Korean Journal of Community Nutrition

Research Articles

[English]
Developing educational videos to inform rightly about school foodservice from kindergarten to high school: a case study: Gyoungok Gang, Chaewon Park, Haejin Kang, Wan Soo Hong, Yoo Kyoung Park, Sook Hee Choi, Seung Hye Kim, Jieun Choi, Jihyun Park, Hyeja Chang; Korean J Community Nutr 2024;29(2):97-113. Published online April 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.2.97

Abstract PDF: Objectives
Since the enactment of the School Nutrition Act in 1981, school lunch programs in South Korea have grown quantitatively and qualitatively with a current student participation rate of 99.8%. Nonetheless, educational materials are needed to reduce misunderstanding and ignorance about school lunch programs. This study aimed to develop 3 educational videos that help students of various ages (kindergarteners/lower-grade elementary, upper-grade elementary, and secondary school, respectively), understand the school lunch program.
Methods
A scenario was created, was made, and the opinions on the scenario from experts in foodservice sectors were collected. A survey was conducted to students and parents to determine topics they wanted to know about school foodservice. The final videos were produced using this information and the expert opinions. The data were analyzed using SPSS 27.0 for Mac (IBM Corp., Armonk, NY, USA); a P-value of < 0.05 was considered significant.
Results
Three videos on school foodservice were developed for various age levels of students: kindergarten/lower-grade elementary, upper-grade elementary, and secondary school. Additionally, English subtitles were included for the multicultural student population. These videos, each lasting about 7 minutes, cover topics such as nutrition, hygiene, and the cultural significance of the school lunch program. The survey results showed that parents and students wanted to know the following topics about the school lunch program: “nutritionally balanced diet” (11.9%), “purchasing safe food ingredients” (10.9%), and “healthy eating habits” (9.9%).
Conclusions
The developed videos will serve as valuable educational resources on school foodservice, foster a deeper understanding of the school lunch program in parents and students, and potentially address their inquiries regarding production processes, nutrition, hygiene, cultural heritage, and health.

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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

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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[English]
Current Status of Sanitary and Nutritional Food Service in Elderly Day Care Center: Jeong hyeon Woo, Yoo Kyoung Park, Mi-Hyun Kim, Soo-Kyung Lee, Kyung hee Song, Hye-Kyeong Kim; Korean J Community Nutr 2020;25(5):374-385. Published online October 31, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.5.374

Abstract PDF

Objectives
This study was conducted to examine the status of foodservice management, with special interest on sanitary and nutritional food service in elderly day care centers. Methods A total of 79 employees who managed foodservice facilities in elderly day care centers were included in the survey. The contents of the questionnaire consisted of general characteristics, importance and performance of sanitary and nutrition management, the reasons for poor performance, factors necessary for improvement, and the employee's demand for support. Data analysis was conducted using the SPSS v25.0. Results Sanitary management showed an average importance score of 4.84 ± 0.40 and a performance score of 4.70 ± 0.61 (t-value: 8.260). The item with the lowest performance score was personal sanitary management (4.58 ± 0.71). In nutrition management, the average importance score was 4.52 ± 0.68, and the performance score was 4.20 ± 1.00 (t-value: 9.609). There were significant differences between the average score of importance and performance in both areas. As a result of an Importance-Performance Analysis, items that were recognized as important but had relatively low performance was “personal hygiene”, “ventilation” and “food storage”. Also in the nutritional management area, “menu planning for disease management” and “checking the saltiness in the soup” etc. had very low performance with low importance recognition. The items shown in the “low priority” quadrant were those that required professional management skills. In the areas that demanded support in foodservice management, education about sanitary and safe institutional food service had the highest score (4.42 ± 0.74), and all other items showed a demand of 4 points or more. Conclusions Foodservice managers recognize the importance of foodservice facility management but performance is relatively low. Institutional support is, therefore, needed to improve performance. For items with low importance, it seems necessary to improve awareness of the necessity of these items and to provide education in this regard. To gradually improve foodservice management, continuous provision of education and training in these areas are of great importance.

