Objectives This study aimed to evaluate the importance and performance of sodium reduction practices among childcare center cooks in the Yongin area before and after a 3-month salinometer support program.
Methods In total, 313 cooks employed in childcare centers in Yongin were surveyed before and after participating in a salinometer support program. The survey included questions on general information, sodium-related dietary habits, and perceived importance and performance levels of sodium reduction approaches in the purchasing, cooking, and serving areas. The centers were divided into childcare centers registered as group-feeding facilities (FS group, n = 68) and those not registered as such (non-FS group, n = 245). The differences between the two groups were analyzed.
Results The overall importance levels increased significantly after the program in both the FS-group (P < 0.001) and non-FS group (P = 0.005). The overall performance levels also increased significantly in both groups (P < 0.001 for all). Consequently, the significant difference between the importance and performance levels disappeared in both groups after the program. However, unlike the FS group, which showed no significant differences between the importance and performance levels after the program in all three areas, the non-FS group still demonstrated lower performance levels than importance levels in the purchasing (P = 0.011) and serving (P = 0.034) areas after the program.
Conclusions The use of salinometers significantly enhanced the performance and importance of low-sodium management practices among cooks in childcare centers, especially in the FS group. The continuous monitoring of salinity measurements and tailored education specialized for the FS and non-FS groups are recommended.
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.
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.
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.
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.
Objectives This study aimed to develop evaluation criteria for the elementary-school-based health promotion program using the RE-AIM framework and to examine their feasibility. Methods Previous evaluation studies on health interventions for elementary-school students using the RE-AIM framework were reviewed systematically to identify appropriate evaluation criteria. A diet and physical activity intervention based on the transtheoretical model was implemented in a pilot study using the “Happy Me” application. The feasibility of using the RE-AIM framework to evaluate it was examined. Results The review yielded the following evaluation criteria: “reach,” the ratio of participants out of the total target population; “efficacy/effectiveness,” the difference in outcomes between the intervention and control groups, or between a pre- and post-test; “adoption,” the rate of use of the program and participation in the next stage of the program; “implementation,” the progress on the program components; “maintenance,” the participants’ and teachers’ intention to continue using the program. The pilot study reached 76.6% of the targeted population. The intake of sugar-sweetened beverages decreased (P < 0.0001), and the duration of walking increased (P < 0.0001). Other indicators could not be evaluated; therefore, potential indicators were suggested. Conclusions This study produced feasible evaluation criteria for elementary-school-based health promotion using the RE-AIM framework. Nevertheless, the feasibility needs to be validated with a broader range of studies and long-term interventions.
Objectives We examined the common allergenic foods, symptoms and management of food allergies in children attending the facilities registered at Center for Children's Foodservice Management in Gangdong-gu, Korea.
Methods: The survey was conducted among the directors or head teachers of 186 children’s food service facilities with 7,591 children in 2019. The questionnaire consisted of three parts, including general information about food service facilities, information related to food allergies and allergenic foods and symptoms in individual children.
Results: The number of children with food allergy was 271 (3.6%), and the proportion decreased with the increase of age. There were 91 children (33.6%) with a medical certificate, and these children had a significantly higher number of allergenic foods and symptoms than those without a medical certificate. Allergenic food groups included meat, fish, eggs and legumes (59.1%), fruits (12.4%), milk and dairy products (8.9%), cereals (7.8%), vegetables (6.2%), processed foods (3.8%) and oils and sugars (1.9%).
Eggs accounted for 22.1%, followed by peanut and tree nuts (18.6%), fruits (12.4%), milk and dairy products (8.9%), shellfish (8.6%), vegetables (6.2%), fish (5.7%), cereals (4.3%) and meat (1.1%). The common allergenic foods were eggs, peanuts, walnuts, kiwi, shrimp, milk, tomatoes, mackerel, blue-green fish, peaches, shellfish (clams and abalone), buckwheat, wheat and soybeans. The most common allergic symptoms were skin and mucous membrane symptoms, such as hives, rash, itching and oral angioedema. Meal management for children with food allergies showed different trends depending on the causative food.
Conclusions: The objective diagnosis by an allergist should be done for food allergy management in children's catering facilities. A system for systematic meal management of causative foods should be prepared.
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Objectives The objective of this study was to develop a zinc database (DB) to estimate the intake levels of zinc in Korean toddlers and preschool children using the data from the Korea National Health and Nutrition Examination Survey (KNHANES).
