Korean Journal of Community Nutrition

[English]
Eating habits and dietary supplement utilization according to food-related lifestyle among Korean adults: a cross-sectional study: EunJung Lee, Jin A Jang, Ji-Myung Kim; Korean J Community Nutr 2024;29(4):253-264. Published online August 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00017

Abstract PDF PubReader ePub: Objectives
This study investigated the association between eating habits and the utilization of dietary supplements (DSs) according to food-related lifestyle (FRL) among Korean adults. Methods: This study included a total of 300 participants (150 men and 150 women) in their 20s to 60s living in Seoul and Gyeonggi Province. We identified two groups by factor and cluster analysis: an ‘active pursuit’ group and a ‘passive pursuit’ group. Differences in eating habits and DS utilization between the two groups were analyzed by chi-square test and t-test. Logistic regression analysis was used to analyze the effect of variables on DS consumption according to FRL. Results: There were significant differences between the two groups in terms of age, alcohol drinking frequency, total dietary score, change in DS consumption after coronavirus disease 2019, and current DS consumption (P < 0.05). The proportion who perceived many health benefits of DSs was higher in the ‘active pursuit’ group than in the ‘passive pursuit’ group (P = 0.003). The most commonly consumed type of DSs was multivitamins & minerals for the ‘active pursuit’ group, and omega-3 fatty acids for the ‘passive pursuit’ group. The ‘an active pursuit’ group consumed DSs 2.93 times more (95% confidence interval [CI]: 1.44–5.97) compared to the ‘passive pursuit’ group, after adjusting for confounders. In the ‘active pursuit’ group, the health pursuit (odds ratio [OR] = 6.54, 95% CI: 1.44– 29.61) and rational consumption pursuit factors (OR = 0.26, 95% CI: 0.08–0.83) were associated with DS consumption, whereas only the health pursuit factor had a significant association (OR = 5.37, 95% CI: 2.08–13.88) within the ‘passive pursuit’ group. However, total dietary score and DSs consumption did not show a relationship. Conclusions: By understanding the consumption characteristics of DSs according to FRL, this can serve as basic data necessary for promoting health through the utilization of DSs and healthy behaviors.

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[English]
Total sugar intake and its contributed foods by age groups in Koreans using the 8th (2019–2021) Korea National Health and Nutrition Examination Survey: a cross-sectional study: Hyejin Yu, Sang-Jin Chung; Korean J Community Nutr 2024;29(3):222-233. Published online June 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.3.222

Abstract PDF PubReader ePub: Objectives
This study was conducted to investigate the status of total sugar intake and contributing foods in Korea according to age groups.
Methods
This study used 24-hour dietary recall data from the 8th Korea National Health and Nutrition Examination Survey (2019–2021) to investigate the nutritional and total sugar intake status among Koreans. A total of 18,338 research participants (≥3 years old) were included in this study. To analyze the types of foods contributing to total sugar intake, these foods were categorized into 15 types. Moreover, we examined the total sugar intake and ranked the most consumed foods by age groups (3–11 years, 12–18 years, 19–34 years, 35–49 years, 50–64 years, over 65 years). A survey procedure was employed for statistical analysis.
Results
The energy intake ratio from total sugars was approximately 12%–15%, which was within the recommended range. However, the proportion of individuals consuming total sugar exceeding 20% of their total caloric intake is nearly 20%, raising concerns about excessive sugar consumption. Furthermore, the percentage of participants whose intake of sugar from processed foods exceeded 10% of their total calories was highest in the 12–18 age group at 37.1%, followed by the 3–11 age group at 35.2%, and the 19–34 age group at 34.0%. Carbonated drinks, cola, and cider were the primary foods consumed by children and adolescents (3–18 years old) and young adults (19–34 years old). For middle-aged and older adults, mixed coffee with sugar and cream was a prominent contributor to sugar intake.
Conclusions
This study investigated sugar consumption patterns among Koreans, finding the principal foods contributing to this intake. Identifying these contributors is pivotal, given their potential impact on public health.

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[Korean]
Effects of watching Mukbang and Cookbang videos on adolescents’ dietary habits and mental health: cross-sectional study using the 18th Korea Youth Risk Behavior Survey: Seung-Hee Hong; Korean J Community Nutr 2024;29(2):156-170. Published online April 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.2.156

Abstract PDF: Objectives
This study aimed to investigate the association between how often Korean adolescents watch Mukbang and Cookbang videos and their dietary habits.
Methods
Data from the 18th Korea Youth Risk Behavior Survey conducted in 2022 was analyzed for this study. The study included 51,850 middle and high school students and assessed various aspects, including demographics, frequency of watching Mukbang and Cookbang videos per week, dietary habits, health behaviors, and mental health factors.
Results
Nearly a third (29.3%) of Korean adolescents watched Mukbang and Cookbang videos one to four times a week, while 13.5% watched them more than five times weekly. Females, those with lower academic achievement, and those from lower socioeconomic backgrounds were significantly more likely to be frequent viewers (P < 0.001). Increased viewing frequency was associated with poorer dietary habits. Adolescents who watched more frequently were less likely to eat breakfast and consume fruits and milk, while their consumption of fast food, high-caffeine drinks, sugary drinks, and late-night snacks increased (P < 0.001). Higher viewing frequency correlated with increased feelings of stress, depression, and loneliness (P < 0.001). Logistic regression analysis confirmed these associations. More frequent viewers were significantly less likely to eat breakfast (odds ratio (OR), 0.63; 95% confidence interval (CI), 0.58–0.68), and more likely to consume fast food (OR, 1.85; 95% CI, 1.69–2.02), high-caffeine drinks (OR, 1.43; 95% CI, 1.30–1.56), sugary drinks (OR, 1.54; 95% CI, 1.41–1.67), and late-night snacks (OR, 1.37; 95% CI, 1.25–1.51).
Conclusions
Our findings suggest that frequent exposure to Mukbang and Cookbang content is linked to unhealthy dietary habits in adolescents. Educational programs may be necessary to mitigate the potential for these videos to negatively influence dietary choices.

