risk of obesity based on body fat percentage increased by 2.181 times (95% confidence interval [CI], 1.526–3.118), while the risk of obesity based on visceral fat level increased by 4.073 times (95% CI, 2.097–7.911).
Conclusions
Our findings suggest a correlation between excessive sodium intake and obesity. Moreover, the sodium index can be used to determine sodium intake.

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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

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]
Association of ultra-processed food with diabetes and impaired fasting glucose in elderly populations (urban and rural): a cross-sectional study: Seung Jae Lee, Mi Sook Cho; Korean J Community Nutr 2024;29(1):51-64. Published online February 29, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.1.51

Abstract PDF: Objectives
This study examined the association between ultra-processed food (UPF) consumption and chronic diseases in elderly Koreans.
Methods
Data from the 2019–2021 Korea National Health and Nutrition Examination Survey were analyzed. Dietary intake and UPF consumption were assessed using the NOVA food classification based on 24-hour recall data from 3,790 participants (aged 65+ years). Participants were divided into 4 groups based on the quartile of energy intake from UPFs. Regions were classified as urban or rural. Multivariable logistic regression was employed to estimate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) after controlling for potential confounders.
Results
Among the participants, 71.3% resided in urban and 28.7% in rural areas. Compared to the urban elderly, rural participants tended to be older, have lower education and income levels, be more likely to live in single-person households, and have a higher smoking rate (P < 0.05). Urban elderly consumed more UPFs daily (146.1 g) compared to rural residents (126.6 g; P < 0.05). “Sugar-sweetened beverages” were the most consumed category in both regions. “Sweetened milk and its products” and “traditional sauces” were prominent in urban areas, while rural elderly consumed more “traditional sauces” and “distilled alcoholic beverages.” Rural areas also had a higher carbohydrate-to-calorie ratio than urban areas. Compared to the lowest quartile of UPF intake, the highest quartile was significantly associated with impaired fasting glucose only in rural areas (AOR, 1.48; 95% CI, 1.00–2.19; P for trend = 0.0014). No significant associations were observed for diabetes in either urban or rural areas.
Conclusions
This study suggests that high intake of UPFs is associated with increased odds of impaired fasting glucose in rural elderly. Further research is needed to elucidate the specific negative health effects of UPFs in different populations, and targeted efforts should promote healthy diets in both urban and rural areas.

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[Korean]
Sustainable diets: a scoping review and descriptive study of concept, measurement, and suggested methods for the development of Korean version: Sukyoung Jung; Korean J Community Nutr 2024;29(1):34-50. Published online February 29, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.1.34

Abstract PDF: Objectives
Transformation through a sustainable food system to provide healthy diets is essential for enhancing both human and planetary health. This study aimed to explain about sustainable diets and illustrate appropriate measurement of adherence to sustainable diets using a pre-existing index.
Methods
For literature review, we used PubMed and Google Scholar databases by combining the search terms “development,” “validation,” “sustainable diet,” “sustainable diet index,” “planetary healthy diet,” “EAT-Lancet diet,” and “EAT-Lancet reference diet.” For data presentation, we used data from National Health and Nutrition Examination Survey, 2017–2018, among adults aged 20 years and older (n = 3,920). Sustainable Diet Index-US (SDI-US), comprising four sub-indices corresponding to four dimensions of sustainable diets (nutritional quality, environmental impacts, affordability, and sociocultural practices), was calculated using data from 24-hour dietary recall interview, food expenditures, and food choices. A higher SDI-US score indicated greater adherence to sustainable diets (range: 4–20). This study also presented SDI-US scores according to the sociodemographic status. All analyses accounted for a complex survey design.
Results
Of 148 papers, 16 were reviewed. Adherence to sustainable diets fell into 3 categories: EAT-Lancet reference diet-based (n = 8), Food and Agriculture Organization (FAO) definitionbased (n = 4), and no specific guidelines but including the sustainability concept (n = 4). Importantly, FAO definition emphasizes on equal importance of four dimensions of diet (nutrition and health, economic, social and cultural, and environmental). The mean SDI-US score was 13 out of 20 points, and was higher in older, female, and highly educated adults than in their counterparts.
Conclusions
This study highlighted that sustainable diets should be assessed using a multidimensional approach because of their complex nature. Currently, SDI can be a good option for operationalizing multidimensional sustainable diets. It is necessary to develop a Korean version of SDI through additional data collection, including environmental impact of food, food price, food budget, and use of ready-made products.