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Development of Protein Enhanced Diet for Socially Vulnerable Elderly
Jihye Hong, Hyung-Geun Jeon, Seulgi Kim, Gitae Park
Journal of the East Asian Society of Dietary Life.2024; 34(1): 39. CrossRef
Snack Provision Practice in Long-Term Care Hospitals and Facilities in Korea
Dayeong Yeo, Hae Jin Kang, Hyejin Ahn, Yoo Kyoung Park
Clinical Nutrition Research.2024; 13(2): 108. CrossRef
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 Journal of Community Nutrition.2024; 29(5): 359. CrossRef
Sanitation Management Performance According to the Characteristics of Coffee Franchise Shops and Sanitation Knowledge According to the Characteristics of Employees
Suk-Kyoung Gu, Sunyoon Jung, Inyong Kim, Yoonhwa Jeong
Journal of the Korean Society of Food Science and Nutrition.2021; 50(11): 1248. CrossRef
Analysis of Awareness, Knowledge, and Behavior about Food Hygiene·Safety Among the elderly
Mi Sook Lee, Sim-Yeol Lee
Korean Journal of Community Nutrition.2021; 26(3): 200. CrossRef

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Original Articles

[English]
Effects of Low-carbohydrate and High-fat Diet Supplemented with Ketogenic Drink on Cognitive Function and Physical Performance in the Elderly at High Risk for Dementia: Eun Ji Kim, Jung Sik Park, Won Sun Choi, Yoo Kyoung Park; Korean J Community Nutr 2019;24(6):525-534. Published online December 31, 2019; DOI: https://doi.org/10.5720/kjcn.2019.24.6.525

Abstract PDF PubReader

OBJECTIVES
Reduced glucose utilization in the main parts of the brain involved in memory is a major cause of Alzheimer's disease, in which ketone bodies are used as the only and effective alternative energy source of glucose. This study examined the effects of a low-carbohydrate and high-fat (LCHF) diet supplemented with a ketogenic nutrition drink on cognitive function and physical activity in the elderly at high risk for dementia.
METHODS
The participants of this study were 28 healthy elderly aged 60-91 years showing a high risk factor of dementia or whose Korean Mini-Mental State Examination (K-MMSE) score was less than 24 points. Over 3 weeks, the case group was given an LCHF diet with nutrition drinks consisting of a ketone/non-ketone ratio of 1.73:1, whereas the control group consumed well-balanced nutrition drinks while maintaining a normal diet. After 3 weeks, K-MMSE, body composition, urine ketone bodies, and physical ability were all evaluated.
RESULTS
Urine ketone bodies of all case group subjects were positive, and K-MMSE score was significantly elevated in the case group only (p=0.021). Weight and BMI were elevated in the control group only (p<0.05). Grip strength was elevated in all subjects (p<0.01), and measurements of gait speed and one leg balance were improved only in the case group (p<0.05).
CONCLUSIONS
We suggest that adherence to the LCHF diet supplemented with a ketogenic drink could possibly influence cognitive and physical function in the elderly with a high risk factor for dementia. Further, we confirmed the applicability of this dietary intervention in the elderly based on its lack of any side effects or changes in nutritional status.

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To Keto or Not to Keto? A Systematic Review of Randomized Controlled Trials Assessing the Effects of Ketogenic Therapy on Alzheimer Disease
Maria G Grammatikopoulou, Dimitrios G Goulis, Konstantinos Gkiouras, Xenophon Theodoridis, Kalliopi K Gkouskou, Athanasios Evangeliou, Efthimis Dardiotis, Dimitrios P Bogdanos
Advances in Nutrition.2020; 11(6): 1583. CrossRef

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[English]
Clinical Nutrition Services of a Long-term Care Hospital in Korea: Mi Hyang Um, Eun Soon Lyu, Song Mi Lee, Seung Min Lee, Eun Lee, Jin A Cha, Mi Sun Park, Ho Sun Lee, Mi Yong Rha, Yoo Kyoung Park; Korean J Community Nutr 2015;20(3):220-235. Published online June 30, 2015; DOI: https://doi.org/10.5720/kjcn.2015.20.3.220

Abstract PDF PubReader

OBJECTIVES
The purpose of this study was to investigate how clinical nutrition services is provided at a long term care hospital in Korea and to investigate job satisfaction levels of the clinical dietitians.
METHODS
Survey questionnaire was sent to dietitians working at a long term care hospital in Korea. The participating hospitals (n=240) were randomly selected from 1,180 long- term care hospitals using a stratified sampling method. A total of 134 long term care hospital s and 223 dietitians completed the survey of clinical nutrition service s and job satisfaction questionnaires The job satisfaction questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas.
RESULTS
The average nutritional screening rate was 17.9% and the rate of computerized nutritional screening system was 9.7% in the participating hospitals. Nutritional intervention rate was only 3.2% of all patients. KOIHA (Korea Institute for Healthcare Accreditation) accreditated hospitals showed only 50% performance rate of nutrition service evaluation area. This shows that after achieving KOIHA accredition, many hospitals do not emphasize the performance of nutritional services. The job satisfaction scores in all four areas ranged from 2/5 to 3/5, implying generally low job satisfaction level in hospital dietitians. Linear regression analysis results showed that the "hospital adequacy grade" type was a significant predictor of job satisfaction level for two areas (working conditions & relationship).
CONCLUSIONS
There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service s in long term care hospitals. Therefore, government and local hospitals have to work on implementing nutritional programs and policies for improved service and care.

