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.
Objectives This study examines the foodservice status of kindergartens attached to elementary schools in Seoul. We further determine the perception of elementary school principals and kindergarten assistant principals on the foodservice management for kindergartens. Methods This survey was conducted from July 17 to 23, 2019, enrolling 207 kindergartens attached to elementary schools in Seoul. Questionnaires were sent to principals of elementary schools and assistant principals of kindergartens, and the data obtained from 89 kindergartens were included in the analysis. The questionnaire consisted of four parts: general information on subjects, foodservice management status, foodservice management status during elementary school vacations, and the perception of principals of elementary schools and assistant principals of kindergartens on foodservice management. Data are presented as frequency and percentage or mean and standard deviation. Statistical comparison between principals of elementary schools and assistant principals of kindergartens was conducted by paired t-test, chi-square test, and Pearson's correlation analysis. Results A separate menu (10.1%) or recipe (20.2%) that considers preschooler characteristics was rarely used for foodservice at kindergartens attached to elementary schools. Most kindergartens did not have a separate dining space (3.4%) or a dedicated cook (93.3%). Although most kindergartens (92.1%) had operational foodservice during elementary school vacations, non-professional staff and non-nutrition teacher were mainly in charge of organizing the menu and purchasing ingredients (34.1% and 41.5%, respectively). The rate of using a contract catering company (28.0%, 23.2%) was also high. Both elementary school principals and assistant principals of kindergartens showed a high perception of the necessity for providing responsibility allowances for nutrition teachers and improving the cooking environment for kindergartens during elementary school vacations. Conclusions There is a need for policies and administrative support measures to improve the quality of foodservices for kindergartens attached to elementary schools.
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Objectives This study examined the Korean elderly’s dietary intake status, subjective health-related perception and chronic disease prevalence among age groups. Associations of dietary quality with subjective health-related perception and chronic diseases were also examined. Methods Based on data from the 7th National Health and Nutrition Examination Survey, a total of 3,231 elderly were selected and categorized into 4 age groups of ‘65 ~ 69’, ‘70 ~ 74’, ‘75 ~ 79’ and ‘over 80’. Nutrient intakes, proportions of those with insufficient nutrient intakes, Korean Healthy Eating Index (KHEI), some subjective health-related perceptions and prevalence of major chronic diseases were compared according to the age groups. Differences in the subjective health-related perceptions and odds ratios of the chronic diseases according to the quartile levels of KHEI within the same age group were analyzed. Results With the increase of age, several nutrient intakes (P < 0.001) and KHEI scores significantly decreased (P < 0.01). In women, activity restriction increased (P < 0.05), and EQ-5D score decreased with age (P < 0.001). Prevalence of hypertension (P < 0.0001), hypercholesterolemia (P < 0.05) and anemia (P < 0.01) significantly increased, while hypertriglyceridemia (P < 0.01) significantly decreased only in men. Obesity prevalence decreased, while underweight prevalence increased (P < 0.05). Subjective health status, EQ-5D score and PHQ-9 score significantly improved as KHEI score increased in certain age groups of women (P< 0.05). Odds ratio of hypercholesterolemia significantly increased with the increase of KHEI score in 65 ~ 69-year-old women. However, hypertension and anemia significantly decreased with the increase of KHEI score in 75 ~ 79-year-old women (P < 0.05). Conclusions The study findings suggest that nutrition management and policy for the Korean elderly need to apply a segmented age standard that can better reflect their dynamic characteristics.
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Objectives The purpose of this study was to develop and evaluate booklets and video clips to prevent children from picky eating. Methods Based on a survey conducted on food preferences of preschool children aged 2 to 5 years, 14 kinds of less preferred vegetables were selected. Accordingly, educational videos, activity books, and teaching-learning guides were produced for preschool children using the 'food bridge' theory, and the educational materials were named “Friendly vegetables”. Educational materials were distributed to childcare institutions, and their effectiveness was investigated for preschool children who were instructed on these materials once every 30 days from March to November, 2019. The children were examined for changes in their knowledge of names, colors, taste/texture, methods of cultivation, and preferences for vegetables before and after the instructional course. Results The awareness of vegetables increased significantly in younger children and the picky eating group. When the assessment was carried out in terms of vegetable knowledge, it was observed that the younger the age or the pickier the in eating food, the more effective the education is compared to the counter part. The preference for vegetables also increased after the instruction compared to the pre-instruction period, but significant changes were seen only in the 2~3 year age group for boys and girls.