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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

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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[English]
The relationship between smartphone usage and eating behavior for elementary school students in Gangneung, South Korea: cross-sectional study: Minji Kim, Meera Jang; Korean J Community Nutr 2024;29(4):278-287. Published online August 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00002

Abstract PDF PubReader ePub: Objectives
This study investigates the relationship between smartphone usage and eating behavior among elementary school students. Methods: This survey was conducted on 4th- to 6th-grade students at elementary schools in Gangneung from September 6th to September 15th, 2023. Of the 129 copies of the questionnaire that were distributed to 5 schools, 66 copies (51.2%) were returned. Results: Compared to the nationwide statistics, the smartphone ownership rate of elementary school students in Gangneung was lower, but the rate of smartphone overdependence was higher. Smartphone dependence was 21.12 points for study subjects and 26.00 points for the overdependence risk group (Org). Compared to national statistics, the self-control failure factor was higher, so study participants in Gangneung City are thought to have great difficulty with self-control. The Org’s weekend smartphone use time of 7.54 hours was significantly more than the general user group (Gug)’s 4.06 hours. The number of days in which the Org consumed late-night snacks per week was 2.92 days, and the Gug had 2.15 days, but the difference was not significant. Eating fast food showed a positive correlation with eating sweet food, eating fatty food, and eating heavily seasoned food. It was found that frequent consumption of fast food is closely correlated with unhealthy eating behavior. Weekend smartphone use time showed a significant positive correlation with smartphone dependence and the number of days late-night snacks consumed per week. Conclusions: Study participants in Gangneung are more dependent on smartphones than national statistics. Smartphone dependence had a negative correlation with healthy eating behavior and a correlation with average unhealthy eating behavior.

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[Korean]
Estimating and evaluating usual total fat and fatty acid intake in the Korean population using data from the 2019–2021 Korea National Health and Nutrition Examination Surveys: a cross-sectional study: Gyeong-yoon Lee, Dong Woo Kim; Korean J Community Nutr 2023;28(5):414-422. Published online October 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.5.414

Abstract PDF

Objectives
This study evaluated usual dietary intakes of total fat and fatty acids among the Korean population based on the revised Dietary Reference Intakes for Koreans 2020 (2020 KDRIs).
Methods
This study utilized data from the eighth Korea National Health and Nutrition Examination Survey (KNHANES 2019–2021). We included 18,895 individuals aged 1 year and above whose 1-day 24-hour dietary recall data were available. To calculate the external variability using the National Cancer Institute 1-day method, data from the U.S. NHANES 2017-March 2020 Pre-pandemic dataset were employed. The total fat and fatty acid intake were evaluated based on the Acceptable Macronutrient Distribution Ranges (AMDRs) and Adequate intake (AI) of 2020 KDRIs for each sex and age groups.
Results
Approximately 86% of the Korean population obtained an adequate amount of energy from total fat consumption (within the AMDRs), indicating an appropriate level of intake. However, the percentage of individuals consuming saturated fatty acids below the AMDR was low, with only 12% among those under 19 years of age and 52% aged 19 years and older. On a positive note, approximately 70% of the population showed adequate consumption of essential fatty acids, exceeding the AI. Nevertheless, monitoring the intake ratio of omega 3 (n-3) to omega 6 (n-6) fatty acids is essential to ensure an optimum balance.
Conclusions
This study explored the possibility of estimating the distribution of nutrient intake in a population by applying the external variability ratio. Therefore, if future KNHANES conduct multiple 24-hour recalls every few years-similar to the U.S. NHANESeven for a subset of participants, this may aid in the accurate assessment of the nutritional status of the population.

Citations

Citations to this article as recorded by

The association between COVID-19 and changes in food consumption in Korea: analyzing the microdata of household income and expenditure from Statistics Korea 2019–2022
Haram Eom, Kyounghee Kim, Seonghwan Cho, Junghoon Moon
Journal of Nutrition and Health.2024; 57(1): 153. CrossRef
Dietary intake and food sources of essential fatty acids among Korean adolescents: a cross-sectional study based on the 2016–2021 KNHANES data
Enkhgerel Erdenetsetseg, Hye Ran Shin, SuJin Song
Korean Journal of Community Nutrition.2024; 29(2): 144. CrossRef

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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

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]
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

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]
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

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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[Korean]
Association between Sarcopenia and Energy and Protein Intakes in Community-dwelling Elderly: Woori Na, Dayoung Oh, Seohyeon Hwang, Bonghee Chung, Cheongmin Sohn; Korean J Community Nutr 2022;27(4):286-295. Published online August 31, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.4.286

