Korean Journal of Community Nutrition

Research Articles

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

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

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[Korean]
Changes in nutritional status of Korean older adults during COVID-19 Pandemic by household income and demographic factors -using the Korea National Health and Nutrition Examination Survey(2019-2020): a cross-sectional study: You-Sin Lee, Yoonna Lee; Korean J Community Nutr 2023;28(4):302-316. Published online August 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.4.302

Objectives
The study aim was to identify changes in the nutritional status of older adults during the COVID-19 pandemic according to household income and demographic characteristics.
Methods
Study participants were 2,408 adults aged 65 and over who participated in the 2019–2020 Korea National Health and Nutrition Examination Survey (KNHANES). To examine changes in nutrient intake levels resulting from COVID-19, data of 2019 and of 2020 were compared. Study participants were divided into three groups based on household income level to compare these changes. The changes were compared according to household income level, age group, and household type.
Results
Percentages of recommended intakes for energy, protein, and most micronutrients were the lowest for the low-income group of both males and females in 2020. The Mean Adequacy Ratio (MAR) score was the lowest for the low-income group in both years. When comparing nutrient density for 2019 and 2020 by income group, the male low-income group experienced a decrease in nutrient densities of vitamin A, thiamine, calcium, and iron. For the same group, a decreased percentage for energy intake from protein was noted. Fruit intake was lowest in the low-income group for both males and females. Low-income males had the lowest intake levels for meat, fish, eggs, and legumes in both 2019 and 2020 and the lowest milk and milk product intake levels in 2020. Older adults living alone or single older adults with children had lower MAR scores than those living with a spouse. Older adults living alone experienced decreases in energy and thiamine and iron intake levels in 2020 compared to their intake levels in 2019.
Conclusions
Because of the COVID-19 pandemic, nutrition intake levels worsened for older adult males in the low-income group and older adults living alone. This finding shows the need for a more systematic nutritional support strategy for the vulnerable older adults population in national disaster situations.

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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

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

Abstract PDF

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

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

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Original Articles

[English]
Children's Food Intake and Nutrition Levels, and Obesity by Maternal Employment: Based on the Korea National Health and Nutrition Examination Survey 2013–2015: Geunyeong Kang, Yoonna Lee, Mihyang UM, Seunghee Kye; Korean J Community Nutr 2019;24(4):331-342. Published online August 31, 2019; DOI: https://doi.org/10.5720/kjcn.2019.24.4.331

Abstract PDF PubReader

OBJECTIVES
This study examines the intake of food and nutrients of children according to the employment and working hours of their mothers.
METHODS
The married women in the source data from the 6th National Health and Nutrition Survey were classified into full-time working mothers, part-time working mothers and housewives according to the working type and the data on their children from 3 to 18 years old were analyzed using SAS 9.4.
RESULTS
The group from 3 to 5 years old was the smallest group with 682 children (20.2%), followed by the group from 6 to 11 years with 1,345 children (39.8%) and the group from 12 to 18 years old with 1,355 children (40.1%). The lowest rates for having no breakfast and dinner were observed in the group with housewives (p<0.05). The calcium and phosphorous intakes were the highest in the group with housewives at 61.9% and 126.8%, respectively, and the lowest in the group with full-time working mothers at 54.7% and 115.3%, respectively (p<0.05). The group with full-time working mothers had the highest rate in the calcium and iron intake less than the dietary reference intake at 74.9% and 30.0%, respectively. It indicated that the group with full-time working mothers did not have sufficient nutrients as compared to the other two groups. Moreover, the group with the part-time working mothers showed the high vitamin A intake ratio of 41.4% (p<0.05).
CONCLUSIONS
This study found evidence of a negative association between mother's employment status and children's diet quality. The employment and economic activity of married women will continuously increase in the future. Therefore, a national nutrition policy is required to provide quality nutrition care for children in the households.

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Biochemical Characteristics and Dietary Intake according to Household Income Levels of Korean Adolescents: Using Data from the 6th (2013 ~ 2015) Korea National Health and Nutrition Examination Survey
Yu-Kyeong Kwon, Sook-Bae Kim
Korean Journal of Community Nutrition.2021; 26(6): 467. CrossRef

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[English]
Study of the Coverage of Nutrition Labeling System on the Nutrient Intake of Koreans - using the 2013 Korea National Health and Nutrition Examination Survey (KNHANES) Data: Ji Eun Park, Haeng Shin Lee, Yoonna Lee; Korean J Community Nutr 2018;23(2):116-127. Published online April 30, 2018; DOI: https://doi.org/10.5720/kjcn.2018.23.2.116