Also, only the picky group of girls showed changes in preference. The children's average interest in the education materials was 3.85 points out of 5 points. Conclusions Through this study, we have developed educational materials for standalone use in childcare facilities and confirmed that they have a significant effect on improving awareness and preferences related to vegetables. In summary, the younger the age or the pickier the child in eating food, the more effective the education. It is believed that additional education on mealtime guidance is needed which can alter the eating behavior of preschool children and improve their diet. It is proposed to widen the scope of use of the materials by collecting diverse opinions from child care teachers.
OBJECTIVES This study examined the association of the total diet quality with the incidence risk of metabolic syndrome constituents and metabolic syndrome among Korean adults. METHODS Based on a community-based cohort of the Korean Genome and Epidemiology Study (KoGES) from 2001 to 2014, data from a total of 5,549 subjects (2,805 men & 2,744 women) aged 40~69 years at the baseline with a total follow-up period of 38,166 person-years were analyzed. The criteria of the National Cholesterol Education Program Adult Treatment Panel was employed to define metabolic syndrome. The total diet quality was estimated using the Korean Healthy Eating Index (KHEI). Hazard ratios (HR) and 95% confidence intervals (CI) for risk of metabolic syndrome constituents and metabolic syndrome in relation to KHEI quintile groups was calculated by multivariate Cox proportional hazards regression model. RESULTS After adjusting for age, energy intake, income, education, physical activity, smoking, and drinking, the incidence of abdominal obesity and high blood pressure was significantly lower, by approximately 29.7% (P < 0.01) and 25.2% (P < 0.01), respectively, in the fifth KHEI quintile compared to the first quintile in men. A significant decreasing trend of the metabolic syndrome incidence was observed across the improving levels of KHEI (HRq5vs.q1: 0.775, 95% CIq5vs.q1: 0.619~0.971, P for trend < 0.01). In women, the incidence of abdominal obesity and metabolic syndrome was significantly lower, by approximately 29.8% (P < 0.01) and 22.5% (P < 0.05), respectively, in the fifth KHEI quintile compared to the first quintile adjusting for multiple covariates. On the other hand, the linear trend of metabolic syndrome risk across the KHEI levels did not reach the significance level. CONCLUSIONS A better diet quality can prevent future metabolic syndrome and its certain risk factors among Korean men and women.
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OBJECTIVES The current survey environment is changing and participation rates in national nutrition surveys are decreasing. Therefore, the purpose of this study was to develop strategies for improving the nutrition survey system in the Korea National Health and Nutrition Examination Survey (KNHANES). METHODS To develop an alternative system for conducting the KNHANES nutritional survey, we conducted focus group interviews with stakeholders of the survey, SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis, and expert reviews. In addition, spatial analysis of potential sites for conducting surveys instead of relying on household visits was performed, and the perception of nutritional surveys in the population eligible for KNHANES was evaluated. RESULTS Based on the results of the focus group interviews, SWOT analysis, and expert reviews, we propose two options for survey sites: vehicles specifically prepared for nutritional surveys and public facilities such as community service centers or public health centers. Among public facilities, community service centers were found to be more appropriate sites than public health centers because they were considered more accessible. About 90% of respondents would participate in the survey in public facilities and about 74% would in vehicles. CONCLUSIONS Conducting national nutrition surveys in specially designed vehicles and public facilities could be a viable alternative to home visits. Next, the validity of these newly proposed nutrition survey methods needs to be compared to the results of the current national nutrition survey.
