Korean Journal of Community Nutrition

[English]
Factors associated with malnutrition in demented and non-demented elderly residing in the community of Korea: a cross-sectional descriptive and analytical study: Jinhee Kwon, Jung Hee Kim, Hyeonjin Jeong, Jung Suk Lee; Korean J Community Nutr 2024;29(5):359-371. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00013

Abstract PDF PubReader ePub: Objectives
This study aimed to investigate and compare factors associated with malnutrition according to the presence or absence of dementia in community-dwelling elderly people.
Methods
Needs assessment data from 311 long-term care insurance (LTCI) recipients (dementia group 203; non-dementia group 108) that participated in the second pilot program of the integrated care model in community care settings under the Korean LTCI system were used. Descriptive statistical analysis, independent t-test, and analysis of variance were conducted on the sociodemographic characteristics, health and functional status, and nutritional status of the dementia and non-dementia groups. Logistic regression analysis was conducted to identify factors associated with malnutrition in the dementia and non-dementia groups.
Results
Malnutrition occurred in 33.5% and 26.9% of participants in the dementia and non-dementia groups, respectively. In the dementia group, living with family rather than living alone (odds ratio [OR]: 3.81; 95% confidence interval [CI]: 1.50–9.66; P = 0.031), increase in Korean Activities of Daily Living (K-ADL) score (OR: 1.35; 95% CI: 1.17–1.55; P < 0.001), and increase in the Neuropsychiatric Inventory-Questionnaire score (OR: 1.02; 95% CI: 1.01–1.03; P = 0.005) were associated with a higher risk of malnutrition. In the non-dementia group, the risk of malnutrition increased as the K-ADL score increased (OR: 1.20; 95% CI: 1.04–1.39; P = 0.011) and in the depressed group (OR: 2.84; 95% CI: 1.04–7.74; P = 0.042).
Conclusions
The study results confirmed the necessity of nutritional management for community-dwelling LTCI recipients. When developing a nutritional management program, considering the differences in factors related to malnutrition between the dementia and non-dementia groups is important. This study proposes policies for improving the LTCI system in terms of nutritional management and the utilization of community resources.

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[Korean]
An educational needs analysis of sustainable dietary education for nutrition teachers: an application of the IPA, Borich needs assessment and The locus for focus model: Eunseo Yang, Borham Yoon; Korean J Community Nutr 2024;29(5):372-381. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00008

Abstract PDF PubReader ePub: Objectives
This study aimed to investigate the importance and performance levels of sustainable dietary education across the health, environment, and society domains as perceived by nutrition teachers and evaluate the needs and priorities for sustainable dietary education.
Methods
An online survey was conducted for 151 nutrition teachers in Jeollanam-do. The survey included 20 questions across the health, environment, and society domains. The data were analyzed using a paired-sample t-test, the importance-performance analysis (IPA), the Borich needs assessment model, and the locus for focus model.
Results
Overall, the average importance levels of the 20 items of sustainable dietary education were significantly higher than their average performance levels (4.44 vs. 3.68). The examination of each educational domain revealed that although the importance of education in the health domain was recognized and actively practiced by the nutrition teachers, the performance was comparatively lower in the environment and society domains. The Borich needs assessment and the locus for focus model identified education on biodiversity conservation, plant-based protein, and the use of local food as the top-priority group in the environment domain along with fair and ethical food, food security, regional food culture, food policy and trade, and family dining culture as the second-priority group in the society domain.
Conclusions
The results of this study underscore the need to support the nutrition teachers’ perception and practice of sustainable dietary education in the environment and society domains. We believe that the educational needs and priorities proposed in this study will be considered in the future development and modification of sustainable dietary education programs.