Abstract PDF PubReader: OBJECTIVES
The purpose of this study was to examine the coverage of the current mandatory nutrition labeling system on the nutrient intake of Koreans.
METHODS
KNHANES dietary intake data (2013) of 7,242 subjects were used in the analysis. KNHANES dietary intake data were collected by a 24-hour recall method by trained dietitians. For analysis, all food items consumed by the subjects were classified into two groups (foods with mandatory labeling and other foods). In the next step, all food items were reclassified into four groups according to the food type and nutrition labeling regulations: raw material food, processed food of raw material characteristics, processed foods without mandatory labeling, and processed foods with mandatory labeling. The intake of energy and five nutrients (carbohydrate, protein, fat, saturated fat, and sodium) of subjects from each food group were analyzed to determine the coverage of the mandatory nutrition labeling system among the total nutrient intake of Koreans.
RESULTS
The average intake of foods with mandatory labeling were 384g/day, which was approximately one quarter of the total daily food intake (1,544 g/day). The proportion of energy and five nutrients intake from foods with mandatory labeling was 18.1%~47.4%. The average food intake from the 4 food groups were 745 g/day (48.3%) for the raw food materials, 54 g/day (3.5%) for the processed food of raw material characteristics, 391 g/day (25.3%) for the processed foods without mandatory labeling, and 354 g/day (22.9%) for the processed foods with mandatory labeling.
CONCLUSIONS
Although nutrition labeling is a useful tool for providing nutritional information to consumers, the coverage of current mandatory nutrition labeling system on daily nutrient intake of the Korean population is not high. To encourage informed choices and improve healthy eating habits of the Korean population, the nutrition labeling system should be expanded to include more food items and foodservice menus.

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[English]
Study on Energy and Nutrient Intake and Food Preference of the Elderly in Care Facilities: Jong Sook Kwon, Seung Hee Lee, Kang Min Lee, Yoonna Lee; Korean J Community Nutr 2016;21(2):200-217. Published online April 30, 2016; DOI: https://doi.org/10.5720/kjcn.2016.21.2.200

Abstract PDF PubReader

OBJECTIVES
The purpose of this study was to assess energy and nutritional intake and investigate the preference for food and cooking methods of the residents in elderly care facilities.
METHODS
Data were collected from 72 residents (10 males and 62 females) aged â‰¥ 70 years in elderly care facilities using questionnaires, food photographs for estimating dietary intake and records for daily physical activity.
RESULTS
Average age of the study participants was 85.0 years and 41, 36 and 8 had dementia, hypertension and diabetes mellitus, respectively. 15%, 65% and 19% of subjects were physically mobile, enervated, and immobile, respectively. Daily energy intake was 1360.2 kcal in men and 1378.0 kcal in women, which were 68.0% and 86.1% of the estimated energy requirement (EER) of dietary reference intake for Koreans (KDRI) for â‰¥ 75 year old individuals, respectively. Estimated energy expenditure (EEE) of subjects calculated using formula from KDRI was 1361.9 kcal and EER calculated using estimated daily physical activity (EDPA) was 1232.9 kcal. Energy intake and EEE from KDRI were higher than EER from EDPA. Dietary intake of dietary fiber, calcium, potassium, zinc, vitamin B2, niacin, vitamin C were lower, and protein, phosphorous, iron, sodium, vitamin A, vitamin B1, vitamin B6, vitamin E were higher than the corresponding ones of KDRI. Subjects liked meats, fishes and shellfish, and fruits, while subjects disliked milk, seaweeds and salted fish and salted vegetables. Cooked rice, soybean paste soup, beef, cooked sliced radish strip, and yogurt were favorite foods, with steam being a favorite cooking method. Subjects considered nutrition as the most important factor for improving food service quality.
CONCLUSIONS
Results of this study could be utilized for improving food-service for the residents in elderly care facilities, and provide a basis for setting reference intake of energy and nutrients of the elderly having very low activity levels.