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[English]
Exploring factors of nutrition teachers’ intentions for sustainable dietary education in South Korea: an application of the theory of planned behavior: Eunseo Yang, Borham Yoon; Korean J Community Nutr 2024;29(2):114-128. Published online April 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.2.114

Abstract PDF: Objectives
The purpose of this study was to investigate the perception of nutrition teachers and the factors influencing their intention toward sustainable dietary education utilizing the theory of planned behavior (TPB).
Methods
The self-administered online survey was completed by nutrition teachers in Jeollanam-do, South Korea. A total of 151 valid questionnaires were analyzed. Factor analysis and multiple regressions were employed to test the research model.
Results
The study findings demonstrated that all TPB variables significantly influenced the sustainable dietary educational intention, with the degree of influence ranking as follows: external perceived behavioral control (β = 0.417), attitude (β = 0.240), internal perceived behavioral control (β = 0.207), and subjective norms (β = 0.181). For external perceived behavioral control, nutrition teachers and elementary schools exhibited higher levels compared to dietitians and middle/high schools, respectively. The participants in sustainable dietary education training programs exhibited a higher level of internal perceived behavioral control compared to those who did not participate. The highest perception levels were reported for attitude (4.26), followed by subjective norms (4.02), internal perceived behavioral control (3.67), and external perceived behavioral control (3.20).
Conclusions
This study affirmed that the TPB variables elucidated the sustainable dietary educational intentions of nutrition teachers. The significant impacts of external and internal perceived behavioral control, attitude, and subjective norms on educational intentions were confirmed. Consequently, proactive support from schools and governments is essential to enhance the facilitating factors and mitigate the barriers toward sustainable dietary education in schools.

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[Korean]
Comparative study on the health and dietary habits of Korean male and female adults before and after the coronavirus disease 2019 pandemic: utilizing data from the 8 th Korea National Health and Nutrition Examination Survey (2019–2021): Chaemin Kim, Eunjung Kim; Korean J Community Nutr 2024;29(1):65-80. Published online February 29, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.1.65

Abstract PDF

Objectives
This study aims to compare changes in physical factors, health behaviors, eating habits, and nutritional intake among Korean male and female adults over a period of three years (2019–2021) before and after the outbreak of coronavirus disease 2019 (COVID-19).
Methods
This study utilized raw data from the 8^th Korea National Health and Nutrition Examination Survey (2019–2021). The participants in this study included 6,235 individuals in 2019, 5,865 individuals in 2020, and 5,635 individuals in 2021. Individuals whose daily energy intake was less than 500 kcal or exceeded 5,000 kcal were excluded from the study.
Results
In comparison to 2019, overweight/obesity rates, weight, waist circumference, weekend sleep hours, and resistance exercise days/week increased in both male and female during the COVID-19 pandemic. Regarding eating habits, the proportions of people skipping breakfast, not eating out, consuming health supplements, and recognizing nutritional labels increased in 2020 and 2021, whereas the rate of skipping dinner decreased. Total energy intake has continued to decrease for the two years since 2019. A comparison of nutrient intake per 1,000 kcal before and after the outbreak of COVID-19 revealed that intake of nutrients, including protein, phosphorus, iron, vitamin A, riboflavin, and niacin increased, while folic acid intake decreased. In male, calcium, phosphorus, riboflavin, and niacin intakes increased, whereas iron, vitamin C, and folic acid intakes decreased. In female, phosphorus, iron, vitamin A, and riboflavin intake increased significantly, while protein and niacin intake decreased significantly.
Conclusions
After COVID-19, the obesity rate, breakfast skipping rate, health supplement intake, and nutritional label use increased, while the frequency of eating out, dinner skipping rate, and total energy intake decreased. These environmental changes and social factors highlight the need for nutritional education and management to ensure proper nutritional intake and reduce obesity rates in the post-COVID-19 era.

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Intake of energy and macronutrients according to household income among elementary, middle, and high school students before and during the COVID-19 pandemic: a cross-sectional study
Chae-Eun Jeong, Heejin Lee, Jung Eun Lee
Korean Journal of Community Nutrition.2024; 29(3): 234. CrossRef

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[Korean]
Association of ultra-processed food with diabetes and impaired fasting glucose in elderly populations (urban and rural): a cross-sectional study: Seung Jae Lee, Mi Sook Cho; Korean J Community Nutr 2024;29(1):51-64. Published online February 29, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.1.51

Abstract PDF: Objectives
This study examined the association between ultra-processed food (UPF) consumption and chronic diseases in elderly Koreans.
Methods
Data from the 2019–2021 Korea National Health and Nutrition Examination Survey were analyzed. Dietary intake and UPF consumption were assessed using the NOVA food classification based on 24-hour recall data from 3,790 participants (aged 65+ years). Participants were divided into 4 groups based on the quartile of energy intake from UPFs. Regions were classified as urban or rural. Multivariable logistic regression was employed to estimate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) after controlling for potential confounders.
Results
Among the participants, 71.3% resided in urban and 28.7% in rural areas. Compared to the urban elderly, rural participants tended to be older, have lower education and income levels, be more likely to live in single-person households, and have a higher smoking rate (P < 0.05). Urban elderly consumed more UPFs daily (146.1 g) compared to rural residents (126.6 g; P < 0.05). “Sugar-sweetened beverages” were the most consumed category in both regions. “Sweetened milk and its products” and “traditional sauces” were prominent in urban areas, while rural elderly consumed more “traditional sauces” and “distilled alcoholic beverages.” Rural areas also had a higher carbohydrate-to-calorie ratio than urban areas. Compared to the lowest quartile of UPF intake, the highest quartile was significantly associated with impaired fasting glucose only in rural areas (AOR, 1.48; 95% CI, 1.00–2.19; P for trend = 0.0014). No significant associations were observed for diabetes in either urban or rural areas.
Conclusions
This study suggests that high intake of UPFs is associated with increased odds of impaired fasting glucose in rural elderly. Further research is needed to elucidate the specific negative health effects of UPFs in different populations, and targeted efforts should promote healthy diets in both urban and rural areas.

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[Korean]
Sustainable diets: a scoping review and descriptive study of concept, measurement, and suggested methods for the development of Korean version: Sukyoung Jung; Korean J Community Nutr 2024;29(1):34-50. Published online February 29, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.1.34