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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

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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[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

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]
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

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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[English]
Associations between the symptoms of gastroesophageal reflux disease and dietary and lifestyle behavior among young Korean adults: a preliminary cross-sectional study: Soheun Shim, Jeong-Hwa Choi, Young-Ran Heo; Korean J Community Nutr 2024;29(5):396-405. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00011

Abstract PDF PubReader ePub: Objectives
Gastroesophageal reflux disease (GERD) is a clinical condition caused by esophageal tissue damage resulting from the reflux of stomach or duodenal contents. An increasing number of GERD cases have been reported recently; however, research on this population, especially young adults, is lacking. This study aimed to investigate the dietary and lifestyle factors associated with GERD symptoms in young Korean adults. Methods: A total of 202 individuals (19–34 years old) living in Gwangju were surveyed using a questionnaire to examine their general characteristics, lifestyle, and dietary behaviors. GERD symptoms were investigated using the gastroesophageal reflux disease questionnaire (GerdQ). The participants were grouped into normal (GerdQ score ≤ 4) and caution (GerdQ score ≥ 5), and their characteristics were analyzed according to the group. Results: The findings suggested 15 participants (7.4%) belonged to the GERD caution group. More non-office workers were in the caution group than in the normal group (P < 0.05). The participants’ smoking, physical activity, sleep duration, and pillow height were not significantly different between the GERD phenotypes; however, the caution group consumed alcohol more frequently than the normal group (P < 0.001). The analyses of the participants’ eating behaviors revealed that the frequency of overeating, late-night snacking and chocolate consumption was significantly higher in the caution group (P < 0.001). Conclusion: Lifestyle and dietary behaviors were associated with GERD symptoms in young Korean adults. Further studies with larger cohorts are required to confirm these findings.

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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]
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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Comparative Evaluation of Effect of Therapeutic Nutrition on Serum Albumin Levels and Nutritional Indices in Patients Undergoing Open Reduction and Internal Fixation for Maxillofacial Fractures – A Prospective Clinical Trial
B. R. Rajanikanth, Amruta T. Achar, Kavitha Prasad, Hema Arvind
Journal of Maxillofacial and Oral Surgery.2025;[Epub] CrossRef

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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
성인 남녀의 먹방 시청시간에 따른 식행동에 대한 연구
하얀 남, 복미 정, 은례 전
Korean Journal of Food and Cookery Science.2024; 40(4): 275. CrossRef

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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

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]
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]
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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성인 남녀의 먹방 시청시간에 따른 식행동에 대한 연구
하얀 남, 복미 정, 은례 전
Korean Journal of Food and Cookery Science.2024; 40(4): 275. CrossRef

547 View
40 Download
1 Crossref

[Korean]
The association between nutrition label utilization and disease management education among hypertension or diabetes diagnosed in Korea using 2018 Community Health Survey: a cross-sectional study: Miran Jin, Jayeun Kim, Kyuhyun Yoon; Korean J Community Nutr 2023;28(1):38-47. Published online February 28, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.1.38

Abstract PDF

Objectives
This study examined the association between the experience of disease management education and the use of nutrition labels according to the sociodemographic characteristics and health behaviors of people diagnosed with hypertension and diabetes living in the community.
Methods
Among the participants from the Community Health Survey (2018), 74,283 individuals diagnosed with hypertension or diabetes were included in the study population. According to gender, this study evaluated nutrition label use by the experience of disease management education, individual sociodemographic characteristics, and health behavior. Finally, using multiple logistic regression analysis, the association between disease management education and nutrition labels was calculated using the odds ratio (OR) and 95% confidence interval (CI).
Results
Males (24.5%) experienced more disease management education than females (22.6%). In addition, younger age, higher education level, and higher equalized personal income experienced more disease management education (P < 0.001). The educational experience rate was higher in the male subjects who did not smoke or were involved in high-risk alcohol consumption (P < 0.001). In addition, the rate of disease management education experience was significantly higher for both men and women who exercised by walking (P < 0.001). The use of nutrition labels was higher in females (9.9%) than males (5.8%), and both males and females were significantly higher in young age, high education, high income, and professional and office positions (P < 0.001). The utilization rate of nutrition labels was high in non-smoking male subjects and high-risk-drinking female subjects. In addition, the utilization rate of nutrition labels was significantly higher in males and females who exercised by walking and those who experienced disease management education (P < 0.001). After adjusting for individual sociodemographic characteristics, health behavior, and disease management education, the use of nutrition labels was high among females (OR 3.19, 95% CI 2.85-3.58), high income (Q4; OR 1.62, 95% CI 1.41-1.87, Q5; OR 1.58, 95% CI 1.37-1.84) and highly educated (high school; OR 2.87, 95% CI 2.62-3.14, above college; OR 5.60, 95% CI 5.02-6.23) while it was low in the elderly (OR 0.43, 95% CI 0.40-0.47), and economically inactive (OR 0.86, 95% CI 0.76-0.96). The use of nutrition labels was high in non-smokers (OR 1.29, 95% CI 1.13-1.48), nonhigh-risk drinkers (OR 1.22, 95% CI 1.08-1.38), and subjects who exercised walking (OR 1.44, 95% CI 1.34-1.54). There was no difference in the utilization rate of nutrition labels according to obesity, and the utilization rate of nutrition labels was significantly higher in subjects who had experienced disease education (OR 1.34, 95% CI 1.24-1.44).
Conclusions
Education on the use of nutrition labels, which contributes to food selection for healthy eating, might be a tool for dietary management. Moreover, the utilization rate can be a good indicator for predicting the proportion of the population practicing the guide for disease management. Improving the utilization rate of nutrition labels through disease management education can be a useful intervention for people with chronic diseases who need healthy eating habits for disease management and preventing complications, particularly those diagnosed with hypertension and diabetes.

