Korean Journal of Community Nutrition

[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]
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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[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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[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]
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]
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]
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]
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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[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]
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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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

351 View
28 Download
1 Crossref

[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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[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

345 View
26 Download
2 Crossref

[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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A Study of the Chemosensory Properties of Commercial Processed Foods Using Electronic Sensors
Hyeonjin Park, Younglan Ban, Sojeong Yoon, Hyangyeon Jeong, Seong Jun Hong, Hee Sung Moon, Se Young Yu, Hyun-Wook Kim, Kyeong Soo Kim, Eun Ju Jeong, Eui-Cheol Shin
Journal of the Korean Society of Food Science and Nutrition.2024; 53(8): 805. CrossRef

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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]
Nutrition education programs necessary for social welfare facilities for persons with disabilities: a cross-sectional study: Jinkyung Kim, Min-Sun Jeon; Korean J Community Nutr 2024;29(1):1-15. Published online February 29, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.1.1

Abstract PDF: Objectives
This study investigated the need for nutrition education aimed at improving the health of residents and users of social welfare facilities for persons with disability and aimed to provide basic information for developing a nutrition education program that meets the needs of the field.
Methods
Altogether, 249 employees working in social welfare facilities for people with disabilities were included in the study. Data on the health status of residents/users, meal management, nutritional education, nutritional education needs, and awareness of nutritional education were obtained through online surveys. A descriptive analysis was conducted to analyze the demographic characteristics, needs, and perceptions of the respondents, and independent t-tests and χ² tests were performed to analyze and compare the differences between residential and daycare facilities.
Results
The majority of residents/users of social welfare facilities for persons with disabilities have developmental disabilities. When educating residents with residents/users of social welfare facilities, ‘personal hygiene’ was the most necessary topic, followed by ‘obesity management’ education. Regarding the methods of providing education, face-toface lectures demonstrated a high demand. They responded that when nutrition education experts provide nutrition education to people with disabilities, they must understand ‘the physical characteristics of persons with disabilities’ and have the ability to determine appropriate nutrition for such people. The most appropriate nutrition program training would be twice a year, lasting 30 min to 1 h per training session.
Conclusions
It will present a direction for operating a nutrition education program for persons with disabilities that meets their needs of social welfare facilities and ultimately contribute to the establishment and activation of nutrition education tailored to welfare facilities for such individuals in Korea.

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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]
Food and dish group diversity on menus of daycare centers provided by Center for Children’s Foodservice Management in Korea: a descriptive study: Youn-Rok Kang, Kyeong-Sook Lim, Hyung-Sook Kim; Korean J Community Nutr 2023;28(6):449-465. Published online December 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.6.449

Abstract PDF: Objectives
This study aimed to analyze menu patterns and food group diversity in daycare centers managed by the Center for Children's Foodservice Management in South Korea.
Methods
Data from 18 Center for Children's Foodservice Management centers across various provinces (excluding Jeju Island) were analyzed. We examined 8,796 meals served in February, May, August, and December 2021, focusing on seasonal lunch and snack menus for children aged 3-5. Foods were categorized into 19 groups for lunch and 21 for snacks. The frequency of food groups and dietary patterns were assessed using the Dietary Diversity Score. Analyses were conducted using Excel 2016 and IBM SPSS Statistics version 28.
Results
Most lunch menus (89%) included five menu items, with a ratio of grain, meat, and vegetables at 88%. Snack menus typically had one item (57%), with significantly more items in the afternoon compared to the morning (P < 0.001). Regarding snack patterns, 75.2% of morning snacks and 61.1% of afternoon snacks contained only one solid food and drink (P < 0.001). Fruit and milk (22.4%) was the most prevalent pattern in morning snacks, while grain and milk (31%) dominated afternoon snacks (P < 0.001). Only 48% of daycare center menus (all snacks and lunch) included all five food groups (grain, meat, vegetables, fruit, and milk). Notably, only 83% included milk and 57% included fruit.
Conclusions
These findings highlight the need to improve food variety and diversity in the Center for Children’s Foodservice Management-managed daycare center menus. Developing more detailed guidelines for menu structure and food composition is crucial to ensure children receive balanced and diverse nutrition.