Abstract PDF: Objectives
Transformation through a sustainable food system to provide healthy diets is essential for enhancing both human and planetary health. This study aimed to explain about sustainable diets and illustrate appropriate measurement of adherence to sustainable diets using a pre-existing index.
Methods
For literature review, we used PubMed and Google Scholar databases by combining the search terms “development,” “validation,” “sustainable diet,” “sustainable diet index,” “planetary healthy diet,” “EAT-Lancet diet,” and “EAT-Lancet reference diet.” For data presentation, we used data from National Health and Nutrition Examination Survey, 2017–2018, among adults aged 20 years and older (n = 3,920). Sustainable Diet Index-US (SDI-US), comprising four sub-indices corresponding to four dimensions of sustainable diets (nutritional quality, environmental impacts, affordability, and sociocultural practices), was calculated using data from 24-hour dietary recall interview, food expenditures, and food choices. A higher SDI-US score indicated greater adherence to sustainable diets (range: 4–20). This study also presented SDI-US scores according to the sociodemographic status. All analyses accounted for a complex survey design.
Results
Of 148 papers, 16 were reviewed. Adherence to sustainable diets fell into 3 categories: EAT-Lancet reference diet-based (n = 8), Food and Agriculture Organization (FAO) definitionbased (n = 4), and no specific guidelines but including the sustainability concept (n = 4). Importantly, FAO definition emphasizes on equal importance of four dimensions of diet (nutrition and health, economic, social and cultural, and environmental). The mean SDI-US score was 13 out of 20 points, and was higher in older, female, and highly educated adults than in their counterparts.
Conclusions
This study highlighted that sustainable diets should be assessed using a multidimensional approach because of their complex nature. Currently, SDI can be a good option for operationalizing multidimensional sustainable diets. It is necessary to develop a Korean version of SDI through additional data collection, including environmental impact of food, food price, food budget, and use of ready-made products.

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[Korean]
Process evaluation of a mobile healthcare program among employees with overweight and obesity: a 12-week intervention study investigating the role of engagement: Imhuei Son, Jiyoun Hong, Young Hee Han, Bo Jeong Gong, Meng Yuan Zhang, Woori Na, Cheongmin Sohn, Taisun Hyun; Korean J Community Nutr 2023;28(6):466-479. Published online December 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.6.466

Abstract PDF: Objectives
A mobile health intervention program was provided for employees with overweight and obesity for 12 weeks, and a process evaluation was completed at the end of the program. We investigated participant engagement based on app usage data, and whether engagement was associated with the degree of satisfaction with the program.
Methods
The program involved the use of a dietary coaching app and a wearable device for monitoring physical activity and body composition. A total of 235 employees participated in the program. App usage data were collected from a mobile platform, and a questionnaire survey on process evaluation and needs assessment was conducted during the post-test.
Results
The engagement level of the participants decreased over time. Participants in their 40s, high school graduates or lower education, and manufacturing workers showed higher engagement than other age groups, college graduates, and office workers, respectively. The overall satisfaction score was 3.6 out of 5. When participants were categorized into three groups according to their engagement level, the upper group was more satisfied than the lower group. A total of 71.5% of participants answered that they wanted to rejoin or recommend the program, and 71.9% answered that the program was helpful in improving their dietary habits. The most helpful components in the program were diet records and a 1:1 chat with the dietary coach from the dietary coaching app. The barriers to improving dietary habits included company dinners, special occasions, lack of time, and eating out. The workplace dietary management programs were recognized as necessary with a need score of 3.9 out of 5.
Conclusions
Participants were generally satisfied with the mobile health intervention program, particularly highly engaged participants. Feedback from a dietary coach was an important factor in increasing satisfaction.

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[Korean]
Estimating and evaluating usual total fat and fatty acid intake in the Korean population using data from the 2019–2021 Korea National Health and Nutrition Examination Surveys: a cross-sectional study: Gyeong-yoon Lee, Dong Woo Kim; Korean J Community Nutr 2023;28(5):414-422. Published online October 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.5.414

Abstract PDF

Objectives
This study evaluated usual dietary intakes of total fat and fatty acids among the Korean population based on the revised Dietary Reference Intakes for Koreans 2020 (2020 KDRIs).
Methods
This study utilized data from the eighth Korea National Health and Nutrition Examination Survey (KNHANES 2019–2021). We included 18,895 individuals aged 1 year and above whose 1-day 24-hour dietary recall data were available. To calculate the external variability using the National Cancer Institute 1-day method, data from the U.S. NHANES 2017-March 2020 Pre-pandemic dataset were employed. The total fat and fatty acid intake were evaluated based on the Acceptable Macronutrient Distribution Ranges (AMDRs) and Adequate intake (AI) of 2020 KDRIs for each sex and age groups.
Results
Approximately 86% of the Korean population obtained an adequate amount of energy from total fat consumption (within the AMDRs), indicating an appropriate level of intake. However, the percentage of individuals consuming saturated fatty acids below the AMDR was low, with only 12% among those under 19 years of age and 52% aged 19 years and older. On a positive note, approximately 70% of the population showed adequate consumption of essential fatty acids, exceeding the AI. Nevertheless, monitoring the intake ratio of omega 3 (n-3) to omega 6 (n-6) fatty acids is essential to ensure an optimum balance.
Conclusions
This study explored the possibility of estimating the distribution of nutrient intake in a population by applying the external variability ratio. Therefore, if future KNHANES conduct multiple 24-hour recalls every few years-similar to the U.S. NHANESeven for a subset of participants, this may aid in the accurate assessment of the nutritional status of the population.

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The association between COVID-19 and changes in food consumption in Korea: analyzing the microdata of household income and expenditure from Statistics Korea 2019–2022
Haram Eom, Kyounghee Kim, Seonghwan Cho, Junghoon Moon
Journal of Nutrition and Health.2024; 57(1): 153. CrossRef
Dietary intake and food sources of essential fatty acids among Korean adolescents: a cross-sectional study based on the 2016–2021 KNHANES data
Enkhgerel Erdenetsetseg, Hye Ran Shin, SuJin Song
Korean Journal of Community Nutrition.2024; 29(2): 144. CrossRef

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

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

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[English]
Association between dietary intake, body measurements, and urinary bone resorption markers in young adults with osteopenia and osteoporosis: a cross-sectional study: Mi-Hyun Kim, Mi-Kyeong Choi; Korean J Community Nutr 2023;28(4):282-292. Published online August 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.4.282

Abstract PDF: Objectives
Bone health in early adulthood, as individuals approach peak bone mass, plays a critical role in preventing osteoporosis later in life. This study aimed to investigate the associations between lifestyle and dietary factors, anthropometric measurements, and urinary bone resorption markers in young adults.
Methods
A cross-sectional study was conducted with 100 healthy Korean adults (50 men and 50 women) in their 20s and early 30s. Bone mineral density (BMD), anthropometric measurements, dietary intake (24-hour recall), and urinary bone resorption indicators (deoxypyridinoline and N-terminal telopeptide of type I collagen) were analyzed. Variables were compared between the osteopenia and osteoporosis groups (OSTEO group: 30% men and 60% women) and the healthy control group.
Results
Men in the OSTEO group were significantly taller than those in the control group (P < 0.05). Women in the OSTEO group had significantly lower body weight and body composition (muscle and body fat) than those in the normal group (P< 0.01). Men in the OSTEO group had a significantly higher intake of animal calcium (Ca) than those in the normal group (P < 0.05). Women in the OSTEO group had significantly higher dietary fiber, vitamin A, Ca, plant Ca, and potassium intake than did those in the normal group (P < 0.05). There were no significant differences in caffeinated beverage consumption, eating habits, or urinary bone resorption indicators between the OSTEO and control groups of either sex.
Conclusions
In our study of young South Korean adults, we observed low bone density levels, with particularly low BMD in taller men and underweight women. We found a higher nutrient intake in the OSTEO group, indicating the possibility of reverse causality, a phenomenon often found in cross-sectional studies. Therefore, there is a need to further elucidate dietary factors related to osteoporosis in young adults through prospective cohort studies involving a larger population.