Abstract PDF

Objectives
Sarcopenia is one of the most representative factors of senescence, and nutritional status is known to affect sarcopenia. This study was performed to analyze the relationships between energy and protein intake and sarcopenia.
Methods
The study subjects were 3,236 individuals aged ≥ 65 that participated in the Korea National Health and Nutrition Examination Survey (KNHANES) 2008 ~ 2011. General characteristics and anthropometric and 24-hour dietary recall data were analyzed. Sarcopenia was diagnosed using a formula based on appendicular skeletal muscle mass (ASM) and body weight. Logistic regression was performed to determine relationships between sarcopenia risk and energy and protein intakes.
Results
For energy intake, the odds ratio (OR) of sarcopenia in women was significantly higher those with the lowest intake [OR = 1.680, 95% confidence interval (CI) = 1.213-2.326] than those with the highest intake (P for trend = 0.001). Regarding protein intake per kg of body weight, the odds ratio of sarcopenia was significantly higher for those that consumed < 0.8 g/kg of protein daily than those that consumed > 1.2g/kg for men (OR = 2.459, 95% CI = 1.481-4.085) and women (OR = 2.178, 95% CI = 1.423-3.334).
Conclusions
This study shows a link between sarcopenia and energy and protein intake levels and suggests that energy and protein consumption be promoted among older adults to prevent sarcopenia.

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Muscle Mass Changes After Daily Consumption of Protein Mix Supplemented With Vitamin D in Adults Over 50 Years of Age: Subgroup Analysis According to the Serum 25(OH)D Levels of a Randomized Controlled Trial
Yeji Kang, Namhee Kim, Yunhwan Lee, Xiangxue An, Yoon-Sok Chung, Yoo Kyoung Park
Clinical Nutrition Research.2023; 12(3): 184. CrossRef

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[English]
Arterial stiffness index, physical activity and food and nutrient intake: cross-sectional study in adults aged 40 years and older: Eun-A Kim, Yun-Mi Kim, Eun-Kyung Kim; Korean J Community Nutr 2024;29(2):81-96. Published online April 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.2.81

Abstract PDF: Objectives
This study aimed to investigate arterial stiffness index, physical activity, and food and nutrient intake in middle-aged adults over 40 years when the incidence of cardiovascular disease begins to increase.
Methods
This study included 106 subjects (48 males and 58 females) aged between 40 and 64 years. The arterial stiffness index (brachial-ankle pulse wave velocity [baPWV], and anklebrachial index [ABI]) were measured using a blood pressure pulse wave testing device. Physical activity was assessed using the Korean version of the Global Physical Activity Questionnaire, and food and nutrient intake was calculated using the Food Frequency Questionnaire.
Results
The mean age of the subjects was 54.4 years. Although the ABI of the subjects was within the normal range, they were divided into tertiles to compare physical activity and food and nutrient intake. In males, the time spent on moderate to vigorous physical activity (MVPA) was significantly higher in T3 (600.6 min/week) than in T1 (304.4 min/week). In females, the time spent in sedentary behavior was significantly lower in T3 (294.5 min/week) than in T1 (472.1 min/week). In addition, the frequency of fish consumption was significantly higher in T3 (1.27 frequency/day) than in T1 (0.64 frequency/day) in females. Polyunsaturated fatty acid (PUFA) and ω-3 fatty acid intake, adjusted for energy intake, were significantly positively correlated with ABI (r = 0.200 and r = 0.218, respectively).
Conclusions
High MVPA (in males), low sedentary behavior (in females), and PUFA and ω-3 fatty acid intake through fish consumption may be associated with low peripheral artery stiffness. Therefore, arteriosclerosis can be prevented through physical activity and proper dietary therapy.

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[Korean]
Effects of watching Mukbang and Cookbang videos on adolescents’ dietary habits and mental health: cross-sectional study using the 18th Korea Youth Risk Behavior Survey: Seung-Hee Hong; Korean J Community Nutr 2024;29(2):156-170. Published online April 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.2.156

Abstract PDF: Objectives
This study aimed to investigate the association between how often Korean adolescents watch Mukbang and Cookbang videos and their dietary habits.
Methods
Data from the 18th Korea Youth Risk Behavior Survey conducted in 2022 was analyzed for this study. The study included 51,850 middle and high school students and assessed various aspects, including demographics, frequency of watching Mukbang and Cookbang videos per week, dietary habits, health behaviors, and mental health factors.
Results
Nearly a third (29.3%) of Korean adolescents watched Mukbang and Cookbang videos one to four times a week, while 13.5% watched them more than five times weekly. Females, those with lower academic achievement, and those from lower socioeconomic backgrounds were significantly more likely to be frequent viewers (P < 0.001). Increased viewing frequency was associated with poorer dietary habits. Adolescents who watched more frequently were less likely to eat breakfast and consume fruits and milk, while their consumption of fast food, high-caffeine drinks, sugary drinks, and late-night snacks increased (P < 0.001). Higher viewing frequency correlated with increased feelings of stress, depression, and loneliness (P < 0.001). Logistic regression analysis confirmed these associations. More frequent viewers were significantly less likely to eat breakfast (odds ratio (OR), 0.63; 95% confidence interval (CI), 0.58–0.68), and more likely to consume fast food (OR, 1.85; 95% CI, 1.69–2.02), high-caffeine drinks (OR, 1.43; 95% CI, 1.30–1.56), sugary drinks (OR, 1.54; 95% CI, 1.41–1.67), and late-night snacks (OR, 1.37; 95% CI, 1.25–1.51).
Conclusions
Our findings suggest that frequent exposure to Mukbang and Cookbang content is linked to unhealthy dietary habits in adolescents. Educational programs may be necessary to mitigate the potential for these videos to negatively influence dietary choices.