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Dietary quality of lunches in senior leisure service facilities in South Korea: analysis of data from the 2013–2017 Korea National Health and Nutrition Examination Survey
Daeun Choi, Youngmi Lee, Haeryun Park, Kyunghee Song, Jinah Hwang
Nutrition Research and Practice.2021; 15(2): 266. CrossRef
Evaluation of the dietary quality and nutritional status of elderly people using the Nutrition Quotient for Elderly (NQ-E) in Seoul
Sun-Wook Ham, Kyung-Hee Kim
Journal of Nutrition and Health.2020; 53(1): 68. CrossRef
Status of health and nutritional intake of the elderly in long-term care facilities: focus on Gwangju Metropolitan City
Gyusang Han, Eunju Yang
Journal of Nutrition and Health.2020; 53(1): 27. CrossRef
Study on the Nutrient Intake and Dietary Quality of Elderly Residents on Various Meal Types in Long-Term Care Facility
Hee-Sook Lim, Eun Bi Oh, Yoo Kyoung Park, Hae-Yun Chung
Journal of the East Asian Society of Dietary Life.2020; 30(2): 172. CrossRef
Health and Nutrition Status of Elderly People with Multimorbidity: A Korea National Health and Nutrition Examination Survey (2013~2015)
Na-Gyeong Oh, Jung-Sook Seo
Korean Journal of Community Nutrition.2020; 25(6): 502. CrossRef
Nutritional status of Korean elderly with dementia in a long-term care facility in Hongseong
Ji-Yeon Lee, Yeong-Soon Hyun, Hee-Seon Kim
Nutrition Research and Practice.2019; 13(1): 32. CrossRef
Food and nutrient intake status of Korean elderly by perceived anxiety and depressive condition: data from Korean National Health and Nutrition Examination Survey 2013 ~ 2015
Da-Mee Kim, Kyung-Hee Kim
Journal of Nutrition and Health.2019; 52(1): 58. CrossRef
Analysis of Food Preference, Recognition and Experience of Elderly Foods among Elderly People
Mi Young Kim, Yoo Na Lee
The Korean Journal of Food And Nutrition.2016; 29(6): 971. CrossRef

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[English]
The Development and Validation of Eating Behavior Test Form for Infants and Young Children: Youngshin Han, Su An Kim, Yoonna Lee, Jeongmee Kim; Korean J Community Nutr 2015;20(1):1-10. Published online February 28, 2015; DOI: https://doi.org/10.5720/kjcn.2015.20.1.1

Abstract PDF Supplementary Material PubReader

OBJECTIVES
This study was conducted to develop and validate Eating Behaviors Test form (EBT) for infants and young children, including eating behaviors of their parents and parental feeding practices.
METHODS
Draft version of EBT form was developed after a pretest on 83 mothers. It was consisted of 42 questions including 3 components; eating behavior of children, eating behavior of parents, and parental feeding practices. Using these questionnaires, the first survey was conducted on 320 infants and children, 1 to 6 year old, for exploratory factor analysis, and the second survey was collected on 731 infants and children for confirmatory factor analysis.
RESULTS
Exploratory factor analysis on 42 questions of EBT form resulted in 3 factor model for children's eating behavior, 3 factor model for parents' eating behavior, and 1 factor model for parental feeding practices. Three factors for children's eating behavior could be explained as follows; factor 1, pickiness (reliability alpha=0.89; explanation of variance=27.79), factor 2, over activity (alpha=0.80, explanation of variance=16.51), and factor 3, irregularity (alpha=0.59, explanation of variance=10.01). Three factors for mother's eating behavior could be explained as follows; factor 1,irregularities (alpha=0.73, explanation of variance=21.73), factor 2, pickiness (alpha=0.65, explanation of variance= 20.16), and factor 3, permissiveness (alpha=0.60, explanation of variance=19.13). Confirmatory factor analysis confirmed an acceptance fit for these models. Internal consistencies for these factors were above 0.6.
CONCLUSIONS
Our results indicated that EBT form is a valid tool to measure comprehensive eating and feeding behaviors for infants and young children.

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[English]
A Study on Dietary Behaviors, Health-Related Lifestyle of Adult Visitors at Public Health Centers in Gyeonggi Urban Area: Jong Sook Kwon, Kyungmin Kim, Hyun Chang Seo, Yoonna Lee, Seunggeon Lim, Young Sug Choi; Korean J Community Nutr 2013;18(6):611-625. Published online December 31, 2013; DOI: https://doi.org/10.5720/kjcn.2013.18.6.611