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

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

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[Korean]
Dietary guidelines adherence and changes in eating habits among college students in the post-COVID-19 period: a cross-sectional study: Eunyoung Yoon; Korean J Community Nutr 2023;28(3):220-234. Published online June 30, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.3.220

Abstract PDF

Objectives
This study aimed to assess the adherence to dietary guidelines among college students in the post-COVID-19 era and examine the changes in their dietary habits as the learning environment transitioned from remote to in-person classes.
Methods
We conducted a survey involving 327 college students in Daejeon from March to April 2023. The survey questionnaires included various factors, including age, gender, type of residence, frequency of use of delivery food, convenience food, and eating out. In addition, we investigated the extent of adherence to the dietary guidelines for Koreans and the degree of dietary changes following the post-COVID-19 shift in class format were investigated. For comparative analysis of the level of adherence to dietary guidelines in relation to dietary habit changes, an ANOVA and a post hoc Scheffe test were employed. We also performed a multiple linear regression analysis to identify dietary factors influencing the level of adherence to dietary guidelines.
Results
The study revealed a high rate of convenience food consumption and a low rate of homemade food intake among students. There was a marked increase in the consumption of processed foods, convenience foods, dining out, sweet foods, high-fat fried foods, beverages, and alcohol following the transition from online to in-person classes. When examining adherence to Korean dietary guidelines, the highest scored practice was ‘Hydration’, and the lowest was ‘Breakfast habit’. Increased consumption of convenience foods, late-night snacks, and dining out were negatively correlated with adherence levels to dietary guidelines, specifically correlating with ‘Healthy weight’, ‘Hydration’, ‘Breakfast habit’, and the total score of adherence. The adoption of ‘regular meals’ was positively associated with increased adherence levels to dietary guidelines.
Conclusions
The transition from remote to in-person classes post-COVID-19 led to increased intake of convenience foods, dining out, sweet foods, high-fat fried foods, and alcohol. The rise in convenience food and late-night snack consumption negatively influenced several aspects of the dietary guidelines adherence, thereby suggesting the need for strategies to encourage healthy dietary habits among college students.

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Attributes of multiple concurrent functional gastrointestinal disorders in female university students in South Korea
Hyo Kyung Kim, Hyunjung Kim, Aram Lee
Women & Health.2024; 64(8): 674. CrossRef

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[English]
Screen time, mealtime media use, and dietary behaviors in Korean preschoolers : a cross-sectional study: Young-Hee Han, Saerom Shin, Eun Yeol Woo, Hye-Kyung Park, Taisun Hyun; Korean J Community Nutr 2023;28(3):206-219. Published online June 30, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.3.206

Abstract PDF: Objectives
Screen time refers to the time spent using screen media, such as televisions, smartphones, computers, or tablets. Excessive exposure to screen media has been reported to negatively impact young children’s health and development, including overweight, short sleep duration, and language delays. This study examined the association of screen time and mealtime media use with dietary behaviors among preschool children.
Methods
A cross-sectional survey was conducted on parents of children aged three to five years using the online questionnaires of the Nutrition Quotient for Preschoolers (NQ-P) and the Dietary Screening Test (DST). Data from 261 children’s parents were analyzed.
Results
Of the 261 children, 96.9% used screen media, 55.6% used screen media for two hours or more daily, and 30.7% were exposed to screen media during meals. The NQ-P scores were significantly lower in the children with longer screen time and mealtime media use. Children who used screen media for two hours or more and those exposed to screen media during meals consumed kimchi less frequently and confectionery and sugar-sweetened beverages more frequently than children who used less than two hours and were not exposed to screen media during meals. In addition, they were more likely to be picky about food, refuse to eat, and less likely to feed themselves than children with shorter screen time and no mealtime media use.
Conclusions
This study reported an association between unhealthy dietary behaviors, feeding difficulties, and screen time and mealtime media use among preschool children. Further research should explore effective strategies for reducing children’s screen time.

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[English]
Effectiveness of a mobile health intervention on weight loss and dietary behavior changes among employees with overweight and obesity: a 12-week intervention study investigating the role of engagement: Imhuei Son, Jiyoun Hong, Young-Hee Han, Bo Jeong Gong, Meng Yuan Zhang, Woori Na, Cheongmin Sohn, Taisun Hyun; Korean J Community Nutr 2023;28(2):141-159. Published online April 30, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.2.141

Abstract PDF

Objectives
This study aimed to determine whether a mobile health (mhealth) intervention is effective in reducing weight and changing dietary behavior among employees with overweight and obesity. The study also investigated whether engagement with the intervention affected its effectiveness.
Methods
The intervention involved the use of a dietary coaching app, a wearable device for monitoring physical activity and body composition, and a messenger app for communicating with participants and an intervention manager. A total of 235 employees were recruited for a 12-week intervention from eight workplaces in Korea. Questionnaire surveys, anthropometric measurements, and 24-h dietary recalls were conducted at baseline and after the intervention.
Results
After the intervention, significant decreases in the mean body weight, body mass index, body fat percentage, and waist circumference were observed. Furthermore, the consumption frequencies of multigrain rice and legumes significantly increased, whereas those of pork belly, instant noodles, processed meat, carbonated beverages, and fast food significantly decreased compared with those at baseline. The mean dietary intake of energy and most nutrients also decreased after the intervention. When the participants were categorized into three groups according to their engagement level, significant differences in anthropometric data, dietary behaviors, and energy intake were observed following the intervention, although there were no differences at baseline, indicating that higher engagement level led to greater improvements in weight loss and dietary behavior.
Conclusions
The intervention had positive effects on weight loss and dietary behavior changes, particularly among employees with higher engagement levels. These results indicate the importance of increasing the level of engagement in the intervention to enhance its effectiveness. The mhealth intervention is a promising model for health promotion for busy workers with limited time.