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[Korean]
Comparative study on the health and dietary habits of Korean male and female adults before and after the coronavirus disease 2019 pandemic: utilizing data from the 8 th Korea National Health and Nutrition Examination Survey (2019–2021): Chaemin Kim, Eunjung Kim; Korean J Community Nutr 2024;29(1):65-80. Published online February 29, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.1.65

Abstract PDF

Objectives
This study aims to compare changes in physical factors, health behaviors, eating habits, and nutritional intake among Korean male and female adults over a period of three years (2019–2021) before and after the outbreak of coronavirus disease 2019 (COVID-19).
Methods
This study utilized raw data from the 8^th Korea National Health and Nutrition Examination Survey (2019–2021). The participants in this study included 6,235 individuals in 2019, 5,865 individuals in 2020, and 5,635 individuals in 2021. Individuals whose daily energy intake was less than 500 kcal or exceeded 5,000 kcal were excluded from the study.
Results
In comparison to 2019, overweight/obesity rates, weight, waist circumference, weekend sleep hours, and resistance exercise days/week increased in both male and female during the COVID-19 pandemic. Regarding eating habits, the proportions of people skipping breakfast, not eating out, consuming health supplements, and recognizing nutritional labels increased in 2020 and 2021, whereas the rate of skipping dinner decreased. Total energy intake has continued to decrease for the two years since 2019. A comparison of nutrient intake per 1,000 kcal before and after the outbreak of COVID-19 revealed that intake of nutrients, including protein, phosphorus, iron, vitamin A, riboflavin, and niacin increased, while folic acid intake decreased. In male, calcium, phosphorus, riboflavin, and niacin intakes increased, whereas iron, vitamin C, and folic acid intakes decreased. In female, phosphorus, iron, vitamin A, and riboflavin intake increased significantly, while protein and niacin intake decreased significantly.
Conclusions
After COVID-19, the obesity rate, breakfast skipping rate, health supplement intake, and nutritional label use increased, while the frequency of eating out, dinner skipping rate, and total energy intake decreased. These environmental changes and social factors highlight the need for nutritional education and management to ensure proper nutritional intake and reduce obesity rates in the post-COVID-19 era.

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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 Journal of Community Nutrition.2024; 29(3): 234. CrossRef

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[Korean]
Blood Biochemical Characteristics, Dietary Intake, and Risk Factors Related to Poor HbA1c Control in Elderly Korean Diabetes Patients: Comparison between the 4 ^th (2007-2009) and the 7 ^th (2016-2018) Korea National Health and Nutrition Examination Surveys: Sung-Won Oh, Sook-Bae Kim; Korean J Community Nutr 2022;27(5):406-421. Published online October 31, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.5.406

Abstract PDF

Objectives
The purpose of this study was to investigate the blood biochemical characteristics, comorbidities, dietary intake, and other risk factors leading to poor glycated hemoglobin (HbA1c) control in elderly Korean diabetes patients over 65 years of age.
Methods
Data from the 4 ^th (2007-2009) and the 7 ^th 2016-2018) Korea National Health and Nutrition Examination Surveys (KNHANES) were used. Socio-demographic characteristics (age, gender, region, household income, education level, marital status, nutrition education, diabetes duration and diabetes treatment), lifestyle characteristics (drinking, smoking, regular walking, and subjective health perception), anthropometric characteristics (height, weight, and waist circumference), blood biochemical characteristics (HbA1c, high- density lipoprotein cholesterol, triglycerides, total cholesterol, blood urea nitrogen, and blood creatinine), co-morbidities (obesity, hypertension, hypercholesterolemia, hypertriglyceridemia, and anemia), energy and nutrients intake, food group intake, and HbA1c control-related risk factors were compared.
Results
Compared to the 4 ^th survey, the 7 ^th survey showed an increase in diabetes prevalence among men, an increase in the prevalence of diabetes in the older patients, and an increase in the duration of diabetes. The energy ratio from carbohydrate consumption in the 7 ^th survey was lower than in the 4 ^th .Compared to the 4 ^th survey, thiamine and riboflavin intake had improved, and the intakes of vitamin A, vitamin C, and niacin had worsened in the 7 ^th . A comparison of food group intakes showed that there was a decrease in the consumption of whole grains, potatoes, and milk and an increase in the intake of beverages and alcoholic beverages. The risk factors for poor control of HbA1c were the duration of diabetes and co-morbid hypertriglyceridemia in the 4 ^th survey, whereas subjective health perception, obesity, and hypercholesterolemia as co-morbidities were found to be risk factors in the 7 ^th in addition to the risk factors highlighted in the 4 ^th survey.
Conclusions
For the future management of elderly Korean diabetes patients, greater care is indicated for men over 75 years, and those with low levels of education. It is necessary to increase the intake of milk and vegetables, and reduce the intake of beverages and alcoholic beverages. In addition, it is necessary to reduce the incidence of obesity, hypercholesterolemia, and hypertriglyceridemia for proper control of blood sugar.