OBJECTIVES We previously developed a dish-based semi-quantitative food frequency questionnaire (FFQ) for Korean adolescents and reported that it had reasonable reliability and validity. The objective of the current study was to construct a web-based dietary evaluation system applying the FFQ for Korean adolescents and examine its applicability in the context of reliability and validity. METHODS A web-based food frequency questionnaire system was designed using a comprehensive approach, incorporating not only dietary data survey but also up-to-date nutrition information and individualized eating behavior guidelines. A convenience sample of 50 boys and girls aged 12~18 years agreed to participate in the study and completed the FFQ twice and 3 days of dietary recall on the developed website during a two-month period. The FFQ’s reliability and validity was examined using correlation and cross classification analysis. We also measured participants’ subjective levels of the web site’s usability, visual effect, understanding, and familiarity. RESULTS Spearman correlation coefficients for reliability ranged from 0.74 (for vitamin A) to 0.94 (for energy). From cross-classification analyses, the proportion of subjects in the same intake quartile was highest for energy (82.0%) and lowest for vitamin A (56.0%). With regard to validity analysis, Spearman correlation coefficients ranged from 0.34 (for fiber) to 0.79 (for energy). The proportions of subjects in the opposite categories between the first FFQ and 3-day diet recall data were generally low from 0.00% (for fat) to 36.2% (for sodium). Average subjective levels of the website’s usability, visual effect, understanding, and familiarity were all found to be over 4 points out of 5 points. CONCLUSIONS The web-based dietary evaluation system developed can serve as a valid and attractive tool for administering FFQ to Korean adolescents.
OBJECTIVES Epidemiological studies have suggested that a higher consumption of whole grain foods can significantly reduce the risk of chronic diseases including cardiovascular diseases, type 2 diabetes and obesity. The objective of the current study was to examine associations among the consumption of whole grains and nutrient intakes and biochemical indicators associated with chronic diseases among generally healthy middle-aged Korean women. METHODS Using 24-hour recall data from the 2008-2009 National Health and Nutrition Examination Surveys, whole grain intake (g/day) was calculated for a total of generally healthy 1,953 subjects. The subjects were divided into three groups by the level of whole grain consumption (0 g/day, > 0 and < 20 g/day or > or = 20 g/day). Mean values or proportions of various nutrient intakes and metabolic risk factors were compared according to the level of whole grain consumption. All statistical analysis was conducted using SAS software version 9.2. RESULTS We observed that the overall consumption of whole grains was quite low. Specifically, 58.2% of subjects reported no whole grain consumption on the day of the survey, and the mean whole grain intake was only 15.3 g/day. The whole grain consumption was positively associated with intakes of various macro and micronutrients, namely, plant proteins and fats, dietary fiber, calcium, plant iron, potassium, zinc, vitamin A, beta-carotene, thiamin, riboflavin, niacin, vitamin B6 and folic acid. In addition, we found significantly decreasing trends in abdominal obesity and hypertriglyceridemia as whole grain intake levels increase. CONCLUSIONS The study findings suggested the importance of promoting whole grain consumption as an efficient tool for improving various dietary aspects and preventing chronic diseases.
This study compared levels of health beliefs and health behavior practices according to lifestyle pattern among adults in Seoul. A self-administered survey questionnaire was collected from a total of 1,004 Seoul residents aged 30-59 years. The levels of perceived benefit, perceived barrier, and self-efficacy from health belief model and health behavior practices were measured across multiple health behavior areas including dietary behavior, drinking, smoking, exercise, functional food consumption, and weight control behavior. Factor analysis and subsequent cluster analysis based on 28 lifestyle questions divided the subjects into four lifestyles of society-, economy-, trend-, and health-oriented lifestyle. Some general characteristics were significantly different by lifestyles. The society-oriented lifestyle was significantly higher in proportions of men and overweight. The trend-oriented lifestyle was significantly younger and spent more monthly allowance. Health-oriented lifestyle was older. The levels of health belief variables and health behavior practices significantly differed by lifestyles. Overall the health-oriented lifestyle showed more desirable levels of health belief variables and health behavior practice in various health behavior areas compared to the other lifestyles, whereas the society-oriented lifestyle was found the other way. Health belief model variables including perceived benefit, perceived barrier, and self-efficacy were generally significant in predicting the levels of various health behavior practice, with somewhat differences by lifestyle pattern and health behavior type. The study findings suggest it may be useful to segment target subjects according to lifestyle pattern in planning and administering health education programs.
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