Abstract PDF PubReader

The purpose of this study was to investigate dietary behaviors and health-related lifestyles of adult visitors at a public health center in Gyeonggi urban area. A survey using questionnaire was conducted with 949 visitors at Seongnam public health centers from June to August, 2012. The data from 905 respondents were analyzed by gender, consisting of 322 males and 583 females, and age group, consisting of 243 low-age group (LA), 312 middle-age group (MA), 350 high-age group (HA), aged 20 to 30 years, 31 to 50 years, and 51 to 69 years, respectively. Average Body Mass Index was 23.0, which increased with age, and education level was high in LA. 59.0 percent of the subjects had various diseases, and the incidence of hypertension was the highest, followed by allergy, hyperlipidemia, diabetes mellitus, joint rheumatism. Incidence rates of chronic disease increased with age, which were lower than those from 2011 Korea National Health and Nutrition Examination Survey (KNHANES). Weekly drinking frequency rate and smoking rate decreased with age, and exercise performing rate was high at male and HA, which showed the same tendency as KNHANES. Female and HA showed more healthy dietary behaviors such as restricting salt, sugar, oily foods, foods containing food additives, calorie, caring for balanced diet, and referring to nutrition label. Subjects chose stress as the first factor, followed by diet, exercise, etc., among 13 suggested factors which strongly influence on human's life-span. In general, public health center visitors, especially female and HA, showed better dietary behaviors and health-related lifestyles compared with KNHANES.

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Dietary Safety Management Awareness and Competency for Healthcare among Adults in Daegu and Gyeongbuk Areas
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Korean Journal of Community Nutrition.2020; 25(2): 112. CrossRef
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Ji Suk Yim, Young Ran Heo
Journal of Nutrition and Health.2020; 53(5): 488. CrossRef

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[English]
Development of Nutrition Education Program for Hypertension Based on Health Belief Model, Applying Focus Group Interview: Seoyun Park, Jong Sook Kwon, Cho il Kim, Yoonna Lee, Hye Kyeong Kim; Korean J Community Nutr 2012;17(5):623-636. Published online October 31, 2012; DOI: https://doi.org/10.5720/kjcn.2012.17.5.623

Abstract PDF PubReader

Health Belief Model is a socio-psychological theory of decision making to individual health-related behaviors. This study was aimed to develop an effective education program for hypertension based on health belief model. The main factors of health belief model were investigated by focus group interview (FGI) with 23 hypertensive or prehypertensive subjects aged over fifty years. 'Perceived susceptibility' to hypertension was family history, neglect of health care, preference for salty food, broth of soup and stew. Lifelong medication, complications, and medical costs were reported as 'perceived severity' of hypertension. 'Perceived benefits' of hypertension management were decrease of medicinal dose, reduction of medical costs, and healthy eating habits of the family, while 'perceived barriers' were lack of palatability of low salt diet, convenience-oriented dietary habits, and limited choice of foods when eating out. Subjects mentioned TV health programs, public health center programs, and advice from doctors and family as 'cues to action' of hypertension management. These qualitative information provided basis for developing a nutrition education program for hypertension which could be implemented in the public health center. Eight week program was composed of understanding hypertension, risk factor management (eating habits, weight), low salt diet (principles, cooking), advanced management for healthy diet in 2 sessions, and summary. Each session was designed to alert the susceptibility and severity, to emphasize the benefits, and to reduce the barriers by providing dietary monitoring, practical advice, and action tips.

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[English]
Influencing Factors on the Dietary supplements Consumption among Children in Korea: Jeeyeon Lee, Dohee Kim, Yoonna Lee, Eunmi Koh, Youngsoo Jang, Hyeyoung Lee, Youngae Jang, Cho il Kim; Korean J Community Nutr 2011;16(6):740-750. Published online December 31, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.6.740

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With a recent increase in dietary supplements (DS) consumption among children in Korea, this study was performed to examine the influencing factors on children's DS consumption. A nationwide survey was conducted employing 3 representative samples of children for summer & fall of 2008 and spring of 2009 by stratified multistage sampling of 120 survey sites per season based on the 2005 census population. Approximately 30 households from each survey site were screened for residing children of 0-19 years and about 1,700 households remained as eligible samples per season. Trained dietitians visited households to perform face-to-face interview to children and/or parents regarding DS consumption including health functional foods (HFF), vitamins/minerals (V/M) supplements and other food supplements during 1 month prior to interview. Out of 5,328 children responded, 18.7% reported DS consumption. Consumption rate was higher in boys (19.9% vs. 17.3% in girls, P < 0.05) and youngsters (22.8% compared to 15.0% in adolescents, P < 0.001). Children from higher income family (P < 0.001), those living in apartments (P < 0.001), those residing in metropolitan area (P < 0.001), and those of mothers with higher education (P < 0.001) were more likely to take DS. Also, mother's employment status and occupation were significantly associated with children's DS consumption. The most popular DS was HFF (72.1%), which was consumed more in children of higher income family. It is revealed that socioeconomic factors affect children's DS consumption significantly. Also it is necessary to estimate children's V/M intake from DS and foods together especially because there are tolerable upper limits set for V/M for safety purposes.