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[Korean]
Facilitators and barriers to achieving dietary and physical activity goals : focus group interviews with city bus drivers and counseling dietitians: Yongmin Jo, Suhyeun Cho, Young-Hee Han, Taisun Hyun; Korean J Community Nutr 2023;28(5):376-391. Published online October 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.5.376

Abstract PDF

Objectives
Our previously published study showed that a workplace nutrition intervention program with personalized goal setting and smartphone-based nutrition counseling improved dietary habits and physical activity in city bus drivers who were overweight/obese. This study explored the facilitators and barriers that participants faced in achieving their dietary and physical activity goals six months after the intervention.
Methods
The study included bus drivers and dietitians who participated in the intervention program. Three focus group interviews were conducted with 10 bus drivers (divided by two groups based on their achievement of set goals) and five dietitians who had provided nutrition counseling.
Results
Willpower was the most important intrapersonal facilitator for drivers to achieve their goals. Other factors that promoted behavioral changes were nutrition counseling by dietitians, trackable physical activity using smartwatches, and setting of practical and achievable goals. Meanwhile, the most important barriers identified were occupational factors such as long driving hours, short breaks, and shift work. Other barriers were environmental factors such as availability of snackable food, accessibility to convenience stores, and cold weather. Family and colleagues were perceived as both facilitators and barriers. In addition, dietitians identified a lack of knowledge about healthy diet as one of the barriers.
Conclusions
Our results suggested that the workplace environment should be improved and that nutrition intervention programs at the workplace could encourage bus drivers to practice healthy eating habits. The facilitators and barriers identified in this study should be considered when planning a nutrition intervention program for bus drivers.

Citations

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Process evaluation of a mobile healthcare program among employees with overweight and obesity: a 12-week intervention study investigating the role of engagement
Imhuei Son, Jiyoun Hong, Young Hee Han, Bo Jeong Gong, Meng Yuan Zhang, Woori Na, Cheongmin Sohn, Taisun Hyun
Korean Journal of Community Nutrition.2023; 28(6): 466. CrossRef

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1 Crossref

[Korean]
Factors related to adolescent obesity and changes: a cross-sectional study based on the Korea Youth Risk Behavior Survey: Bora Lee, Ho Kyung Ryu; Korean J Community Nutr 2023;28(5):363-375. Published online October 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.5.363

Abstract PDF

Objectives
The objective of this study was to identify factors associated with adolescent obesity, as well as any new factors that correlated with a change in the rate of obesity over time.
Methods
The study used 5-yearly data collected by the Korea Youth Risk Behavior Survey starting from the year 2006 up until 2021 (data from 2nd, 7th, 11th, and 17th surveys were analyzed). Factors such as demographics, dietary factors, health behavioral factors, and mental health factors were studied. All data were analyzed using IBM SPSS 27.0, employing chi-square tests and multiple logistic regression analysis.
Results
This study included data from a total of 255,200 participants. Factors contributing to obesity varied with time. Over the survey duration of 15 years, low academic achievement, parents with low levels of education, low frequency of fruit consumption, low frequency of fast food intake, long periods of being seated, and high levels of stress were significantly associated with a high rate of obesity. Factors that showed a new correlation with an increase in obesity rates included living with single parents, low frequency of muscle strengthening exercises, and experiencing intense sadness and despair in the past year. Factors that were correlated with a change in obesity rates over time included household economic status, frequency of carbonated beverage consumption, frequency of intense physical activity, and frequency of alcohol consumption. Breakfast intake and smoking were not significantly associated with obesity rates in the 15-year period.
Conclusions
While several factors associated with obesity remained consistent over time, several new factors have emerged in response to social, economic, and environmental changes contributed to a change in obesity rate over time. Therefore, to prevent and manage adolescent obesity, continuous research into the new emergent factors contributing to obesity is needed.