Citations

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Importance and Performance of Nutrition Management for In-Patients with Dysphagia Perceived by Dietitians at Clinical Settings in Seoul and Gyeonggi Areas
Kyung-Eun Lee, Dasom Kim
Journal of the East Asian Society of Dietary Life.2019; 29(5): 421. CrossRef
Nutrition Care Management Practices for In-Patients with Dysphagia in Korean Clinical Settings
Dasom Kim, Kyung-Eun Lee
Clinical Nutrition Research.2019; 8(4): 272. CrossRef
Eating Problems and Nutritional Status of Elderly Patients in Long-term Care Hospitals according to Whether They consume Foodservice Meals or Other Meals
Yoo Ri Choi, Eun Young Yoon
Korean Journal of Human Ecology.2017; 26(2): 145. CrossRef
Importance-Performance Analysis of Clinical Nutrition Management in Convalescent Hospitals in the Gyeongnam Area
Seon-Jeon Lee, Eunju Park
Journal of the Korean Dietetic Association.2016; 22(1): 53. CrossRef

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[English]
Nutrient and Carotenoid Intakes and Dietary Habits in Mentally Disabled Adults: Mi Yeon Ahn, Hwang Woon Moon, Hae Yun Chung, Yoo Kyoung Park; Korean J Community Nutr 2015;20(3):208-219. Published online June 30, 2015; DOI: https://doi.org/10.5720/kjcn.2015.20.3.208

Abstract PDF PubReader: OBJECTIVES
According to preceding studies, many people with mental disability have unbalanced dietary habits or excessive intake of calories. Most of them are overweight or obese due to lack of self-control for food consumption, swallowing with inadequate chewing and physical inactivity. Therefore, this study aimed to assess the nutritional intake, including carotenoid, in mentally disabled people and find out a possible solution for nutritional improvement.
METHODS
People with intellectual disability (N=28), emotional disability (N=44) participated in this study. The disorder grades were from I to III and ages were between 20 and 65 years. Assessments included anthropometry, daily intake of nutrients, including carotenoid, ROMA III questionnaire for assessing bowel movement.
RESULTS
The average BMI of intellectually disabled people and emotionally disabled people was in the range of overweight and obesity respectively (23.7 +/- 6.3 kg/m2, 25.8 +/- 4.1 kg/m2). Overall, the frequencies of vegetable and dairy product intakes were lower in this population. When compared with Recommended Nutrient Intake (RNI) from Dietary Reference Intakes for Koreans 2010, the intakes of vitamin B1, vitamin B2 and calcium were insufficient in both groups. Also, lycopene intakes of carotenoid were low, compared with traditional Korean diet of the non-disabled people from the second year 2008 of the 4th National Health and Nutrition Survey. In addition, emotionally disabled people also had lower intake of cryptoxanthin.
CONCLUSIONS
The mentally disabled people in this study showed lower intakes of vitamin B1, vitamin B2, calcium and carotenoids. Based on these findings, we recommend that it is important to encourage mentally disabled people to consume sufficient amounts of such nutrients in order to promote nutritional status.

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[English]
The Effect of Repeated Nutrition Education on Health Improvement Program by Diet Quality Index-International (DQI-I) Evaluation in Office Workers: Mi Jang, Hye Ryeon Kim, Myung Ok Hwang, Yun Mi Paek, Tae In Choi, Yoo Kyoung Park; Korean J Community Nutr 2010;15(5):614-624. Published online October 31, 2010

Abstract PDF: The purpose of this study was to investigate the effect of 3-month nutrition education (First Time Intervention, FI) + additional 3-month nutrition education (Repeated Intervention, RI) which was performed after the 8-month follow-up. FI was conducted during 0-3 months and RI for 11-14 months. Ninety-two subjects completed FI program, and 38 out of 92 subjects who received FI finished the RI. Anthropometric data, dietary assessment (24hr recall) and fasting blood analysis were measured at 0 month, 3 months, 11 months and 14 months time points. After FI (3 mo), waist circumference, triglycerides, total cholesterol were significantly decreased. At 11 month follow-up, body weight, BMI, hip circumference, SBP, DBP were significantly rebounced and HDL cholesterol was significantly decreased. Therefore, the effect of short-term nutrition education was not being sustained. After the secondary nutrition intervention (14 mo), waist circumference and hip circumference were again significantly decreased. Total diet quality index-international (DQI-I) score was significantly increased in both FI group and RI group. The changes in DQI-I scores were significantly correlated with the changes in body weight (r = -0.129, p < 0.05) and counts of nutrition education (r = 0.159, p < 0.05), indicating that effective nutrition education helps improve the diet quality leading to a possible role in CVD prevention among male workers. Although a short-term intervention seems to be a success, the effect was not retained in this study. Therefore, we suggest incorporating nutrition education as a routine program for male worker at worksite.