Methods: A total of 3,361 food items for the DB representing the usual diet of Korean toddlers and preschool children were selected based on KNHANES (2009~2013) and the food composition table of Rural Development Administration (RDA). The existing values of zinc in foods were collected from the latest food composition tables of RDA (9th revision) and the US Department of Agriculture (legacy release). The zinc contents were filled preferentially with these collected values. The missing values were replaced with the calculated values or imputed values using the existing values of similar food items from the data source. The zinc intake levels of Korean toddlers and preschool children were estimated using KNHANES and zinc DB Results: A total of 1,188 existing values, 412 calculated values, and 1,727 imputed values were included in the zinc DB. The mean intake levels of zinc for 1-2-year-old children and 3-5-year-olds were 5.17 ± 2.94 mg/day and 6.30 ± 2.84 mg/day, respectively.There was no significant difference in the zinc intake levels between boys and girls in each group.
Conclusions: This newly developed zinc DB would be helpful to assess the zinc nutritional status and investigate the association between the zinc intakes and related health concerns in Korean toddlers and preschool children.
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Objectives This study examined the association between the dietary behavior and weight status of preschool children and their mothers in Daejeon, Korea.
Methods: A total of 301 mother–preschool children (aged 3~6 years) dyads were included in this study. The dietary behavior of children and their mothers was assessed using the Nutrition Quotient (NQ) questionnaire for preschoolers and adults, respectively. The NQ questionnaires were completed by the mothers. The overweight/ obesity status of children and their mothers was determined using data on height and body weight reported by the mothers. Multiple logistic regression was performed to examine the relationship between the dietary behavior and weight status of children and their mothers.
Results: The mean NQ score was 58.9 ± 9.7 in children and 55.6 ± 9.2 in mothers. The NQ score was higher in boys than girls but did not vary by age. The prevalence of overweight/obesity was 27.5% in children and 46.5% in mothers. The physical activity level of mothers and their NQ scores were positively associated with the NQ scores of the children. After adjustment for covariates, the mothers in the highest tertile of NQ scores showed a lower odds ratio (OR) for the unhealthy dietary behavior of children (OR = 0.24, 95% CI = 0.11~0.53, P< 0.001) compared to those in the lowest tertile.
The obese mothers showed a higher OR for children’s overweight/obesity (OR = 3.38, 95% CI = 1.68~6.80, P = 0.001) compared to normal weight mothers.
Conclusions: The dietary behavior and weight status of young children and their mothers were closely linked. Nutrition education programs targeting mothers are necessary for improving maternal and child nutrition. Specifically, these programs need to be tailored to the socioeconomic characteristics or weight status of mothers.
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Objectives This study was conducted to assess the eating behavior, growth, and dietary practices of children aged 3~5 years living in the Seoul and Gyeonggi Provinces.
Methods: Self-administered questionnaires were completed by 237 mothers of preschool children between April and June 2018. Z-scores for weight-for-age, height-for-age, and BMI-for-age were calculated to determine the children’s growth status. Dietary practices were evaluated using the nutrition quotient for Korean preschoolers (NQ-P).
Results: In our study, 29.5% of children were in the eating-small-amounts group, 46.8% of children were in the neophobic behavior group, and 61.2% of children were in the refusal-of-specific food group. Specific foods found to have a high frequency of rejection are listed in descending order as follows: shellfish, soy, mushroom, shrimp, vegetables, milk, eggs, yogurt, seaweed, meat, fruits, and fish. The eating-smallamounts group had lower Z-scores for weight-for-age, height-for-age, and BMI-for-age than the non-picky eaters’ group. Compared to the non-picky eaters' group, the eatingsmall-amounts group of picky eaters had lower scores on the moderation and environment items of the NQ-P, the neophobic behavior group had lower scores on the balance and environment items of the NQ-P, and the refusal-of-specific food group had lower scores on the balance, moderation, and environment items of the NQ-P.
Conclusions: Children classified with picky eating behavior had lower growth and development, lower diet diversity, less balanced food intake, and had greater difficulty in abstaining from eating unhealthy foods than non-picky eaters. Therefore, a lot of patience and intensive efforts are needed to encourage children to encounter, experience, and accept unfamiliar food. It is more effective to provide eating behavior guidance by gently encouraging children, than by being strict and forceful. Besides, since the eating behavior of children is influenced maximally by the dietary lifestyle at their homes, it is important to ensure that a healthy dietary lifestyle is maintained at home.