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Factors Influencing the Dietary Behavior of Patients with Type 2 Diabetes Mellitus: A Cross-sectional Study
Sohyun Jin, Youngshin Song
Journal of Korean Academy of Fundamentals of Nursing.2024; 31(1): 80. CrossRef
Association of ultra-processed food with diabetes and impaired fasting glucose in elderly populations (urban and rural): a cross-sectional study
Seung Jae Lee, Mi Sook Cho
Korean Journal of Community Nutrition.2024; 29(1): 51. CrossRef
Consistency of 1-day and 3-day average dietary intake and the relationship of dietary intake with blood glucose, hbA1c, BMI, and lipids in patients with type 2 diabetes
DaeEun Lee, Haejung Lee, Sangeun Lee, MinJin Lee, Ah Reum Khang
Journal of Korean Biological Nursing Science.2023; 25(1): 20. CrossRef

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[Korean]
Using Service Design Tools in Community Nutrition Research: A Case Study in Developing Dietary Guidelines for Young Adults: Eunbin Jo, Jae Eun Shim, Hyun Joo Ryou, Kirang Kim, Su Jin Song, Hyun Ja Kim, Jeong Sun Ahn, Kwang-il Kwon, Hye Young Lee, Sohyun Park; Korean J Community Nutr 2022;27(3):177-191. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.177

Abstract PDF

Objectives
Recent epidemiological data reported that young adults in their 20 ~ 30s are a vulnerable population with unhealthy dietary practices and a few signs of deteriorated health indicators. However, there are no dietary guidelines that are specifically developed for the young adult population. This study introduces some data collection tools that are mostly used in the service design field, and demonstrates how these tools can be used in nutrition research for developing dietary guidelines for specific target groups.
Methods
To understand the context of food choices among young people, 39 people were enrolled to complete a probes booklet. Thematic analysis and word cloud were performed to capture the main themes from the probes and a persona was developed based on the findings.
Results
Data from the probes enabled us to grasp the various contextual meanings of eating practices among young people. Most participants understand what a healthy diet is and often have a willingness to practice it. However, there were very few participants who were following the practices. We created four types of persona for developing dietary guidelines: healthy eating, emotional eating, convenient eating, and trendy eating.
Conclusions
Probes and persona were used in order to understand the lives of young adults and develop targeted messages. We hope that this introduction will be helpful to researchers who are looking for new ways of understanding their target population in the field of community nutrition.

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Development of a campus-based intervention program to strengthen food literacy among university students: A qualitative formative study
Eunji Ko, Eunjin Jang, Jiwon Sim, Minjeong Jeong, Sohyun Park
Korean Journal of Community Nutrition.2023; 28(6): 495. CrossRef

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[English]
Exploring the customer perceived value of online grocery shopping: a cross-sectional study of Korean and Chinese consumers using Means-End Chain theory: Xinyu Jiang, Hyo Bin Im, Min A Lee; Korean J Community Nutr 2024;29(4):318-335. Published online August 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00007

Abstract PDF PubReader ePub: Objectives
Despite the growing market share of online grocery shopping, there is a need to understand customer perceived value due to the ongoing advancements in information technology. This study explores the connections between attributes, consequences, and values. Additionally, it conducts a cross-country comparison of consumers’ online grocery shopping behaviors to gain a deeper understanding of consumer market segments and any potential variations among them.
Methods
Data was collected through an online questionnaire survey conducted from May 1 to 15, 2024, targeting 400 consumers in Seoul, Korea, and Shanghai, China, who have experience with online grocery shopping. The survey utilized the Means-End Chain theory and association pattern technique hard laddering. Data collation and analysis were conducted using the IBM SPSS Statistics 28.0 program. The LadderUX software was employed to analyze the links between attributes, consequences, and values and create the consumer purchasing process’s implication matrix and hierarchical value map (HVM).
Results
The study identified key attributes that influence online grocery shopping decisions, including delivery service, price, freshness, and quality. Korean consumers demonstrated a higher sensitivity to price (19.0%) and delivery service (17.0%). In contrast, Chinese consumers prioritized delivery service (15.0%) and after-sales service (14.8%). Commonly cited consequences included time saving (12.6% for Koreans, 11.3% for Chinese), whereas prevalent values encompassed convenience (36.8% for Koreans, 19.6% for Chinese) and economic value (26.6% for Koreans, 14.7% for Chinese). The HVM underscored these insights, highlighting diverse consumer preferences and country-specific nuances.
Conclusions
The findings highlight the current state of online food consumption and consumers’ value systems, revealing variations among countries. These findings offer empirical insights that can be used to create customized global marketing strategies that resonate with various consumer preferences and market dynamics.