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Citations to this article as recorded by

Improving the nutrition quotient and dietary self-efficacy through personalized goal setting and smartphone-based nutrition counseling among adults in their 20s and 30s
Dahyeon Kim, Dawon Park, Young-Hee Han, Taisun Hyun
Journal of Nutrition and Health.2023; 56(4): 419. CrossRef
Process evaluation of a mobile healthcare program among employees with overweight and obesity: a 12-week intervention study investigating the role of engagement
Imhuei Son, Jiyoun Hong, Young Hee Han, Bo Jeong Gong, Meng Yuan Zhang, Woori Na, Cheongmin Sohn, Taisun Hyun
Korean Journal of Community Nutrition.2023; 28(6): 466. CrossRef
Systematic Review on the Study of the Childhood and Adolescent Obesity in Korea: Dietary Risk Factors
Eun Jeong Heo, Jae Eun Shim, Eun Young Yoon
Korean Journal of Community Nutrition.2017; 22(3): 191. CrossRef

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

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

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[Korean]
Comparison of blood biochemical characteristics and dietary intake by sex in gastric cancer patients over 40 years in Korea based on 7^th (2016-2018) Korea National Health and Nutrition Examination Survey: a cross-sectional study: Hyeon-Ju Lee, Sung-Won Oh, Sook-Bae Kim; Korean J Community Nutr 2023;28(1):48-60. Published online February 28, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.1.48

Abstract PDF: Objectives
The purpose of this study was to compare the sex-associated differences in the dietary intake of gastric cancer patients in Korea.
Methods
Data from the Korea National Health and Nutrition Examination Survey (KNHANES) the 7 th (2016-2018) were analyzed in the present study. The subjects included 122 gastric cancer patients aged over 40 years (75 male, 47 female). General characteristics (age, marital status, household income, education, food security, comorbidities, alcohol drinking, and smoking), anthropometric characteristics (height, weight, body mass index, and blood pressure), blood biochemical characteristics [fasting plasma glucose (FPG), blood urea nitrogen (BUN), creatinine, triglyceride, total cholesterol, and HDL-cholesterol)], and quantity and quality of dietary intake were compared between male and female participants.
Results
Males had higher rates of having a spouse, prevalence of hypertension, alcohol drinking, and smoking than females. The proportion of males with a normal range of FPG, BUN, and HDL-cholesterol was lower than that in females. The total cholesterol levels above the normal range were higher in females than in males. We also found that females had a higher percentage of intakes below the estimated energy requirement (EER) and intakes below the estimated average requirement (EAR) for carbohydrates, niacin, phosphorus, and iron than males. The index of nutritional quality (INQ) for phosphorus and folate, nutrient adequacy ratio (NAR) for vitamin C, thiamine, niacin, folate, calcium, and phosphorus, and the mean adequacy ratio (MAR) were lower in females than males.
Conclusions
In Korean gastric cancer patients, management of comorbidities such as diabetes and hypertriglyceridemia, lowering FPG, and raising HDL-cholesterol level management is required for males, whereas management of lowering total cholesterol and raising hematocrit is required for females. The quantitative and qualitative nutritional intakes were poor in gastric cancer patients, especially in females, who had a lower nutritional intake than males. We suggest that nutritional interventions are needed to improve the overall nutritional intake in both male and female gastric cancer patients. In particular, we propose that support is urgently needed for females whose nutritional intake is lower than that of males. In addition, family, social, and national support for nutritional management of female gastric cancer patients is highly necessary.

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[Korean]
A Study on the Dietary Behavior of Korean Adults: Focus on Dietary Supplement Intake, Household Size, and COVID-19: Jinkyung Choi; Korean J Community Nutr 2022;27(6):468-479. Published online December 31, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.6.468

Abstract PDF

Objectives
This study investigates dietary supplement intakes by examining the characteristics of dietary and health-related behaviors. Data were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES). Dietary and health-related behaviors were also examined before and after the occurrence of COVID-19 and household types (multi-members vs. single person).
Methods
Data used in this study were collected from the 2019-2020 KNHANES by including adults aged 19 to 64 years. Pregnant, lactating, and subjects consuming calories less than 500 and more than 5,000 were excluded. Differences in dietary and health-related behaviors before and after COVID-19, and between the two types of households were analyzed by Chi-square analyses using Rao-Scott. Logistic regression analyses were applied to determine which dietary and health-related behaviors affected the dietary supplement intakes. In addition, descriptive analysis was run for demographic characteristics.
Results
The dietary supplement intake rate differed significantly with respect to the gender, age, education, marital status, and household income. Dietary supplement intakes, frequency of eating out, obesity, and body weight changes were significantly different before and after COVID-19. In addition, meal evaluation, frequency of eating out, drinking, smoking, activity, subjective health evaluation, and body weight changes showed significant differences by household type. Attitude towards nutrition, activity, meal evaluation, obesity, and smoking were factors that affected the intake of dietary supplements.
Conclusions
While increased intake of dietary supplements is a prevalent phenomenon, this intake needs to be monitored and studied closely, considering the sociodemographic characteristics and dietary and health-related behaviors. Furthermore, the dietary supplement intake trend after COVID-19 needs to be studied along with food intake.

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Comparison of Eating Habits and Behaviors of Young Single-Person Households based on Food-Related Lifestyle
Dokyung Kim, Sim-Yeol Lee
Korean Journal of Health Promotion.2023; 23(3): 117. CrossRef
Effect of Dietary Supplements on Vitamin and Mineral Intake Among Koreans: Data From the 2018-2020 Korea National Health and Nutrition Examination Survey
Moon Yeong Hwang, Jiyoun Hong
Food Supplements and Biomaterials for Health.2023;[Epub] CrossRef
Dietary guidelines adherence and changes in eating habits among college students in the post-COVID-19 period: a cross-sectional study
Eunyoung Yoon
Korean Journal of Community Nutrition.2023; 28(3): 220. CrossRef

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[Korean]
Assessment of Nutrient Intake and Dietary Quality of Korean Adults in Metabolic Syndrome Patients According to Taking Medical Care: Based on the 2017 Korea National Health and Nutrition Examination Survey: Juhee Lee, Kyungsuk Choi; Korean J Community Nutr 2022;27(4):321-340. Published online August 31, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.4.321