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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 was performed to identify the current barriers of obesity management for children using Community Child Care Centers and their caregivers (parents and teachers working in the Centers). Further, this study explored the possibility of utilizing a mobile phone application for tailored obesity prevention and management programs to overcome the current difficulties associated with children's obesity management. Methods The qualitative data were collected through in-depth interviews with 20 obese and overweight children or children who wanted to participate in this study using Community Child Care Centers, 12 teachers working at the Centers, and a focus group interview with five parents of children using the Centers. Data were analyzed with a thematic approach categorizing themes and sub-themes based on the transcripts. Results The current barriers of obesity management of obese and overweight children using Community Child Care Centers were lack of self-directed motivation regarding obesity management (chronic obesity-induced lifestyles and reduced self-confidence due to stigma) and lack of support from households and Community Child Care Centers (latchkey child, inconsistency in dietary guidance between the Center and household, repetitive pressure to eat, and absence of regular nutrition education). Mobile phone applications may have potential to overcome the current barriers by providing handy and interesting obesity management based on visual media (real-time tracking of lifestyles using behavior records and social support using gamification), environmental support (supplementation of parental care and network-based education between the Community Child Care Center and household), and individualized intervention (encouragement of tailored and gradual changes in eating habits and tailored goal setting). It is predicted that the real-time mobile phone program will provide information for improving nutritional knowledge and behavioral skills as well as lead to sustainable children’s coping strategies regarding obesity management. In addition, it is expected that environmental factors may be improved by network-based education between the Community Child Care Centers and households using the characteristics of mobile phones, which are free from space and time constraints. Conclusions The tailored education program for children using Community Child Care Centers based on mobile phones may prevent and reduce childhood obesity by overcoming the current barriers of obesity management for children, providing environmental and individualized support to promote healthy lifestyles and quality of life in the future.
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Objectives The aim of this study was to investigate dietary intakes and nutritional status among Uganda primary school children from two selected schools in urban and rural areas. Methods Data were collected from 350 pupils (6-14 years) in Mpigi district, Uganda. All participants were offered a school lunch meal (usually maize porridge and boiled beans). Dietary survey was conducted in October 2016. Data for dietary intake levels were collected by the 24-hour recall method with trained school staffs. The data were converted into nutrient intakes using the CAN-Pro 5.0 Program and compared with KDRIs to evaluate the nutritional status of the subjects. Diet quality indexes such as nutrient density, nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ) and a diet diversity index such as diet diversity score (DDS) were calculated to evaluate nutritional status among subjects. Data were analyzed using SPSS statistical programs. Results Results show that the intakes of most nutrients were significantly different by schools. The nutritional status of micro-nutrients was very low in both schools according to analysis of nutritional indexes such as NARs and INQs. Students from both schools should improve intakes of micro-nutrients related to child growth such as calcium, Vitamin B6, zinc and folate. According to the analysis of dietary diversity, there was difference in dietary patterns by schools presumably due to their locations. Conclusions This suggests that current meals could not provide adequate nutrients for the subjects and urgent nutrition interventions for school food services are needed to improve their nutritional well-being. New foods supplements based on local cuisine are also needed to ensure dietary diversity and sustainable development plans.
OBJECTIVES This study examined the salinity of soups provided at childcare centers by measuring the salinity for three years and providing basic data for sodium reduction. METHODS The soup salinity was measured using a Bluetooth salinity meter from January 2015 to December 2017 at 80 childcare foodservice establishments enrolled in the Suseong Center for Children's Foodservice Management in Daegu. RESULTS An analysis of the soup salinity each year showed that the salinity decreased significantly from 0.48% in 2015 to 0.41% in 2017, particularly in clear soups and soybean soups compared to other soups (P < 0.05). The salinity and sodium content in seafood soups (0.45% and 179.1 mg/100 g, respectively) were highest, followed by soybean soups (0.44%, 175.2 mg/100 g), with perilla seed soups containing the lowest (0.42%, 167.2 mg/100 g) (P < 0.05). The salinity was significantly higher in institutional foodservice establishments than small foodservice establishments (P < 0.001). The salinity and sodium content were the highest in foodservice establishments with a small number of measurements, and the salinity was the lowest in foodservice establishments with salinity measurements performed an average of 151 times each year (three times a week) or more (P < 0.05). The soup salinity was low in the order of winter, spring, summer, and autumn, and the salinity decreased significantly year by year in all seasons. (P < 0.05). CONCLUSIONS The soup salinity was significantly lower in foodservice establishments where the salinity was measured more than three times a week, indicating that continuous salinity management is effective.