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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

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]
Dietary intake and food sources of essential fatty acids among Korean adolescents: a cross-sectional study based on the 2016–2021 KNHANES data: Enkhgerel Erdenetsetseg, Hye Ran Shin, SuJin Song; Korean J Community Nutr 2024;29(2):144-155. Published online April 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.2.144

Abstract PDF: Objectives
This study evaluated dietary intake and food sources of essential fatty acids in Korean adolescents.
Methods
This study was comprised of 3,932 adolescents (9–18 years) who participated in the 2016–2021 Korea National Health and Nutrition Examination Surveys. Dietary intake and food sources of essential fatty acids, including alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and linoleic acid (LA) were evaluated using data obtained from one-day 24-hour dietary recall. The proportions of adolescents consuming ALA, EPA + DHA, and LA above or below the adequate intake (AI) of the 2020 Dietary Reference Intakes for Koreans were calculated. All statistical analyses accounted for the complex sampling design effect and appropriate sample weights.
Results
The mean intakes of ALA, EPA, DHA, and LA among Korean adolescents were 1.29 g/day, 69.6 mg/day, 166.0 mg/day, and 11.1 g/day, respectively. Boys had higher intakes of all essential fatty acids compared to girls. By age group, adolescents aged 15–18 years showed lower intakes of EPA and DHA compared to adolescents in younger age groups. The 9–11-yearold adolescents had lower intakes of ALA and LA than older adolescents. The proportions of adolescents who consumed more than AI were 35.7% for ALA, 30.4% for EPA + DHA, and 41.5% for LA. Adherence to the AI for ALA did not differ by sex or age group, although boys showed a lower adherence to the AI for EPA + DHA than girls. Major food sources for ALA and LA were plant-based oils, mayonnaise, pork, and eggs. Mackerel was the most significant contributor to EPA and DHA intake (EPA, 22.6%; DHA, 22.2%), followed by laver, squid, and anchovy.
Conclusions
The proportion of Korean adolescents who consumed EPA + DHA more than AI was low. Our findings highlight that nutrition education emphasizing an intake of essential fatty acids from healthy food sources is needed among Korean adolescents.

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[English]
Impact of postoperative dietary types on nutrition and treatment prognosis in hospitalized patients undergoing oral and maxillofacial surgery: a comparative study: Sung Bin Youn, Se-Hui Ahn, Dong-Ho Cho, Hoon Myoung; Korean J Community Nutr 2024;29(2):129-143. Published online April 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.2.129

Abstract PDF: Objectives
The objective of this study is to compare a nutritionally balanced soft blend diet (SBD) with a soft fluid diet (SFD) on the health of inpatients who have undergone oral and maxillofacial (OMF) surgery, ultimately aiming to enhance care outcomes, improve healthrelated quality of life (QOL), and increase satisfaction with the hospital.
Methods
Thirty-two patients were randomized into two groups: sixteen received SFD and sixteen received SBD. Anthropometric, laboratory evaluations were conducted upon admission and discharge. Patients filled out questionnaires on demographics, diet satisfaction, food intake amount, and health-related QOL on the day of discharge, assessed using the EuroQoL 5 Dimensions 3 Level and EuroQoL Visual Analogue Scale (EQ-VAS) instruments. Data were analyzed with descriptive statistics, χ 2 tests for group differences, and paired nonparametric t-tests for within-group comparisons. The Mann-Whitney U test evaluated inter-group differences in preoperative weight and body mass index (BMI), postoperative changes, meal satisfaction, intake, health-related QOL, and self-assessed health status. P-values were set at a significance level of 0.05.
Results
The SBD group had higher dietary intake (63.2% vs. 51.0%) and greater diet satisfaction (80.6 vs. 48.1, P < 0.0001) compared to SFD group. Health-related QOL, measured by EQ-VAS, was better in SBD group (70.3 vs. 58.8, P < 0.05). Postoperative weight and BMI decreased in SFD group but increased in SBD group (P < 0.01). Changes in laboratory results showed more stability in the SBD group. No postoperative infections were reported in SBD group, whereas SFD group had a 31.25% complication rate.
Conclusions
While SFD is often recommended after OMF surgery to protect oral wound healing process, our study reveals that SBD not only enhances physical and psychological outcomes but also, somewhat unexpectedly, supports wound healing and reduces complications. Essentially, SBD promotes physical recovery and enhances health-related QOL than SFD by supporting both somatic and mental healing aspects.