Citations

Citations to this article as recorded by

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 Journal of Community Nutrition.2024; 29(2): 156. CrossRef

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1 Crossref

[Korean]
Understanding consumer awareness and utilization of local food in Jecheon during the COVID-19 pandemic: a descriptive study: Hye-ryeong Shin, Soojin Park; Korean J Community Nutr 2023;28(4):329-339. Published online August 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.4.329

Abstract PDF: Objectives
This study aims to explore consumer awareness and usage patterns of local food in Jecheon city during the COVID-19 pandemic, contributing to the establishment of the Jecheon City Food Plan.
Methods
Surveys were conducted from July 24 to August 24, 2021, using a combination of web-link and self-administered methods for adults living in Jecheon city (n = 250). Descriptive analysis, t-test, importance and satisfaction analysis (ISA) of local food choice attributes were performed using SPSS Statistics.
Results
Participants prioritized freshness when purchasing agricultural products. The freshness of Jecheon local food was the selection attribute with the highest consumer satisfaction and could provide purchase motivation. Approximately 73.6% of respondents understood the concept of local food, and 70% were familiar with Jecheon's local food.Notably, 94.8% expressed an intention to purchase but held negative views on selling local food in other areas. The need to increase the supply of local food to vulnerable populations and public school catering was highly recognized. The ISA identified ‘affordable price’, ‘delivery service’, and ‘product information’ as areas requiring improvement. On the other hand, ‘freshness of products’, ‘quality for the price’, and ‘support for local farmers and economy’ were identified as attributes to be maintained and strengthened.
Conclusions
Consumers in Jecheon city recognized local foods as more than just 'consumer goods’. Our findings suggest the need for further research on local food revitalization and more comprehensive local food planning to enhance consumer satisfaction.

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[Korean]
Correlation between adolescents’ dietary safety management competency and value recognition, efficacy, and competency of convergence using dietary area: a descriptive study: Yunhwa Kim, Yeon-Kyung Lee; Korean J Community Nutr 2023;28(4):317-328. Published online August 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.4.317

Abstract PDF: Objectives
This study aimed to investigate the correlation between adolescents’ dietary safety management competency, value recognition, efficacy, and competency of convergence using the dietary area (CUDA).
Methods
Data were collected from 480 middle and high school students in Daegu, Gyeongbuk and Seoul, Gyeonggi using a self-administered five-point Likert scale questionnaire from May to July 2021. A questionnaire was used to investigate dietary safety management competency, awareness of convergence, recognition of the benefits, efficacy, and competency of CUDA.
Results
We conducted factor, reliability, correlation, and regression analyses using SPSS 25. The average scores for each factor were: dietary significance (3.68); dietary safety management knowledge (3.34); food selection and cooking (3.72); nutrition management (3.38); weight management (3.28); risk dietary management (3.13); CUDA interest (2.98); convergence necessity (3.50); benefits in specialized areas (3.31); benefits in everyday life (3.48); efficacy of science and technology convergence (3.35); convergence efficacy with humanities, social science, and arts (3.31); and CUDA competency (3.41). The score for interest in CUDA was lower than that for the recognition of CUDA benefits. Significant positive correlations were observed between all factors except between risk dietary management and both nutrition and weight management (P < 0.01). Interest in CUDA and recognition of the need for convergence exhibited a positive and significant effect on all factors of the perception of CUDA benefits and efficacy. The subgroup factors of dietary safety management competency and the recognition of CUDA had a positive effect on the CUDA competency (P < 0.001, R ² = 0.58).
Conclusions
Strengthening dietary safety management competency and increasing the awareness of CUDA can enhance adolescents’ convergence competency. Therefore, CUDA and targeted education must be actively promoted among adolescents.

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[English]
The frequency of convenience food consumption and attitude of sodium and sugar reduction among middle and high school students in Seoul: a descriptive study: Seoyeon Park, Yeonhee Shin, Seoyeon Lee, Heejung Park; Korean J Community Nutr 2023;28(4):269-281. Published online August 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.4.269