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OBJECTIVES The purpose of this study was to examine the food allergy-related knowledge, awareness, and performance of dietitians at children's hospitals, depending on whether or not they have a clinical dietitian certificate. METHODS A questionnaire survey was administered to 41 dieticians at children's hospitals registered as a part of the Korean Hospital Association. The survey consisted of questionnaires examining general characteristics, nutritional counseling-related characteristics, and food allergy-related characteristics (food allergy-related knowledge, awareness, and performance). We examined differences according to the status of clinical dietitian certification. RESULTS The proportion of subjects who were holders of clinical dietitian certificates was 48.8%. There were differences between holders of clinical dietitian certificates and non-holders as follows. Regarding nutritional awareness and performance, ‘needs to provide nutrition counseling in children's hospitals’, ‘providing nutrition counseling services in working hospitals’, and ‘whether there is a nutrition counseling room’ scored higher among holders of clinical dietitian certificates than non-holders. Holders of clinical dietitian certificates showed higher scores for knowledge of food allergy symptoms and food allergy management than non-holders. For food allergy awareness and performance, ‘self-assessment of food allergy knowledge understanding level’, ‘awareness of open oral food challenge (OFC)’, ‘recognition of the need for education and counseling on food allergy for patients/guardians’, and ‘food allergy related educational experience’ scored higher among holders of clinical dietitians certificates than in non-holders. CONCLUSIONS Children's hospital dietitians with a clinical dietitian certificate showed high knowledge, awareness, and performance related to food allergies. It is thus necessary to employ a clinical dietitian for food allergy management in children's hospitals. In addition, training and conservative education are necessary for the management of food allergies for children's hospital dietitians.
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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OBJECTIVES This study examined whether the infant feeding type and duration are related to the introduction of complementary feeding, and whether the appropriate introduction of complementary feeding in infancy is related to tooth decay in toddlers. METHODS The subjects were 1,521 toddlers among 2~3 year old children in the Korea National Health and Nutrition Examination Survey from 2008 to 2015. The toddlers were divided into the appropriate group (4~6 months) and delayed group (>6 months) according to the timing of complementary feeding introduction. RESULTS The delayed group were 26.5% of subjects and the formula feeding period in the appropriate group and delayed group was 8.4 and 10.3 months, respectively (P=0.002). On the other hand, there was no difference in the breastfeeding period between the appropriate group and delayed group (P=0.6955). Early childhood caries was more common in the delayed group (P=0.0065). The delayed introduction of complementary feeding was associated with a risk of early childhood caries according to the logistic models (OR 1.81, 95% CI 1.27–2.57). CONCLUSIONS The introduction of complementary feeding is associated with early childhood caries. Therefore, the importance of the proper introduction of complementary feeding in infancy should be emphasized, and public relations and education for maternal care and breastfeeding should be provided through health care institutions.
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OBJECTIVES This study was conducted to investigate the current difficulties surrounding children's obesity management and evaluate the application of a mobile phone as a tool to overcome such difficulties of obesity management from the perspective of main caregivers of elementary school students. METHODS The qualitative data were collected through 3 focus group interviews including 6 full-time housewives, 7 mothers with overweight children, and 4 working mothers. Data were analyzed using a thematic approach. RESULTS The limitations of current children's obesity management included difficulty in diet management and exercise as well as challenges of setting goals and lack of support at the household and school levels. Mobile technology may be useful to overcome the current problems by providing real-time knowledge on diet management and physical activity, online compensation scheme according to goal setting, and interactive environmental supports at both household and school levels for promoting overall health. CONCLUSIONS The mobile-based multiple support program may assist in overcoming the current limitations of child obesity management by providing tailored information and by creating a more supportive environment.
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OBJECTIVES This study examined the status of children's favorite foods intake and the relationship with the policy environment based on the Special Act on Safety Control of Children's Dietary Life for suggesting a supportive policy strategy. METHODS The subjects were 4th grade students (n=1,638) in elementary school from 45 schools collected from seven areas (Seoul, Daegu, Daejeon, Gyeonggi, Chungnam, Jeonbuk, and Gyeongnam). The children participated in a self-administered questionnaire survey in class under the supervision of the teacher. The questionnaire consisted of items, such as social demographic characteristics, frequency of intake of the children's favorite foods, and policy cognition. A t-test and ANOVA were applied to explore the relationship between the frequency of children's favorite foods intake and policy cognition. The survey was implemented from August 2016 to September 2016. RESULTS For the boys, the frequency of ‘high-calorie low nutrient foods intake’ (HCLN) was significantly higher than that of the girls (p<0.01). For the children who received information on their favorite foods from the internet, the frequency of HCLN was higher than the other sources (p<0.01). The time of TV viewing and computer usage, and smartphone usage was associated with a higher frequency of HCLN, and a lower healthy favorite food intake (all p<0.001). The intake frequency of healthy favorite foods indicated a positive correlation with the policy cognition, including policy perception, usefulness, necessity and buying intention, and educational experience. CONCLUSIONS This study showed a correlation with the frequency of children's favorite foods intake and policy. In particular, the frequency of children's healthy favorite foods intake indicated a meaningful relationship with the policy than the frequency of HCLN. This study also found that the consumption of children's healthy favorite foods was positively correlated with the educational experience. To develop a supportive policy for a good dietary environment for children, there is a need to focus on how to collaborate with multiple levels of influences, such as the national level, school level, and family.