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Major Sources of Sodium Intake of the Korean Population at Prepared Dish Level: Based on the KNHANES 2008 & 2009: Miyong Yon, Yoonna Lee, Dohee Kim, Jeeyeon Lee, Eunmi Koh, Eunjeong Nam, Hyehyung Shin, Baeg won Kang, Jong Wook Kim, Seok Heo, Hea young Cho, Cho il Kim; Korean J Community Nutr 2011;16(4):473-487. Published online August 31, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.4.473

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We attempted to define the sources of sodium intake for the Korean population at prepared dish level to provide a basis for developing sustainable nutrition policies and feasible programs for sodium intake reduction. Dietary intake data from 2008 and 2009 Korea National Health and Nutrition Examination Survey was used in the analysis for sodium intake sources. Sodium intake from individual dish consumed by each subject was calculated and used in delineating major sodium sources at dish and dish group level for sub-populations of different sex and age. Also, sodium intake was compared between eaters and non-eaters of some specific dish groups with considerable contribution to total sodium intake. The number of subjects included in the analysis was 18,022 and mean sodium intake was 4,600 mg/capita/day. Major sources of sodium intake at dish group level were in the following order: kimchi (1125 mg, 24.5%), noodles (572 mg, 12.4%), soups (488 mg, 10.6%), stews (399 mg, 8.7%), and cooked rice (284 mg, 6.2%). The magnitude of contribution to total sodium intake by soups and stews was different by age group. Sodium intake difference between eaters and non-eaters was much larger for kimchi group (2,343 mg for male, 1,452 mg for female) than for soups or stews. Interaction between consumption of aforementioned specific dish groups and age was highly significant (p < 0.0005) for both sexes. This study revealed an importance of having not only the control over sodium content of foods/dishes, but also the customized approach for different groups of population to accomplish an appreciable reduction in sodium intake.

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[English]
Comparison of the Nutrient Intakes by the Score of Dietary Action Guides for Korean Children among the Elementary School Students in Gwangju City: Bok Hee Kim, Mi young Sung, Yoonna Lee; Korean J Community Nutr 2011;16(4):411-425. Published online August 31, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.4.411

Abstract PDF PubReader

This study was conducted to examine differences in nutrient intakes by the compliance with the Dietary Action Guide for Korean Children. The subjects included 343 elementary school students in Gwangju city. Compliance with the Dietary Action Guide for Children showed that 62.4% of subjects had breakfast everyday; 44.3% of subjects ate vegetables/fruits/milk and dairy products daily; 26.8% of subjects ate a variety of lean meats/fish/eggs/bean products daily; 32.9% of subjects enjoyed outdoor activity everyday and ate according to their energy needs; 40.2% of subjects chose healthy and nutritious foods for snack; and 15.5% of subjects avoided food waste. Intakes of most of nutrients including energy were significantly higher (p < 0.05) in those who complied with the Dietary Action Guide well. Also nutrient intakes had the positive correlation with the scores of Dietary Action Guide (p < 0.05). From these results, nutrient intakes of children were significantly influenced by dietary factors suggested in the Dietary Action Guide for Children. In addition, the results also confirmed that good food behaviors were indispensible to maintaining a proper nutritional status. Based on these results, good food behaviors and practice were critical to secure good health and proper nutritional status for children, and that nutrition education should be strengthened in school as well as at home.

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Gender Differences in Adolescents' Dietary Perceptions and Practices
Taejung Woo, Hye-Jin Lee, Kyoung Ae Lee, Seung Min Lee, Kyung-Hea Lee
Korean Journal of Community Nutrition.2016; 21(2): 165. CrossRef
Evaluation of Obesity and Nutritional Status by Age among Low-income Women aged over 20 -Using Data from the Fourth Korea National Health and Nutrition Examination Survey-
Hee-Kyung Jang
Journal of the East Asian Society of Dietary Life.2015; 25(2): 246. CrossRef
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Bok Hee Kim, Bang Geul Shim, Eun Jeong
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Hae Sook Oh
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The Korean Journal of Food And Nutrition.2014; 27(4): 660. CrossRef
Relationship between adhering to dietary guidelines and the risk of obesity in Korean children
Soo Hyun Yu, YoonJu Song, Mijung Park, Shin Hye Kim, Sangah Shin, Hyojee Joung
Nutrition Research and Practice.2014; 8(6): 705. CrossRef
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Korean Journal of Community Nutrition.2012; 17(2): 133. CrossRef
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Korean Journal of Community Nutrition.2011; 16(6): 647. CrossRef