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Comparison of Health Status and Life Satisfaction According to Food Security in Single-Person Households of Elderly Population
Dong Hoon Jung, Jae Won Han, Wonha Kim, Hee-Sook Lim
Clinical Nutrition Research.2024; 13(1): 42. CrossRef
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
Factors Influencing Participation in Hypertension Management Education Among Diagnosed Hypertensive Patients in Busan: Utilizing the 2021 Community Health Survey
Hye Jung Jun, Kyoung Mi Kim
Research in Community and Public Health Nursing.2024; 35: 424. CrossRef
An association between socioeconomic status and preventive screening for diabetic eye and kidney complications among individuals with type 2 diabetes
Changwoo Shon, Jongnam Hwang
Korean Journal of Health Education and Promotion.2023; 40(5): 27. CrossRef

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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

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]
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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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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[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

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]
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]
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]
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

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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[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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[Korean]
Knowledge on complementary foods of mothers with young children and their perception of convenience complementary foods: Yoojeong Joo, Jihyun Yoon, Linxi Huang, Youngmin Nam; Korean J Community Nutr 2024;29(1):16-33. Published online February 29, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.1.16

Abstract PDF

Objectives
The purpose of this study was to examine mothers’ knowledge levels on complementary foods and their perception of convenience complementary foods.
Methods
An online survey was conducted with mothers aged 20–49 years who had purchased convenience complementary foods and had a preschool child aged 4 months or older. The respondents were categorized into 3 groups based on their knowledge scores: low- (0–50 points), mid- (55–65 points), and high- (70–100 points) knowledge groups.
Results
The average score of mothers’ knowledge on complementary foods was 58.8 out of 100 points. Working mothers were found to have lower levels of knowledge compared to mothers who were housewives. Only 1/4 of responding mothers had educational experience on complementary foods. Mothers expressed a desire for information on the types of complementary foods (72.2%) and the intake amounts (60.3%) corresponding to each phase of their child’s development. Multivariate analysis of variance revealed significant differences in health (P = 0.002), variety (P = 0.039), and hygiene (P = 0.041) among the factors taken into consideration when purchasing convenience complementary foods according to the mothers’ knowledge levels. Mothers in the high-knowledge group placed a greater importance on ‘balanced nutrition’ (P = 0.022) and ‘hygienic cooking’ (P = 0.010) compared to mothers in the low-knowledge group. The results of the modified importance-performance analysis, which compared the importance and performance of the factors taken into consideration when purchasing convenience complementary foods, highlighted the need for efforts in ‘health,’‘hygiene,’ and ‘price,’ while also indicating an excessive effort in ‘convenience.’ Conclusions: This study suggests expanding relevant education programs to enhance mothers’ knowledge on complementary foods, especially for working mothers. In the industry, marketing strategies for complementary food products could be developed that align with the needs of mothers, focusing on health, hygiene, and price.