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OBJECTIVES This study examined the relationship between the personality traits and job performance of Centers for Children's Foodservice Management (CCFSM) staff on emotional exhaustion and job satisfaction. In addition, the characteristics of the center organization were examined to provide practical guidelines for the operation of the center. The aim was to determine management implications with an important meaning in human resource management to enhance the efficiency of the operation of Centers for Children's Foodservice Management (CCFSM). METHODS Out of 207 centers, there were 1,057 employees at 173 centers who agreed to participate in the study, the questionnaire was mailed on February 17, 2017 and collected by mail on March 31, 2017. Finally, 81 centers (46.82%) participated in the survey and 493 questionnaires were used. RESULTS Neuroticism among the five personality factors had a positive (+) influence on ‘cynicism’ and ‘exhaustion’ among the three subordinate factors of emotional exhaustion, negative (−) effects on the ‘job’ among the six subscales of job satisfaction. In addition, openness showed a negative (−) effect on ‘loss of professional confidence’ of emotional exhaustion and positive (+) relationship with the ‘job’ of job satisfaction. Agreeableness appeared to have a negative (−) effect on all factors of emotional exhaustion and a positive (+) influence on all factors of job satisfaction. As a result of analyzing the effects of job performance on emotional exhaustion and job satisfaction, the planning and operations management team showed a positive (+) influence on all factors of emotional exhaustion and negative (−) influence on all factors of job satisfaction. On the other hand, the nutrition management team showed a negative (−) influence on all emotional exhaustion factors and a positive (+) influence on the factors of job satisfaction. The hygiene management team showed a positive (+) relationship with ‘Emotional exhaustion’ among the subordinate factors of emotional exhaustion and a negative (−) influence on the ‘Educational opportunity’ of job satisfaction. CONCLUSIONS The personality type and job performance of Centers for Children's foodservice management (ccfsm) staff significantly affected the emotional exhaustion and job satisfaction.
OBJECTIVES This study was conducted to investigate the associations between obesity and the children's Nutrition Quotient (NQ) and to further examine the relationships between NQ and mini dietary assessment (MDA) of their parents. METHODS The subjects were 355 children aged 3 to 5 years and their parents in Dongducheon. We collected parental-reported NQ questionnaires for children and MDA of parents. Anthropometric measurements, height, weight and BMI by BIA were measured in children. Overweight and obesity were determined according to age- and sex-specific BMI percentile from the 2007 Korean national growth chart. Statistical analyses consisted of the chi-squared test, ANOVA, partial correlations and logistic regression analysis adjustments for parents BMI. RESULTS Approximately 20.8% of preschool children were classified as overweight or obese. Underweight children showed a significantly higher score for balance than overweight children. The NQ of the children was 61.9 ± 11.6, and NQ scores and their parents' MDA did not exhibit any significant differences according to degree of obesity. After adjusting for parent's BMI, children's BMI was significantly correlated with balance and moderation among NQ factors. Parent's MDA showed significant correlation with their children's NQ, balance, diversity, moderation, regularity, practice and NQ grade, except for diversity of father. Additionally, NQ grade had a significantly increased (150.1%) odds ratio (OR) of being overweight (95% CI 1.008–2.234). CONCLUSIONS These results show that NQ for children is influenced by their parents' MDA and BMI. Furthermore, our findings support the association between overweight prevention and improvement of NQ grade among preschool children.