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[English]
Nutritional Environment Influences Hypertension in the Middle-aged Korean Adults: based on 1998 & 2001 National Health and Nutrition Survey: Hae Jeung Lee, Haeng Shin Lee, Yoonna Lee, Young Ai Jang, Jae Jin Moon, Cho il Kim; Korean J Community Nutr 2007;12(3):272-283. Published online June 30, 2007

Abstract PDF: This study was performed to delineate the relationship between lifestyle and nutritional risk factors associated with hypertension in representative middle-aged Korean population. Hypertension in this study is defined as hypertensive (SBP> or = 140 mmHg or DBP> or = 90 mmHg) adults without recognition of a disease state before a health exam. With data from the 1998 and 2001 National Health and Nutritional Survey, nutrient intakes of 6,112 adults, 40-64 years of age were calculated using food composition database and matched with health examination records by individual ID. After excluding those with extreme intake values, the number of final subjects included in the analysis was 5,200 (male 2,458, female 2,742). Using logistic regression method, socio-demographic data, lifestyle factors, and nutrient intakes were analyzed. Risky factors for hypertension revealed in this study were age, sex, BMI over 23, waist circumference, alcohol intake of more than 16 g (male) or 8 g (female). Regarding nutrient intakes, the intakes of highest quartile for energy (> or = 2363.0 kcal) and protein (> or = 90.2 g) were significantly associated with higher risk of hypertension after adjusting for age, sex, and other socio-demographic factors (OR = 1.312 (1.046-1.711), OR = 1.488(1.194-1.854), respectively)). Although high intakes of sodium (> or = 6604.0 mg) and phosphorus seemed to be risk factors of hypertension also before energy adjustment (OR = 1.278(1.034-1.581), OR = 1.280(1.024 -1.600), respectively), only high intakes of energy and protein remained significant after adjustment. This study revealed that modifying risky lifestyles and dietary patterns, especially high energy intake, high protein intake, and high alcohol drinking, in middle-aged Korean adults could result in a prevalence decrease and/or prevention of hypertension.

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[English]
Characteristics of Infants' Temperaments and Eating Behaviors, Mothers' Eating Behaviors and Feeding Practices in Poor Eating Infants: Yoonjung Kim, Young Shin Han, Sang Jin Chung, Yoonna Lee, Sang Il Lee, Haymie Choi; Korean J Community Nutr 2006;11(4):449-458. Published online August 31, 2006

Abstract PDF: The purpose of this study was to determine the characteristics of infants' temperaments and eating behaviors, mothers' eating behaviors and feeding practices in poor eating infants. The participants were 80 infants of 12 - 24 months (27 poor eaters and 53 matched normal controls) from a hospital and a public health center. Mothers were questioned about their eating behaviors and feeding practices, and infants' temperaments, eating behaviors, and nutrient intakes by one day food recall. Subjects were divided by mean nutrient adequacy ratio (MAR, < 0.75; poor eater). Intakes of Ca, P, Fe, Zn, thiamin, riboflavin, niacin, vitamin C, E, folate were below 75% RDA in poor eaters, whereas protein, thiamin, riboflavin, vitamin B6, C, folate exceeded 125% RDA in good eaters. Rhythmicity of infants' temperaments and eating behaviors, restriction of mothers' eating behaviors and feeding practices were significantly lower, whereas activity levels of infants' temperaments were higher than good eaters. In multiple logistic regression model of poor eaters, activity of infants' temperaments (T, OR: 1.19, CI: 1.05 - 1.35) and attention spans of infants' eating behaviors (A, OR: 1.18, CI: 1.03 - 1.35) were significantly positive, whereas rhythmicity of infants' eating behaviors (R, OR: 0.79, CI: 0.67 - 0.94) was significantly negative [E (the logit) = -6.8644 + 0.1712 x T - 0.2337 x R + 0.1641 x A]. Our findings suggest that examination of eating behaviors, feeding practices, and temperaments will help target interventions to improve infants' food intakes, and these variables should be examined at the time of nutrition counseling.