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[English]
Blood Lipid Levels, Nutrient Intakes and Health-Related Lifestyles of Industrial Male Workers According to Apolipoprotein E Polymorphisms: Yoo Kyoung Park, Sang Woon Cho, Ji Yeon Kang, Yun Mi Paek, Sook Hee Sung, Tae In Choi; Korean J Community Nutr 2008;13(5):713-722. Published online October 31, 2008

Abstract PDF: The purpose of this study was to investigate the association among nutrient intakes and health-related lifestyles with cardiovascular disease risk assessed by blood lipid profile according to Apolipoprotein E genotypes. Middle-aged industrial male workers who had completed their annual medical examination were recruited and data of 675 subjects who finished the nutrient survey were used in the analysis. Anthropometric parameters, dietary assessment (FFQ), health-related lifestyles and blood profiles were used for statistical analyses. Apo E genotype groups were classified into the following three genotypes: Apo E2 group (including E2/E2, E2/E3, E2/E4), Apo E3 group (including E3/E3), Apo E4 group (including E3/E4, E4/E4). The frequency of Apo E2, E3, and E4 allele were 13.3%, 75.0% and 11.7% respectively. There were no significant differences in the anthropometric parameters depending on different Apo E genotypes. Also, no significant differences in the nutrient intakes were found according to the genotype groups. The nutrient intakes of all subjects were similar to or higher than the level of KDRIs (Dietary Reference Intakes For Koreans) except for intakes of calcium (67.44% of KDRIs), vitamin A (73.83% of KDRIs) and vitamin B2 (78.02% of KDRIs). Also, there were no significant differences of health-related lifestyles according to Apo E genotype groups. As for the lipid profiles, Apo E4 group had significantly higher total and LDL-cholesterol concentrations than the Apo E2 group (p < 0.05). We confirmed that plasma total and LDL-cholesterol concentrations were greatly influenced by Apo E genotypes. However, nutrient intakes and health-related lifestyles were not associated with Apo E genotypes.

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[English]
Effects of Worksite Nutrition Counseling for Health Promotion; Twelve-Weeks of Nutrition Counseling Has Positive Effect on Metabolic Syndrome Risk Factors in Male Workers: Mi Sun Lee, Hae Jin Kang, Hye Sun Oh, Yun Mi Paek, Ryo Won Choue, Yoo Kyoung Park, Tae In Choi; Korean J Community Nutr 2008;13(1):46-61. Published online February 29, 2008

Abstract PDF: The purpose of this study was to investigate the effect of nutrition counseling on improving metabolic syndrome (MS) risk factors. Sixty-eight subjects were grouped according to their numbers of MS risk factors. Subjects who have three or more risk factors of MS were defined as "High risk", subjects who have two risk factors of MS were defined as "low risk", and subjects who have below two risk factors of MS were defined as "no risk" group. All groups finished nutrition counseling every three weeks for 12 weeks. Anthropometric, dietary assessments (24 hr-recall) and blood samples were measured at 0 and 12 weeks nutrition counseling. After 12 weeks of intervention, anthropometric data (weight, BMI, body fat (%), and waist/hip ratio) were significantly decreased (p < 0.05) in all groups. Daily consumption of calorie was decreased significantly (p < 0.05) in the group of low risk and high risk. Blood level of fasting plasma glucose was significantly decreased (p < 0.001) in all groups after 12 weeks of intervention. Significantly, the fasting plasma glucose level was returned to normal range in the high risk group. The number of people who have three or more risk factors of MS (high risk group) was decreased from 25 to 12. Sum of MS Criteria decreased from 85 to 52 in the group of MS and decreased from 143 to 99 in all groups. These results indicate that nutrition counseling for male workers at the worksite proved to be helpful by reducing the risk factors of MS and thereby reducing the risk of cardiovascular disease. Continuing and systematic nutritional management programs should be developed and implemented for male workers at the worksites.

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