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[Korean]
Systematization of food and nutrition education content based on national kindergarten curriculum: a qualitative formative study: Jung-Hyun Kim, Eugene Shim, Eunyoung Baik; Korean J Community Nutr 2023;28(6):509-522. Published online December 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.6.509

Abstract PDF: Objectives
This study is intended to develop a curriculum for kindergarten food and nutrition education aimed at preschool children, reflecting government policy and meeting the demands of preschool settings.
Methods
Existing educational materials were analyzed, and key elements of the 2019 Revised Nuri Curriculum (“Nuri Curriculum”) and Guidelines for Nutrition and Food Education in Kindergartens, Elementary, Middle, and High Schools (“Guidelines”) were examined as foundational information for developing the curriculum for food and nutrition education.
Results
Basing ourselves on the five domains of the Nuri Curriculum, “Physical Activity and Health,” “Communication,” “Social Relationships,” “Art Experience,” and “Natural Science Inquiry,” we integrated three areas from the Guidelines, namely “Dietary Habits and Health,” “Dietary Habits and Safety,” and “Dietary Habits and Culture,” to structure the curriculum for kindergarten food and nutrition education. Three specific domains, “Nutrition and Health,” “Food and Culture,” and “Safe Dietary Practices,” were tailored for preschool children, each comprising core concepts, content elements, and educational materials. In the “Nutrition and Health” domain, core concepts such as “nutrition” were addressed through content elements such as “balanced eating” and “vegetables and fruit,” while “health” included elements such as “eating regularly” and “nutrients for disease prevention,” each with two educational content components. The “Food and Culture” domain focused on “food” with content on “local foods (vegetable-garden experience)” and “food culture” with content on “our dining table (rice and side dishes),” “our agricultural products,” “global cuisine (multiculture),” and “considerate dietary practices,” each with four educational content components. The “Safe Dietary Practices” domain included core concepts such as “hygiene” with content on “hand-washing habits” and “food poisoning management,” and “safety” with content on “food labeling.” Conclusions: The systematized curriculum for kindergarten food and nutrition education aligns with the Nuri Curriculum and is interconnected with the Guidelines. This curriculum can be used as foundational material for developing educational resources tailored to the characteristics of preschoolers, contributing to effective implementation in early childhood education.

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[Korean]
Problems Encountered in Analyzing the Market Size, Purchase, and Consumption of HMR in the Republic of Korea: Sung Ok Kwon, Injoo Choi, Yoojeong Joo, Jihyun Yoon; Korean J Community Nutr 2022;27(6):480-491. Published online December 31, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.6.480

Abstract PDF

Objectives
This study examined the problems encountered when analyzing the market size, purchase, and consumption of HMR (home meal replacements) in the Republic of Korea.
Methods
The macro data relevant to the market size and purchase status of HMR were critically summarized. The micro data retrieved from the 2019 & 2020 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed to understand the consumption of HMR.
Results
The Korea Agro-Fisheries & Food Trade Corporation and the Ministry of Food and Drug Administration reported the market size of HMR, whereas the Korean Rural Economic Institute and the Rural Development Administration reported the purchase expense and frequencies of HMR. Since the values on the market size and purchase status were calculated or surveyed using different scopes of HMR, there have been reliability issues for the data presented. Additionally, lack of consensus on the use of Korean terms corresponding to HMR was found to be a problem. To examine the consumption of HMR, analysis of the food intake data from KNHANES presented results with very low validity due to the inappropriate survey and coding scheme not reflecting the inclusion of new food types.
Conclusions
Several problematic discrepancies were encountered in the statistics on HMR. The fundamental cause of these problems was the absence of agreement on the scope of HMR and the Korean terms corresponding to it. Considering the increasing importance of HMR in Korean diets, urgent cooperative efforts are required between the government and academia to derive an agreed Korean term and establish the scope of HMR.

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Usage and Quality Satisfaction of Convenience Food at Convenience Stores according to the Eating Behavior of University Students in Southern Gyeonggi Province
Se-In Oh, Ok-Sun Kim
Journal of the East Asian Society of Dietary Life.2023; 33(6): 492. CrossRef

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[Korean]
Comparison of the Nutrient Intake and Health Status of Elderly Koreans According to their BMI Status: Focus on the Underweight Elderly Population: You-Sin Lee, Yoonna Lee; Korean J Community Nutr 2022;27(5):422-434. Published online October 31, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.5.422