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[English]
Dietary Intake Pattern of the Korean Adult Population by Weight Status: 2001 National Health and Nutrition Survey: Yoonna Lee, Haeng Shin Lee, Young Ai Jang, Hae Jeung Lee, Bok Hee Kim, Cho Il Kim; Korean J Community Nutr 2006;11(3):317-326. Published online June 30, 2006

Abstract PDF: To explore the relationship between weight status and food intake pattern, the Nutrition Survey results of the 2001 National Health and Nutrition Survey were analyzed. Dietary intake data of Korean adults aged 20 to 64, years who participated in the 2001 National Health and Nutrition Survey, was used along with their demographic data. Subjects were classified into 4 groups based on the BMI value of subjects: underweight, normal, overweight and obese. For male adults, obese subjects had significantly higher mean intake of energy, protein, carbohydrates, and fat than normal subjects. In addition, obese male adults consumed more animal foods, especially more meats, than normal subjects. However, females obese subjects did not show higher intake of energy or fat. Although obese male adults showed higher energy intake, calcium and iron intake per 1000 kcal was lower than normal adults. Average calcium intake in females was low; about 70% of RDA regardless of obesity level. In addition, riboflavin and Vitamin A intake was lower in overweight and obese female than in normal females. Percentage of subjects with low fruit and vegetable intake (<400 g per day) was also high in female subjects. These results showed that food and nutrient intake patterns of obese population were different between male and female adults. These dietary intake patterns need to be considered in developing and implementing nutrition policy and intervention programs to prevent and control obesity. Moreover, the National Survey and monitoring system should be developed for continuous and effective investigation on the relationship between obesity and dietary intake.

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[English]
Food and Nutrient Consumption Patterns of the Korean Adult Population by Income Level - 2001 National Health and Nutrition Survey: Bok Hee Kim, Joung Won Lee, Yoonna Lee, Haeng Shin Lee, Young Ai Jang, Cho il Kim; Korean J Community Nutr 2005;10(6):952-962. Published online December 31, 2005

Abstract PDF: To explore the relationship between economic status and food and nutrient intake patterns, the 2001 National Health and Nutrition Survey result was analyzed. Dietary intake data of 6,978 Korean adults of 20 years and older who participated in the 2001 National Health and Nutrition Survey were used along with their demographic data. Economic status of the subjects was classified into the following 4 groups based on the self-reported average monthly income of household with reference to the minimum monthly living expenses (MLE) in 2001: low<100% MLE < or = middle<200% MLE < or = high<300% MLE < or = higher. Individuals in the higher income class had significantly higher mean intake for most of the nutrients including energy, protein, carbohydrate, fat, calcium, thiamin, riboflavin, niacin and vitamin C, and a higher percentage of energy intake from fat. In addition, they consumed more animal foods including meats, eggs, fish/shellfish, milk/dairy products and fats. On the other hand, the mean intakes of individuals in the lower economic class for calcium, vitamin A, and riboflavin were lower than 75% of RDAs. And, there was a predominant difference in contribution of fat to total energy intake among the groups of different economic status. These results showed that household income is an important factor influencing the food and nutrient intake patterns of the Korean adult population. Although individuals at different age classes may respond differently to a change in economic status, developing and implementing nutrition policy and intervention programs for those nutritionally vulnerable groups should consider the economic status as an important factor to customize and differentiate the content of the program.

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[English]
The Characteristics of Infants' Temperament, Maternal Feeding Behavior and Feeding Practices in Picky Eaters: Yoon Jung Kim, Sang Jin Chung, Young Shin Han, Yoonna Lee, Sang Il Lee, Ki Won Byun, Haymie Choi; Korean J Community Nutr 2005;10(4):462-470. Published online August 31, 2005

Abstract PDF: The purpose of this study was to determine the characteristics of infants' temperaments, maternal feeding behaviors and feeding practices in picky eaters. Participants were 83 infants (aged 12 - 24 months) from "A" hospital (Seoul) and "B" public health center (Kyunggido). Mothers completed questionnaires that assessed their own feeding behavior, feeding practices, infants' temperament and infants' feeding behavior. Picky eaters' demographics were not significantly different from non-picky eaters after adjusting sex and age. The average of thiamin, niacin and vitamin E intakes of picky eaters were below 75% Korean RDA, whereas vitamin A intakes exceed 120% RDA in both groups. Activity level of infants' temperament and disinhibition of maternal feeding behavior in picky eaters were significantly higher than those in non-picky eater. All constructs of infants feeding behavior were significantly associated with certain constructs of infants' temperament, maternal feeding practice and maternal feeding behavior. The pickiness of infants feeding behavior was positively correlated with activity level of infants' temperament, pickiness and disinhibition of maternal feeding behavior and negatively correlated with adaptability of infants' temperament. Findings suggest that maternal feeding behavior and feeding practices as well as infants' temperament should be addressed in nutrition education for picky eaters.