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Development and Evaluation of a Nutrition Education Website for the Prevention and Management of Childhood Obesity
Miyong Yon, Chan Park, Kwan-Hee Yoo, Taisun Hyun
Korean Journal of Community Nutrition.2012; 17(4): 390. CrossRef
Breakfast Skipping and Related Factors in Children in Poverty
Kyung Ja June, Jin-Young Kim, Seungmi Park, Ji Yun Lee
Journal of Korean Academy of Community Health Nursing.2011; 22(2): 204. CrossRef

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[English]
Screen time, mealtime media use, and dietary behaviors in Korean preschoolers : a cross-sectional study: Young-Hee Han, Saerom Shin, Eun Yeol Woo, Hye-Kyung Park, Taisun Hyun; Korean J Community Nutr 2023;28(3):206-219. Published online June 30, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.3.206

Abstract PDF: Objectives
Screen time refers to the time spent using screen media, such as televisions, smartphones, computers, or tablets. Excessive exposure to screen media has been reported to negatively impact young children’s health and development, including overweight, short sleep duration, and language delays. This study examined the association of screen time and mealtime media use with dietary behaviors among preschool children.
Methods
A cross-sectional survey was conducted on parents of children aged three to five years using the online questionnaires of the Nutrition Quotient for Preschoolers (NQ-P) and the Dietary Screening Test (DST). Data from 261 children’s parents were analyzed.
Results
Of the 261 children, 96.9% used screen media, 55.6% used screen media for two hours or more daily, and 30.7% were exposed to screen media during meals. The NQ-P scores were significantly lower in the children with longer screen time and mealtime media use. Children who used screen media for two hours or more and those exposed to screen media during meals consumed kimchi less frequently and confectionery and sugar-sweetened beverages more frequently than children who used less than two hours and were not exposed to screen media during meals. In addition, they were more likely to be picky about food, refuse to eat, and less likely to feed themselves than children with shorter screen time and no mealtime media use.
Conclusions
This study reported an association between unhealthy dietary behaviors, feeding difficulties, and screen time and mealtime media use among preschool children. Further research should explore effective strategies for reducing children’s screen time.

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[English]
Mercury exposure is associated with obesity: a systematic review and meta-analysis: Jimin Jeon, Kyong Park; Korean J Community Nutr 2023;28(3):192-205. Published online June 30, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.3.192

Abstract PDF

Objectives
Previous studies have evaluated the association between mercury exposure and obesity but have yielded mixed conclusions. The aim of this study was to systematically review and summarize scientific evidence regarding the association between mercury exposure and obesity in the human population.
Methods
We conducted a systematic search of PubMed, Web of Science, Scopus, and Science Direct for articles related to mercury exposure and obesity. Meta-analyses of the highest and lowest categories of mercury levels were evaluated using a random effects model. Begg’s test was used to detect publication bias.
Results
A total of 9 articles were included. The pooled random effects odds ratio (OR) for mercury exposure and obesity of all 9 studies was 1.66 (95% confidence interval [CI]: 1.16-2.38). This positive association was evident in adults (OR: 1.61, 95% CI: 1.02-2.54) and among studies with Asian populations (OR: 2.00, 95% CI: 1.53-2.59), but not among those with North America/African populations (OR: 0.90, 95% CI: 0.50-1.65).
Conclusions
The present meta-analysis identified a positive association between mercury exposure and obesity. These findings suggest that toxic environmental metals such as mercury may be an important risk factor for obesity along with dietary habits and lifestyles.

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Association between heavy metal exposure and biomarkers for non-alcoholic fatty liver disease in Korean adolescents
Dong-Wook Lee, Jongmin Oh, Yu Min Lee, Hyun-Joo Bae, Youn-Hee Lim
Heliyon.2024; 10(19): e37840. CrossRef

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[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

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]
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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Modelling the mass adoption potentials of fashion-augmented reality among the young consumers: evidence from an emerging economy
Mohima Akther, Mohammad Nurul Hassan Reza, Abdullah Al Mamun, Norzalita Abd Aziz, Marvello Yang
Journal of Fashion Marketing and Management: An International Journal.2024;[Epub] CrossRef

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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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[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

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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[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]
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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[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

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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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A Basic Study to Establish a Nutrition Education System for Welfare Facilities for the Elderly at Home Using Body Composition Analysis and Nutritional Management Cards
Sun Hee Lee, Seung-Lim Lee
The Korean Journal of Community Living Science.2024; 35(3): 471. CrossRef

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