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OBJECTIVES The purpose of this study was to compare the physical activity level (PAL), the physical activity pattern and the energy expenditure in male and female elementary school soccer players using the accelerometer and the physical activity diary. METHODS Twenty-five (male 11, female 14) elementary school soccer players (9–12 years) participated in this study. During their daily activities, they wore an accelerometer for seven days (five weekdays and two weekend days) and completed the physical activity diary for three days (two weekdays and one weekend day). PAL was calculated by using the physical activity diary and three equations (Pate Preschool, Freedson Children, and Freedson) were used to calculate the intensity of physical activity and energy expenditure from the counts of accelerometer. RESULTS The average of physical activity by day of the week, CPM (Counts Per Minute) and METs (Metabolic Equivalents) were significantly higher in males (723.3 ± 149.2 CPM, 2.07 ± 0.18 METs) compared to females (505.6 ± 119.9 CPM, 1.79 ± 0.20 METs), but there was no significant difference in PAEE (Physical Activity Energy Expenditure) between the two groups (males: 15.5 ± 9.1 kcal/day, females: 11.5 ± 6.0 kcal/day). During weekdays, physical activity intensity was significantly higher in males compared to females at lunch time and training time than at other times. In both genders, the PAL was higher during weekdays (males 1.98, females 1.89) compared to weekend (males 1.62, females 1.61) (p<0.05). CONCLUSIONS Our study observations suggest the necessity to develop an accelerometer equation for accurately evaluating the physical activity of elementary school athletes.
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OBJECTIVES The study was conducted to investigate the relationship between several stress measures in everyday life, emotional eating behavior, and dietary pattern (snacks, fatty foods, sweet beverages, fruits and vegetables) in school-aged children. METHODS One hundred and ninety-four students of an elementary school located in Seongnam City participated in the study. The students responded to the survey questionnaire by self-report, which consisted of items regarding general characteristics, height, weight, dietary habits, frequency of consuming healthy (fruits and vegetables) and unhealthy foods (snacks, fatty foods, and sweet beverages), emotional eating behavior, and daily stress. Correlational analysis was performed to examine the relationship between stress, emotional eating behavior, and dietary pattern, and Poisson and logistic regression analyses were conducted to investigate the effects of stress on dietary pattern. RESULTS Positive correlations were found between all stress factors and emotional eating behavior and between the friend and personal factor (one of the stress factors) and the consumption of sweet beverages. The frequency of consuming sweet beverages was 2.6 times higher in the high stress group than in the low stress group (95% CI). CONCLUSIONS Children's daily stress was associated with emotional eating behavior and undesirable dietary pattern such as consumption of sweet beverages.
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OBJECTIVES Accurate assessment of energy expenditure is important for estimation of energy requirements in athletic children. The objective of this study was to evaluate the accuracy of accelerometer for prediction of selected activities' energy expenditure and intensity in athletic elementary school children. METHODS The present study involved 31 soccer players (16 males and 15 females) from an elementary school (9-12 years). During the measurements, children performed eight selected activities while simultaneously wearing the accelerometer and carrying the portable indirect calorimeter. Five equations (Freedson/Trost, Treuth, Pate, Puyau, Mattocks) were assessed for the prediction of energy expenditure from accelerometer counts, while Evenson equation was added for prediction of activity intensity, making msix equations in total. The accuracy of accelerometer for energy prediction was assessed by comparing measured and predicted values, using the paired t-test. The intensity classification accuracy was evaluated with kappa statistics and ROC-Curve. RESULTS For activities of lying down, television viewing and reading, Freedson/Trost, Treuth were accurate in predicting energy expenditure. Regarding Pate, it was accurate for vacuuming and slow treadmill walking energy prediction. Mattocks was accurate in treadmill running activities. Concerning activity intensity classification accuracy, Pate (kappa=0.72) had the best performance across the four intensities (sedentary, light, moderate, vigorous). In case of the sedentary activities, all equations had a good prediction accuracy, while with light activities and Vigorous activities, Pate had an excellent accuracy (ROC-AUC=0.91, 0.94). For Moderate activities, all equations showed a poor performance. CONCLUSIONS In conclusion, none of the assessed equations was accurate in predicting energy expenditure across all assessed activities in athletic children. For activity intensity classification, Pate had the best prediction accuracy.