Abstract PDF

Objectives
This study established a practical direction for the prevention and management of metabolic syndrome by evaluating the health status, nutrition intake level, and diet quality according to metabolic syndrome and related drug treatment in Korean adults.
Methods
The data from the 2017 KNHANES (Korea National Health and Nutrition Examination Survey) was analyzed. The analysis included 2,978 adults, classified into the normal, metabolic syndrome (MetS), metabolic syndrome with medicines (MetS-M), and without medicines (MetS-noM) groups. The nutrient intake, NAR (nutrient adequacy ratio), INQ (index of nutritional quality), and DDS (dietary diversity score) were analyzed.
Results
The mean BMI was significantly higher in the MetS group than in the normal group for all subjects. Subjects of the MetS group tended to consume less energy and major nutrients, while males aged 50 ~ 64 and all females showed less intake of nutrients in the MetS-M group. The energy intake ratio was within 55 ~ 65 : 7~ 20 : 15 ~ 30 of KDRI (Korean Dietary Recommended Intake), but the carbohydrate energy ratio of all subjects aged 50 to 64 was over 65%. The NAR of the major nutrients was lower in the MetS-M group, the average INQ was around 0.8, especially the INQ of calcium and vitamin A was less than 1, and the total DDS score was less than 4 points.
Conclusions
This study confirmed that the nutrient intake and diet quality differed among subjects diagnosed with metabolic syndrome and managed with medical care. The intakes of energy and many nutrients, the quality of diets, and the diversity of food groups in the MetS-M group were lower than in the normal group. Therefore, these will be an important basis for establishing a specific direction of diet education for preventing and managing metabolic syndrome according to gender, age, metabolic syndrome, and drug treatment.

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Identification of shared genetic risks underlying metabolic syndrome and its related traits in the Korean population
Jun Young Kim, Yoon Shin Cho
Frontiers in Genetics.2024;[Epub] CrossRef
Comparative Analysis of Nutritional Intake in Normal, Caution, and Metabolic Syndrome Groups: Data from the 2019 Eighth KNHANES
Min-Young Chong, Inhwa Han
Journal of the Korean Society of Food Science and Nutrition.2023; 52(12): 1304. CrossRef
Effects of Cinnamon (Cinnamomum zeylanicum) Extract on Adipocyte Differentiation in 3T3-L1 Cells and Lipid Accumulation in Mice Fed a High-Fat Diet
Joohee Oh, SongHee Ahn, Xiangqin Zhou, Yu Jin Lim, Sookyeong Hong, Hyun-Sook Kim
Nutrients.2023; 15(24): 5110. CrossRef
Distribution of the Metabolic Syndrome by Obesity and Health Behavior Based on the Eighth KNHANES at 2019
Min-Young Chong, Inhwa Han
Journal of the Korean Society of Food Science and Nutrition.2022; 51(11): 1136. CrossRef

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[Korean]
Dietary Iron Intake of Koreans Estimated using 2 Different Sources of Iron Contents are Comparable: Food & Nutrient Database and Iron Contents of Cooked Foods in the Korean Total Diet Study: Jeeyeon Lee, Sung Ok Kwon, Yoonjae Yeoh, Min Jeong Seo, Gae Ho Lee, Cho-il Kim; Korean J Community Nutr 2022;27(3):245-253. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.245

Abstract PDF

Objectives
This study was conducted to find out if the dietary iron intake of Koreans estimated by 2 different methods (iron content sources) using the food intake data from the Korea National Health and Nutrition Examination Survey (KNHANES) are comparable. One method was based on the KNHANES's Food & Nutrient Database (FND) derived mainly from the Korean Food Composition Table and the other used the iron content (IC) of food samples processed in the Korean Total Diet Study (KTDS).
Methods
Dietary intake data from the 2013-2016 KNHANES was used to select representative foods (RFs) in KTDS for iron analysis. Selection of the RFs and cooking methods for each RF (RF × cooking method pair) was performed according to the ‘Guidebook for Korean Total Diet Studies’ and resulted in a total of 132 RFs and 224 ‘RF × cooking method’ pairs. RFs were collected in 9 metropolitan cities nationwide once or twice (for those with seasonality) in 2018 and made into 6 composites each, based on the origin and season prior to cooking. Then, the RF composites prepared to a ‘table ready’ state for KTDS were analyzed by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Dietary iron intake of the Korean population was estimated using only RFs’ intake data based on the 2 sources of iron content, namely FND-KNHANES and IC-KTDS.
Results
RFs in KTDS covered 92.0% of total food intake of Koreans in the 2016-2018 KNHANES. Mean iron intake of Koreans was 7.77 mg/person/day by IC-KTDS vs 9.73 mg/person/day by FND-KNHANES. The major food groups contributing to iron intake were meats (21.7%), vegetables (20.5%), and grains & cereals (13.4%) as per IC-KTDS. On the other hand, the latter source (FND-KNHANES) resulted in a very different profile: grains & cereals (31.1%), vegetables (16.8%), and meats (15.3%). While the top iron source was beef, accounting for 8.6% in the former, it was polished rice (19.2%) in the latter. There was a 10-fold difference in the iron content of polished rice between 2 sources that iron intakes excluding the contribution by polished rice resulted in very similar values: 7.58 mg/person/day by IC-KTDS and 7.86 mg/person/day by FNDKNHANES.
Conclusions
This study revealed that the dietary iron intake estimated by 2 different methods were quite comparable, excluding one RF, namely polished rice. KTDS was thus proven to be a useful tool in estimating a ‘closer-to-real’ dietary intake of nutrients for Koreans and further research on various nutrients is warranted.

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Dietary sodium and potassium intake of Koreans estimated using 2 different sources of their contents in foods, Food & Nutrient Database and the Korean Total Diet Study: a comparative study
Jee Yeon Lee, Sung Ok Kwon, Soo Hyun Lee, Min Jeong Seo, Gae Ho Lee, Cho-il Kim
Korean Journal of Community Nutrition.2023; 28(3): 235. CrossRef

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[Korean]
The Relationship Between the Korean Adults Diet Evaluated Using Dietary Quality Indices and Metabolic Risk Factors: Based on the 2016 ~ 2019 Korea National Health and Nutrition Examination Survey: Chong-Yu Ding, Pil-Sook Park, Mi-Yeon Park; Korean J Community Nutr 2022;27(3):223-244. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.223