Abstract PDF

Objectives
With an increase in the population of the elderly in Korea, their nutritional status has become a cause for concern. This study was designed to compare the nutritional intake and health status of the Korean elderly according to their body mass index.
Methods
The subjects were 3,274 elderly people aged 65 and above who had participated in the 2016-2018 Korea National Health and Nutrition Examination Survey. The subjects were divided into four groups: underweight, normal, overweight, and obese, based on their BMI. The general characteristics, daily energy, and nutrient intakes, nutrient intakes compared to the recommended nutrient intake, percentage of participants whose nutrient intake was lower than the estimated average requirement (EAR), index of nutrient quality, the mean adequacy ratio (MAR), intakes by food group, and health status of the four groups were compared.
Results
Underweight elderly people showed lower energy, lipids, dietary fiber, vitamin C, riboflavin, niacin, phosphorus, sodium, and potassium intake and MAR score (P < 0.001) compared to the normal or obese elderly. The mean protein, riboflavin, niacin, vitamin C, phosphorus, and iron intake of the underweight elderly was lower than the EAR (P < 0.05). Underweight elderly people also had a lower intake of vegetables and fats, oil and sweets food groups than the other groups (P < 0.001). The prevalence of diabetes and dyslipidemia was higher in the obese group, but the percentage of anemia was higher in the underweight group.
Conclusions
Underweight elderly people were vulnerable to undernutrition and were at a higher risk of anemia.

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Effect of physical activity on free fatty acids, insulin resistance, and blood pressure in obese older women
Woo-Hyeon Son, Min-Seong Ha, Tae-Jin Park
Physical Activity and Nutrition.2024; 28(2): 1. CrossRef

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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

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]
Exploring factors of nutrition teachers’ intentions for sustainable dietary education in South Korea: an application of the theory of planned behavior: Eunseo Yang, Borham Yoon; Korean J Community Nutr 2024;29(2):114-128. Published online April 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.2.114

Abstract PDF: Objectives
The purpose of this study was to investigate the perception of nutrition teachers and the factors influencing their intention toward sustainable dietary education utilizing the theory of planned behavior (TPB).
Methods
The self-administered online survey was completed by nutrition teachers in Jeollanam-do, South Korea. A total of 151 valid questionnaires were analyzed. Factor analysis and multiple regressions were employed to test the research model.
Results
The study findings demonstrated that all TPB variables significantly influenced the sustainable dietary educational intention, with the degree of influence ranking as follows: external perceived behavioral control (β = 0.417), attitude (β = 0.240), internal perceived behavioral control (β = 0.207), and subjective norms (β = 0.181). For external perceived behavioral control, nutrition teachers and elementary schools exhibited higher levels compared to dietitians and middle/high schools, respectively. The participants in sustainable dietary education training programs exhibited a higher level of internal perceived behavioral control compared to those who did not participate. The highest perception levels were reported for attitude (4.26), followed by subjective norms (4.02), internal perceived behavioral control (3.67), and external perceived behavioral control (3.20).
Conclusions
This study affirmed that the TPB variables elucidated the sustainable dietary educational intentions of nutrition teachers. The significant impacts of external and internal perceived behavioral control, attitude, and subjective norms on educational intentions were confirmed. Consequently, proactive support from schools and governments is essential to enhance the facilitating factors and mitigate the barriers toward sustainable dietary education in schools.

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[Korean]
Effectiveness of NQ-E index-based individual nutrition counseling for community-care elderly: an intervention study on improving nutritional status, complex chronic diseases, and quality of life: Yoonjeong Choi, Jihyun Lee, Heesook Lim, Yoo Kyoung Park; Korean J Community Nutr 2023;28(6):480-494. Published online December 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.6.480

Abstract PDF: Objectives
This study sought to assess the effectiveness of community-based nutrition counseling on improving nutritional status, managing complex chronic diseases, and enhancing the quality of life for elderly individuals with chronic conditions, particularly in older adults with high levels of food insecurity and multiple chronic illnesses.
Methods
Thirty elderly subjects with diabetes and hypertension who were registered at local Senior Welfare Center received individualized nutrition counseling, based on their Nutrition Quotient for the Elderly (NQ-E) index. Over a 16-week period, they received tailored counseling and underwent various health and nutritional assessments. The final analysis included 28 participants after two dropped out. Data analysis was conducted using the SPSS v28.0.
Results
The subjects were over 70, with multiple chronic diseases including diabetes and hypertension and predominantly female. After 16 weeks, significant improvements were observed in the subjects’ grip strength, and HbA1c levels, as well as in their NQ-E scores, indicating improved dietary balance and diversity. There were no significant improvements in the ‘Moderation’ subdomain of the NQ-E index, suggesting that this aspect requires further attention in nutritional counseling. The subjects' nutritional risk scores (NSI) were also significantly decreased, indicating less nutritional risk. Lastly, as measured by the SF-36K, the subjects’ quality of life showed significant improvement in several domains including physical role performance and social function.
Conclusions
This study demonstrates that tailored nutrition counseling, based on the NQ-E index, can improve elderly health, manage chronic diseases, and enhance quality of life. This approach potentially broadens the scope of community nutritionists' roles within an aging society. However, additional research is necessary to evaluate these interventions' long-term effects and sustainability.

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