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Developing a Multimodal Monitoring System for Geriatric Depression Youngshin Cho, Kyuhee Lim, Sunghee Lee, Yuntae Kim, Mijung Kim, Chang Oh Kim, Youkyung Kim, Heejung Kim CIN: Computers, Informatics, Nursing.2023; 41(1): 46. CrossRef
Comparison of Physical Activity Level, Physical Activity Pattern and Energy Expenditure in Male and Female Elementary School Soccer Players using Accelerometer and Physical Activity Diary Hae-Sun An, Su-Ji Choi, Mo-Ran Lee, Jung-Sook Lee, Eun-Kyung Kim Korean Journal of Community Nutrition.2017; 22(6): 529. CrossRef
OBJECTIVES The purpose of this study was to investigate the awareness and nutritional management of food allergy (FA) by preschooler's faculty members in child care centers. METHODS A questionnaire survey was conducted among faculty members of child care centers in Seoul. The questionnaire was designed to identify the prevalence of food allergies, requirements of food allergy support and differences in food management depending on the presence of allergic diseases. After excluding incomplete responses, the data of 171 faculties in 137 child care centers (95.0%) were used for statistical analysis. RESULTS According to the 137 collected questionnaires, 96 child care centers asked parents about their children's allergic disease and 151 children from 66 child care centers had food allergies. A reported 89 children from 43 child care centers had food restrictions. However, 9 child care centers (21.0%) were not aware of food restriction for children with food allergies. Only 6 child care centers (14.0%) supplied substitute foods with the same amount and type of nutrients. Forty eight faculties (28.1%) received training about food allergies. Although there were some differences according to institution type, most of the faculty members wanted food allergy-related support. CONCLUSIONS This study identified a lack of food allergy training for faculty members in child care centers. For proper management, it is necessary for faculty members of child care centers to be educated on overall food allergies. Food allergy-related support such as menus without allergenic ingredients, guidelines on emergency care for food allergies and anaphylaxis should be provided for faculty members in child care centers.
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OBJECTIVES This study was conducted to investigate providers' perspectives on current challenges in implementing a program for prevention and management of childhood obesity and adoption of mobile phone as a potential solution of leveraging multimodal delivery and support in a school setting. METHODS The qualitative data were collected through face-to-face in-depth interviews with 23 elementary-school teachers, 6 pediatricians, and 6 dieticians from community health centers and analyzed using a qualitative research methodology. RESULTS Current challenges and potential solutions of obesity-prevention and -management program for obesity program for elementary school children were deduced as two themes each. Lack of tailored intervention due to limited recipient motivation, lack of individualized behavioral intervention, and different environmental conditions can be solvable by mobile technology-based personalized intervention which brings about interactive recipient participation, customized behavioral intervention, and ubiquitous accessibility. Lack of sustainable management due to stigmatization, limited interactions between program providers and inconsistent administrative support can be handled by multimodal support based on school setting using mobile platform providing education of health promoting behaviors toward larger scale and interactive networking between program participants, and minimizing administrative burden. CONCLUSIONS Adoption of mobile-based health management program may overcome current limitations of child obesity program such as lack of tailored intervention and sustainable management via personalized intervention and multimodal supports although some concerns such as increased screen time need to be carefully considered in a further study.
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OBJECTIVES The present study systematically reviewed previous studies published in Korea regarding obesity status of children and adolescents in order to provide valid directions for future research and to help establish evidence-based prevention strategies. METHODS The articles were selected by searching the primary keyword ‘obesity’ and the secondary keywords ‘children’, ‘young children’, ‘adolescents’ or ‘kids’ on the KISS (Korean Studies Information Service System). Out of 503 articles excluding the overlap, 308 articles were selected with inclusion and exclusion criteria. Secular trends of obesity research, distribution of subjects, potential risk factors for obesity, and intervention method for obesity management were documented. The associations between obesity and dietary factors were summarized. RESULTS The overall number of research studies has increased since 2000 but obesity management studies have decreased in recent years. Most of the studies used a cross-sectional design. Research on preschool children were extremely limited. Intervention studies targeting males were prevalent. The most significant variables relevant to dietary habits were speed of eating, regular breakfast and snacking. The most significant food and nutrient intake factors were thiamin and iron. Intakes of cereals and animal foods were significantly higher in obese children than the counterparts. CONCLUSIONS The present review of locally published articles on the obesity status in children and adolescents suggested the need for well-designed further studies focused on risk factors of obesity and on a range of intervention methods conducive to the development of obesity prevention and management programs.