Abstract PDF

Objectives
This study was designed to investigate the relationship between metabolic risk factors, Index of Nutrition Quality, and the dietary quality index score of Korean adults.
Methods
The subjects were 18,652 Korean adults aged 19 years or older (7,899 males, 10,753 females) who participated in the 2016-2019 Korea National Health and Nutrition Examination Survey. Subjects were divided into normal, pre-metabolic syndrome, and metabolic syndrome (MetS) groups according to the number of their metabolic risk factors. Data were analyzed using the SPSS program.
Results
About 44.7% of men in the MetS group were at least college graduates (P < 0.001), whereas 52.0% of women in the MetS group were middle school graduates or lower (P < 0.001). The frequency of fruit and dairy products intake tended to decrease as the number of metabolic risk factors increased in both men and women (P for trend < 0.001). As the number of metabolic risk factors decreased, the frequency of grain intake tended to decrease in men (P for trend < 0.001) while the frequency of intake of red meat (P for trend = 0.001), poultry (P for trend < 0.001), and eggs (P for trend < 0.001) decreased in women. The total scores of Diet Quality Index-International (DQI-I) (men P < 0.001, women P < 0.01) and Korean Healthy Eating Index (KHEI) (men and women P < 0.001) were significantly lower in the MetS group compared to the other groups, and the total score of DQI-I and KHEI tended to decrease as the number of metabolic risk factors increased.
Conclusions
Dietary quality evaluation using various indices can provide more information on the dietary problems related to metabolic risk factors. Nutrients and foods that have been confirmed to be related to metabolic risk factors can be used to develop dietary guidelines for the nutritional management of metabolic diseases.

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Cardiocerebrovascular Disease or Fatty Liver Incidence Associated with Pattern of Metabolic Risk Factors and Nutritional Status of Korean Adults: A Prospective Cohort Study
Pil Sook Park, Mei Sheng Li, Chong Yu Ding, Mi Yeon Park
Journal of Health Informatics and Statistics.2023; 48(2): 165. CrossRef
Assessment of Nutrient Intake and Dietary Quality of Korean Adults in Metabolic Syndrome Patients According to Taking Medical Care: Based on the 2017 Korea National Health and Nutrition Examination Survey
Juhee Lee, Kyungsuk Choi
Korean Journal of Community Nutrition.2022; 27(4): 321. CrossRef

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[Korean]
Dietary Behaviors Associated with Health Perception of Korean Adolescents from Multicultural Families: based on data from the 2017 ~ 2019 Korea Youth Risk Behavior Surveys: YueRong Hu, SuJin Song; Korean J Community Nutr 2022;27(3):192-204. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.192

Abstract PDF

Objectives
This study examined the association between dietary behaviors and perceived health status among Korean adolescents from multicultural families.
Methods
This cross-sectional study included 2,459 Korean adolescents from multicultural families (aged 13 ~ 18 years) who participated in the 2017 ~ 2019 Korea Youth Risk Behavior Surveys. Information on the sociodemographic variables, dietary behaviors, and lifestyle variables was selfreported using a web-based questionnaire. The dietary behaviors analyzed in this study were the breakfast and food intake frequencies, including fruit, vegetable, milk, fast food, carbonated drink, sweet drink, and high caffeine/energy drinks. The adolescents’ health perception was self-rated as healthy, average, or unhealthy. The dietary behaviors associated with health perception were examined using a multiple logistic regression after adjusting for the confounding variables.
Results
In this study population, 7.6% of adolescents perceived their health status as unhealthy, and 25.4% perceived it as average. The adolescents who were girls, middle school students, and in households with a low economic status showed significantly higher percentages of poor health perception (P-values < 0.001). Skipping breakfast was significantly associated with a negative health perception. Compared to the adolescents who consumed fruits every day, those who did not consume fruits during the previous week showed a higher odd ratio (OR) for a negative health perception [OR = 2.29, 95% confidence interval (CI) = 1.32–3.97]. The adolescents who frequently consumed carbonated drinks ( 5 times/week) perceived their health status as unhealthy relative to those who did not consume carbonated drinks (OR = 2.15, 95% CI = 1.25–3.71). Skipping breakfast was significantly associated with an increased OR for a negative health perception in girls but not in boys. Compared to adolescents with a normal weight, those with overweight/ obesity (OR = 1.75, 95% CI = 1.21–2.52) and underweight (OR = 2.19, 95% CI = 1.25–3.82) showed higher ORs for negative health perception. Positive associations of overweight/obesity and underweight with negative health perception were observed in boys but not in girls.
Conclusions
Dietary behaviors and weight status were associated with the health perception in Korean adolescents from multicultural families. These findings suggest that nutrition interventions on breakfast intake and healthy food choices for this population might effectively improve their weight and perceived health status.

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The unequal weight of COVID-19 pandemic: national trends in body mass index among Korean adolescents by immigrant-origin and gender from 2013 to 2022
Nari Yoo, Yumin Hong, Yoonyoung Choi
International Journal of Adolescence and Youth.2024;[Epub] CrossRef

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[Korean]
Using Service Design Tools in Community Nutrition Research: A Case Study in Developing Dietary Guidelines for Young Adults: Eunbin Jo, Jae Eun Shim, Hyun Joo Ryou, Kirang Kim, Su Jin Song, Hyun Ja Kim, Jeong Sun Ahn, Kwang-il Kwon, Hye Young Lee, Sohyun Park; Korean J Community Nutr 2022;27(3):177-191. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.177

Abstract PDF

Objectives
Recent epidemiological data reported that young adults in their 20 ~ 30s are a vulnerable population with unhealthy dietary practices and a few signs of deteriorated health indicators. However, there are no dietary guidelines that are specifically developed for the young adult population. This study introduces some data collection tools that are mostly used in the service design field, and demonstrates how these tools can be used in nutrition research for developing dietary guidelines for specific target groups.
Methods
To understand the context of food choices among young people, 39 people were enrolled to complete a probes booklet. Thematic analysis and word cloud were performed to capture the main themes from the probes and a persona was developed based on the findings.
Results
Data from the probes enabled us to grasp the various contextual meanings of eating practices among young people. Most participants understand what a healthy diet is and often have a willingness to practice it. However, there were very few participants who were following the practices. We created four types of persona for developing dietary guidelines: healthy eating, emotional eating, convenient eating, and trendy eating.
Conclusions
Probes and persona were used in order to understand the lives of young adults and develop targeted messages. We hope that this introduction will be helpful to researchers who are looking for new ways of understanding their target population in the field of community nutrition.