Abstract PDF: Objectives
This study aimed to examine the frequency of convenience food consumption at convenience stores (CVS) and the CVS usage patterns of middle and high school students as well as to understand students’ attitude toward sodium and sugar reduction.
Methods
We used an online questionnaire for data collection. The questionnaire comprised five distinct categories: general characteristics, CVS usage, frequency of consumption according to convenience food menus at CVS, attitude toward sodium and sugar reduction, and adherence to dietary guidelines.
Results
A total of 75 students from Seoul (14 middle school students and 61 high school students) participated in the study. Most respondents visit CVS 3-5 times a week. CVS are predominantly used during weekdays, mostly during lunch, and dinner. The students mostly checked the caloric content and expiration date as food labeling information. The participants were aware of the need to reduce their sugar and sodium intake. Among frequent CVS convenience food consumers, there was an increased consideration of the need to reduce their sugar and sodium consumption, despite their actual selection of foods with high sugar and sodium content. Additionally, they did not check the sugar and sodium levels indicated in food labeling. Further, the dietary action guide from the Ministry of Health and Welfare were poorly followed by most students.
Conclusions
There is a need for nutrition education specifically addressing the sugar and sodium content of the convenience foods predominantly consumed by students. Additionally, educating students with frequent convenience food consumption to actively check the sugar and sodium information on food labels could help promote healthier food choices.

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[Korean]
Dietary sodium and potassium intake of Koreans estimated using 2 different sources of their contents in foods, Food & Nutrient Database and the Korean Total Diet Study : a comparative study: Jee Yeon Lee, Sung Ok Kwon, Soo Hyun Lee, Min Jeong Seo, Gae Ho Lee, Cho-il Kim; Korean J Community Nutr 2023;28(3):235-244. Published online June 30, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.3.235

Abstract PDF: Objectives
Based on the results from the Korean Total Diet Study (KTDS), the sodium (Na) and potassium (K) intake of Koreans were estimated and compared with intake estimates from the Food & Nutrient Database (FNDB), as in the Korea National Health and Nutrition Examination Survey (KNHANES) to verify the validity of these estimates.
Methods
One hundred and thirty-four representative foods (RFs) covering 92.5% of the total food intake of Koreans were selected, and 228 pairs of corresponding ‘RF x representative cooking method’ were derived by reflecting the methods used mainly in terms of frequency and quantity in their cooking. RF samples were collected from three cities with a larger population size in three regions (nine cities) nationwide, and six composite samples were made for each RF, considering its regional and/or seasonal characteristics. One thousand three hundred and sixty-eight ‘RF x representative cooking method’ pair samples were prepared, and the Na and K contents were assessed using inductively coupled plasma atomic emission spectrometry (ICP-MS). The Na and K intake of the Korean population was estimated by linking the content with the food intake data from the 7th KNHANES.
Results
The mean Na and K intake of Koreans were 2,807.4 mg and 2,335.0 mg per person per day, respectively. A comparison with the Na and K intake from KNHANES, including only RFs of KTDS, showed comparable results with less than 5% variation. While the contribution and ranking of food items to Na intake were similar between KNHANES and KTDS, there were differences in K intake. This was attributed to the large discrepancies in the K content of rice and coffee between KTDS results and the values in the 9th Revision of the National Food Composition Table used in KNHANES.
Conclusions
The Na and K intake of Koreans estimated based on the KTDS, which performed nutrient analysis on samples prepared to a ‘table-ready’ state using foods of the representative collection, was similar and comparable with that of KNHANES. This supports the validity and usefulness of FNDB-based nutrient intake estimation at the population level. The list of nutrients studied in KTDS is expected to be expanded, allowing for intake estimation of nutrients with currently insufficient or absent information in the FNDBs in use.

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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]
Changes in dietary habits and chronic diseases before and after COVID-19 by regions using data from the 2018-2020 Korea Community Health Survey and Consumer Behavior Survey for Foods: a cross-sectional study: Surim Park, Eun-hee Jang, Seungmin Lee; Korean J Community Nutr 2023;28(2):124-140. Published online April 30, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.2.124