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Using methylome data to inform exposome-health association studies: An application to the identification of environmental drivers of child body mass index Solène Cadiou, Mariona Bustamante, Lydiane Agier, Sandra Andrusaityte, Xavier Basagaña, Angel Carracedo, Leda Chatzi, Regina Grazuleviciene, Juan R. Gonzalez, Kristine B. Gutzkow, Léa Maitre, Dan Mason, Frédéric Millot, Mark Nieuwenhuijsen, Eleni Papadopo Environment International.2020; 138: 105622. CrossRef
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OBJECTIVES This study was conducted to investigate the nutritional status and dietary behavior of Korean and Chinese elementary school children using Nutritional Quotient (NQ). METHODS The survey was conducted by distributing questionnaires to the parents of the child, after selecting four elementary schools located in Pusan city of Korea and three elementary schools located in Luoyang city, Henan Province of China, from Grade 1 to Grade 6 in each school. RESULTS The NQ scores of Korean children and Chinese children were 64.99 and 66.57, respectively, which did not show a statistically significant difference. Korean children significantly showed higher diversity score (p<0.001) than Chinese, but Chinese children significantly showed higher moderation (p < 0.001), regularity (p < 0.001) and practice score (p < 0.01) than Korean. NQ grades showed a statistically significant difference. According to food security of the household, NQ scores of the Chinese children of secure household were significantly higher than those of food insecurity household (p < 0.01). In particular, it showed a significant difference in the practice (p < 0.001), moderation (p < 0.05) and regularity score (p < 0.05). Korean children's NQ score showed a significant correlation with the score of following the Dietary Guidelines of parents, but Chinese did not show such a correlation. CONCLUSIONS There were differences in children's dietary behaviors and parents' impact to children's dietary attitude between Korean and Chinese. NQ developed for Korean could be successfully applied to Chinese.
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OBJECTIVES This study was conducted to evaluate the nutrition quotient (NQ) by mother's parenting style which may influence the NQ in preschool children. METHODS Subjects were 310 mothers and their 4-6 year old children. The questionnaire composed of demographic characteristics, mother's parenting style at meal time and eating behavior as measured by NQ questions. The NQ questions consisted of 19 food behavior checklist items and all items were grouped into 5 factors: balance, diversity, moderation, regularity, and practice. Mother's parenting style was classified by using words for nutrition education at meal time. All data were statistically analyzed by SPSS program (Ver. 23) and the statistical differences in variables were evaluated by Student's t-test, χ²-test, One-way ANOVA. RESULTS We observed that in children whose mothers use the parenting style at meal time of ‘explanation’ and ‘compliment & cheer up’ had high dietary regularity, diversity, practice. The children of mothers who use the parenting style at meal time of ‘persuasion’ and ‘reward’ were found to have a lower degree of balance, diversity, and practice. Especially, children of ‘reward’ style mothers had lower moderation of dietary life. On the other hand, among the parenting style at meal time of ‘comparison & demand’, ‘treating’ and ‘faire’, there was no significant difference in the NQ factor by each group. NQ grade was higher among those who used more explanation (p < 0.001) and persuasion (p < 0.01) and with use of less persuasion (p < 0.01) and reward (p < 0.01). The positive association observed between the frequency of dietary education of mothers and higher NQ grade indicated the degree of dietary practices of those children. On the other hand, the children of mothers who rarely practice the dietary education at home had lower NQ grade (p < 0.001). CONCLUSIONS In order to promote children's proper dietary behaviors, it is important to provide nutrition education to children as well as provide guidance on parenting style at meal time.
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OBJECTIVES This study was performed to measure the food allergy (FA) awareness and management by the parents of preschool children. METHODS A questionnaire survey was conducted with the parents of preschool children. The questionnaire was designed to identify the prevalence of food allergies, requirements of food allergy support and differences in food management according to the presence or absence allergic diseases, using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. After excluding incomplete responses, the data of 158 parents of preschool children (90.3%) was used for statistical analysis. RESULTS The rate of the preschool children who had experienced food allergy (FA, ever) was 38.6% while diagnosed for food allergy by doctor (Diagnosis of FA, ever) was 17.7%. Forty nine preschool children (80.3%) had food restriction, and twenty three of them (37.7%) had self-restriction without diagnosis. The consumption frequencies of allergenic foods in FA group, such as ramyeon, noodles, bread, eggs, yogurt and ice cream were significantly (p<0.001) lower than those of the other two groups. The major allergenic foods were eggs, milk, wheat and processed foods in FA group. The overall food allergy-related knowledge level of parents was insufficient. Only 26 parents (16.5%) had received training about food allergies. All parents wanted to receive food allergy-related supports. In addition, most of parents wanted information on substitute menu for children with food allergy. CONCLUSIONS This study identified a lack of food allergy training for the parents of preschool children and the necessity for food allergy education. Food allergy-related supports, such as menus without allergenic ingredients, guidelines for managing food allergy & anaphylaxis emergency care plan etc, should be provided to the parents in order to avoid events related to food allergies.
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