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[English]
Factors Associated with Breakfast Skipping in Elementary School Children in Korea: Sang Jin Chung, Yoonna Lee, Sunja Kwon; Korean J Community Nutr 2004;9(1):3-11. Published online February 29, 2004

Abstract PDF: The objective of this study was to examine relationships between breakfast skipping and ecological factors related to eating practice. Participants were 537 children (male: 274, female: 263) from two elementary schools in Kyunggido (School A) and Seoul (School B). Analysis included cross-tabulation of demographics, factors related to eating practice and weight status, frequency of breakfast skipping and types of breakfast and the number of foods at breakfast by schools. Logistic regression were conducted to identify the factors associated with breakfast skipping. Children in school B showed higher socioeconomic status by living environment and the type of fathers' job than those in school A. Eighty six percent of children in school B and 75% in school A ate breakfast 5 times and more per week. School and father's occupation differences correlated with the frequency of breakfast, but not mother's employ status was not. After controlling school, type of father's job, mother's employ status, eating breakfast 5 times and more was associated with eating with other family members, feeling hungry before breakfast, normal weight status, eating Korean traditional meal type and number of food eaten at breakfast. The results stress the need for intervention programs aimed at decreased skipping breakfast among elementary school children. While programs need to reach all children skipping breakfast, approaches need to be suitable to in particular those from low socioeconomic backgrounds.

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[English]
Effect of Nutrition Education Program on Body Fat and Blood Lipids of Obese Young Adolescent Girls: Yoonna Lee, Haymie Choi; Korean J Community Nutr 1999;4(1):11-19. Published online March 31, 1999

Abstract PDF: The purpose of this study was to evaluate the effect of a nutrition education program on 42 obese young adolescent girls. Nutrition education was performed for six months including both group and individual programs, and was focused on improving their eating habits and food composition. The topics discussed once a week included : eating habits, lifestyle management, 5 basic food groups, snack and fast-food, how to eliminate empty calories, fat and hyperlipidemia, food diary, benefits and methods of exercise, vitamin and minerals, evaluation of fad diets, yo-yo effects and so on. The effects of the nutrition education program were evaluated for nutrition education and exercise regimen group (NE+E), nutrition education only group(NE), and control group(C). NE+E group had additional exercise programs 3times each week, while NE group was educated about exercise only by a nutrition education program. In both NE+E and NE groups, there was a significant decrease in bodyfat compared to C group, but NE+E group had a greater change than NE group(5.5% vs 3.1%). In addition, serum triglycerides decreased about 40mg/dl and total cholesterol 20mg/dl in both NE+E and NE groups. But HDL-C level was increased only in NE+E group. The greater changes in body fat and blood lipid levels occurred between the pre- and mid terms fo the education regimen. They kept their changed measurement throughout the 6 months follow-up studies. The results of this study show that this nutrition education program is helpful for obese adolescent girls in decreasing body fat and serum lipid levels. Also, the combination of an exercise regimen with the nutrition education proved to be more effective.

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[English]
Bone Density of the Middle Aged Women Residing in Urban Area and the Related Factors: I. distribution of Bone density According to Age and the Prevalence of Osteoporosis in the Middle Aged Women Residing in Urban Area: Sook Mee Son, Yoonna Lee; Korean J Community Nutr 1998;3(3):380-388. Published online August 31, 1998

Abstract PDF: This study was conducted to investigate the distribution of bone density according to age and the prevalence rate of osteoporosis I 613, middle-aged women who visited Saint Bundo Hospital in Pusan from June to December, 1997. Mean bone density of lumbar spine(L2L4), and femoral neck of 50-59 years of age was significantly lower than those of 40-49 years of age(p<0.05). At the 60years of age, mean bone density of two sites were less than those of 50-59 years of age. Mean bone density of lumbar spine tin the group of sixties were 20.7% lower than that of group aged under 40 ; For femoral neck, women in their sixties showed 22.6% lower density compared to the women aged under forty. Bone density of ward's triangle of sixties were the least, which was 34.2% lower than that of group aged under 40. Bone density in lumbar spine, femoral neck, trochanter and ward's triangle correlates strongly with each other(p<0.001). The proportion of osteoporosis was 3.6% in the group of forties, 10.9% in the group of fifties and 33.8% for the group aged over 60, which was assessed by bone density of lumbar spine. Bone density of lumbar spine, femoral neck and ward's triangle were positively correlated with height, weight and BMI(p<0.001~p<0.01), and weight showed highest correlation with the bone density. Forty-four percent of variation in lumbar spine bone density was explained by age and weight.

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