Abstract PDF: Objectives
This study examined the changes in dietary habits, the prevalence of chronic diseases, and mental health problems in the regional areas of the Republic of Korea before and after the COVID-19 pandemic to provide evidence of the status of regional health inequalities.
Methods
This study analyzed Korean adults aged 19 or older who participated in the Korea Community Health Survey (n = 686,708) and Consumer Behavior Survey for Foods (n = 19,109) from 2018 to 2020. The participants were classified according to their residence area (Seoul metropolitan area, Metropolitan cities, Provinces); 2018-2019 were defined as before COVID-19, and 2020 as after COVID-19. The dietary behaviors, chronic diseases, and mental health problems were measured using a self-report questionnaire.
Results
After COVID-19, the eating-out usage rate in the Seoul metropolitan area and Provinces decreased compared to before COVID-19 (P < 0.001), and when responding that they eat out, the frequency of eating out with household members in the Seoul metropolitan area increased (P = 0.024). The deliveries/takeout usage rate in the Provinces decreased after COVID-19 compared to before (P < 0.001). After COVID-19, the prevalence of obesity decreased in all regions (P < 0.001), and the prevalence of hypertension increased significantly in the Provinces (P = 0.015). The prevalence of diabetes mellitus increased continuously before and after COVID-19 in all regions (P < 0.002). High-risk subjective stress levels increased significantly in the Seoul metropolitan area (P < 0.001), and sleep duration significantly increased in all regions (P < 0.001). Major depressive disorder was reduced significantly in Metropolitan cities (P = 0.042) and Provinces (P < 0.001).
Conclusions
After the COVID-19 pandemic, the prevalence of chronic diseases and mental health problems showed regional differences along with changes in dietary habits. It is necessary to reflect the regional differences in dietary habits in future policies resolving regional health inequalities.

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[English]
Examination of explicit and implicit emotions and relationship with the intention to support breastfeeding in public: a descriptive study: Katilin D. Overgaard, Lauren M. Dinour, Adrian L. Kerrihard, Yeon K. Bai; Korean J Community Nutr 2023;28(2):114-123. Published online April 30, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.2.114

Abstract PDF: Objectives
Current social norms in the United States do not favor breastfeeding in public. This study examined associations between college students’ explicit and implicit emotions of breastfeeding in public and their intention to support public breastfeeding.
Methods
Twenty-two student participants viewed images of a breastfeeding woman with a fully-covered, fully-exposed, or partially-exposed breast in a public setting. After viewing each image, participants’ explicit emotions (self-reported) of the image were measured using a questionnaire and their implicit emotions (facial expression) were measured using FaceReader technology. We examined if a relationship exists between both emotions [toward images] and intention to support breastfeeding in public using correlation techniques. We determined the relative influence of two emotions on the intention to support breastfeeding in public using regression analyses.
Results
The nursing images depicting a fully-covered breast (r = 0.425, P = 0.049 vs. r = 0.271, P = 0.222) and fully-exposed breast (r = 0.437, P = 0.042 vs. r = 0.317, P = 0.150) had stronger associations with explicit emotions and intention to support breastfeeding in public compared to implicit emotions and intention. Breastfeeding knowledge was associated with a positive explicit emotion for images with partial- (β = 0.60, P = 0.003) and full-breast exposure (β = 0.65, P = 0.002).
Conclusions
Explicit emotions appear to drive stated intentions to support public breastfeeding. Further research is needed to understand the disconnect between explicit and implicit emotions, the factors that influence these emotions, and whether stated intentions lead to consistent behavior.

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[Korean]
Nutrition teacher’s perception and current status of nutrition education for free learning semester program: a preliminary study: Mi Joo Park, Jeong-Hwa Choi, Young-Ran Heo; Korean J Community Nutr 2023;28(1):24-37. Published online February 28, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.1.24

Abstract PDF: Objectives
This study aimed to investigate the current status of nutrition education via a free learning semester program (NE). The understanding of the program, the potential difficulties, and future initiatives for NE improvement were also investigated.
Methods
A total number of 161 nutrition teachers from Gwangju and Jeonnam filled in a questionnaire and participated in this survey, which was performed from July to August 2019.
Results
Our results showed that 8.1% of the nutrition teachers had taught nutrition education in free learning semester programs. The most frequently implemented model was subject selection, followed by club activities. Most of the nutrition teachers comprehended the purpose of NE. The attitude of nutrition teachers to NE differed by the understanding of its purpose. Positive attitude was evident due to a better understanding of the purpose by nutrition teachers. Nutrition teachers reported the most common difficulties of NE were the lack of preparation due to the heavy workload and the lack of a standard running program. The most effective method of NE was the activity classes. The experience of practicing NE influenced the choice of contents for each operating model. Nutrition teachers that were experienced in NE conducted via free learning semester programs preferred the selected topics model, but those without experience chose the career search model.
Conclusions
Although some obstacles exist, nutrition teachers had a positive attitude and perceived well the importance of NE. Therefore, the awareness for the significance of NE of nutrition teachers needs to be improved. For better NE practice, it is necessary to reduce/ manage the workload of general food service. Furthermore, the development of standard running and promotion programs, and teacher training programs should be ensured.

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[Korean]
Nutritional status of Daejeon citizens and needs of community nutrition care services: a cross-sectional study: Dahye Lee, Minsun Jeon; Korean J Community Nutr 2023;28(1):11-23. Published online February 28, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.1.11

Abstract PDF: Objectives
This study aimed to determine the nutritional status of residents, to examine the perception and needs of community nutrition care service, and to compare and analyze the results of females and males living in Daejeon, Korea.
Methods
The subjects were 592 adults and elderly (278 men and 314 women) residents of Daejeon. The dietary quality was assessed using the nutrition quotient (NQ), and data of the perception and needs for community nutrition care service were obtained by a questionnaire survey. Descriptive analysis was applied to analyze the demographic characteristics, perception and needs of the respondents, and independent t-test and chi-square test were performed to analyze and compare the differences between female and male participants.
Results
A nutritional status that required monitoring was established in 78.9% of the respondents in this study. The balance factor (29.1 points) was much lower than the national average. In the diversity factor, the NQ score of the female group was 47.6 points, which was 8 points lower than that of males; the NQ grade was 43.9%, showing a significant difference between females and males (P < 0.001). The respondents answered that those who needed community nutrition care services were residents experiencing health care difficulties. Additionally, dietitians (35.6%) were pointed out as the most suitable service providers. The most important factor of community nutrition care service operation was securing the budget (47.0%).
Conclusions
The results of the present study show that Daejeon residents need overall nutrition support, and a demand for community nutrition care services exists. Our findings provide basic data and can serve as a foundation for the development and establishment of a community nutrition care service model.

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[English]
Nutritional status and dietary behavior of North Korean adolescent refugees based on Nutrition Quotient for Korean adolescents: a preliminary study: Young Goh, Seong-Woo Choi, So-Yeong Kim, Jeong-Hwa Choi; Korean J Community Nutr 2023;28(1):1-10. Published online February 28, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.1.1

Abstract PDF: Objectives
This study aimed to investigate the nutritional status and dietary behavior of adolescents from North Korean refugee (NKR) families residing in South Korea (SK), who are known to be at a higher risk of malnutrition due to their lower socioeconomic status and facing other psychological challenges.
Methods
A total of 178 adolescents (91 males and 87 females) from NKR families were included in the analysis, and their demographic details such as age, birthplace, parental nationality, and duration of their settlement in SK were collected through questionnaires. Anthropometric measurements were also taken to determine their growth and nutritional status according to the 2017 Korean National Growth Charts for children and adolescents. The study used the Nutrition Quotient for Korean Adolescents (NQ-A) questionnaire to assess the dietary behavior of the participants.
Results
Approximately 11.8% and 10.1% of participants were identified with malnutrition and obesity, respectively. The total mean score for the NQ-A was 50.1. The mean scores for the individual factors of balance, diversity, moderation, environment, and practice were 49.2, 44.7, 43.8, 51.2, and 61.5, respectively. Approximately 47.2% of participants had a low NQA grade. However, there was no significant difference in the NQ-A scores according to their nutritional status or duration of time in SK.
Conclusions
Adolescents from NKR families exhibited both malnutrition and obesity. However, their dietary behavior, as assessed using the NQ-A, did not vary with their nutritional status. The unique challenges and related dietary behavior of North Korean adolescent refugees should be taken into consideration, when developing targeted strategies for nutritional education and health management programs.

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