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Development of a campus-based intervention program to strengthen food literacy among university students: A qualitative formative study
Eunji Ko, Eunjin Jang, Jiwon Sim, Minjeong Jeong, Sohyun Park
Korean Journal of Community Nutrition.2023; 28(6): 495. CrossRef

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[Korean]
Development and Validation of a Questionnaire on the Feasibility of a Mobile Dietary Self-Monitoring Application: Heejin Lee, Jeong Sun Ahn, Jung Eun Lee; Korean J Community Nutr 2022;27(2):146-157. Published online April 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.2.146

Abstract PDF: Objectives
This study aimed to develop and assess the content validity and internal consistency of a questionnaire on the feasibility of mobile dietary self-monitoring applications.
Methods
We developed a feasibility questionnaire to assess the overall usage, convenience, usefulness, and satisfaction of mobile dietary applications. The initial draft of the questionnaire contained 17 items with yes/no, multiple-choice, and open-ended questions and 52 items on 5-point Likert scales. To validate the content, ten experts evaluated the relevance of the items for each subscale using a 5-point scale. We calculated the item-level content validity index (I-CVI) and scale-level content validity index (S-CVI). A total of 102 adults answered the questionnaires which reflected the experts' reviews. We conducted an exploratory factor analysis to determine the underlying structure of responses and categorized convenience, usefulness, and satisfaction. We also calculated Cronbach's alpha coefficient to examine the internal consistency of items in each subscale.
Results
The S-CVI score of the items was 0.86, and we removed items with an I-CVI score of < 0.80. We combined, revised, or separated some remaining items and added one item as per the experts' comments. As a result, we included 16 items about overall usage and 42 sub-questions. Based on the responses of the 102 adults, we performed exploratory factor analysis using the principal axis method. We retained items with a factor loading of > 0.40, resulting in a final set of 35 questions (convenience: 15, usefulness: 12, satisfaction: 8 items). The Cronbach's alpha values of the three scales were 0.93, 0.91, and 0.91 for 1) usefulness, 2) convenience, and 3) satisfaction, respectively.
Conclusions
We developed a feasibility questionnaire for mobile dietary self-monitoring applications and examined its content validity and internal consistency. Our questionnaire has the potential to measure the feasibility of mobile dietary self-monitoring applications.

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[Korean]
Trends in Dietary Behavior Changes by Region using 2008 ~ 2019 Community Health Survey Data: Yun-Hui Jeong, Hye-Young Kim, Hae-Young Lee; Korean J Community Nutr 2022;27(2):132-145. Published online April 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.2.132

Abstract PDF

Objectives
This study examined trends in the health status and dietary behavior changes by region using the raw data from the 2008 ~ 2019 Community Health Survey.
Methods
This study analyzed the data of 2,738,572 people among the raw data of the Community Health Survey from 2008 to 2019. The regional differences in health status and dietary behavior were examined by classifying the regions into capital and non-capital regions, and the non-capital regions were classified into metropolitan cities and provinces. A chi-square test was conducted on the body mass index (BMI), diagnosis of diabetes and hypertension, frequency of eating breakfast, salty taste in usual diet, recognition of nutrition labeling, reading of nutrition labeling, and utilization of nutrition labeling.
Results
In determining obesity using the BMI, the normal weight by year decreased, and the obesity rate by year was 34.6% in 2019, which increased by 13% compared to 2008. In addition, the diabetes diagnosis rate and hypertension diagnosis rate continued to increase with the year. Both diabetes and hypertension diagnosis rates were higher in the non-capital regions than in the capital region. Eating breakfast five to seven times per week was most common and showed a significant decreasing trend by year (P < 0.001). The percentage of respondents who said they eat slightly bland foods increased from 19.5% in 2008 to 19.9% in 2010 and then to 22.1% in 2013. The percentage then decreased to 19.9% in 2019, but showed an overall increasing trend (P < 0.001). According to the region, the capital region had a higher percentage than the non-capital region. The nutrition labeling's recognition rate and utilization rate increased yearly, whereas the reading rate decreased.
Conclusions
The study results presented the primary data necessary to develop nutrition education programs and establish strategies for local nutrition management projects to improve disease prevention and dietary problems.

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Comparison of the levels of energy intake from dish and food groups by gender and age among Korean obese adults: data obtained from the 2013-2018 Korea National Health and Nutrition Examination Survey
Cheongmin Sohn, Woori Na, Chaeryeon Kim, Seunghee Choi, Oh Yoen Kim, Jounghee Lee, Mi Ock Yoon, Myoungsook Lee
Journal of Nutrition and Health.2022; 55(6): 670. CrossRef

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[Korean]
A Qualitative Study of the Awareness and Influencing Factors of the Dietary Habits of the Male and Female Workers' at a Manufacturing Facility in Gwangju: Ji Suk Yim, Young-Ran Heo; Korean J Community Nutr 2022;27(1):12-26. Published online February 28, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.1.12

Abstract PDF

Objectives
This paper aimed to provide an in-depth analysis of the factors influencing the dietary habits of male and female workers at a facility in Gwangju and their awareness of the same.
Methods
A total of 32 workers were divided into eight groups based on work type, gender, and age, and focus group interviews (FGIs) were conducted. The FGIs included cognitive, behavioral, and environmental questionnaires based on dietary habits and the social cognitive theory. The interviews were analyzed by subject and sub-subject using audio recordings and transcriptions.
Results
Male workers in the concerned company favored meat while female workers preferred vegetables, yet by and large, the preferences were irregular. Male workers living alone frequently ate ready meals and female workers often skipped meals. An analysis of the factors influencing the study subjects’ dietary habits from the cognitive, behavioral, and environmental perspectives showed that the main factors negatively affecting their dietary habits were shiftwork, living alone, and drinking. Workers were unaware of these factors and their poor eating habits. Instead, male workers complained of poor cooking skills, while female workers complained of loneliness. Workers thus appeared to need the support of nutrition education and a counseling assistant to cope with this situation.
Conclusions
The study identified the fact that the absence of nutrition education left the workers unaware of their poor eating habits. The workers would need counseling and support to help them build healthy dietary habits. It would also be necessary to focus on raising the workers’ cognitive awareness of dietary habits and enhancing their behavioral ability to cope with bad eating habits through nutrition education that reflects the reality of their situation.

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Effectiveness of a mobile health intervention on weight loss and dietary behavior changes among employees with overweight and obesity: a 12-week intervention study investigating the role of engagement
Imhuei Son, Jiyoun Hong, Young-Hee Han, Bo Jeong Gong, Meng Yuan Zhang, Woori Na, Cheongmin Sohn, Taisun Hyun
Korean Journal of Community Nutrition.2023; 28(2): 141. CrossRef

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[Korean]
Away-from-Home Eating and Dietary Patterns of Ugandan Adults: a Web-based- Survey: Anthony Kityo, Pil-Sook Park; Korean J Community Nutr 2022;27(1):1-11. Published online February 28, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.1.1

Abstract PDF

Objectives
Away-from-home (AFH) eating has been associated with poor diet quality and health outcomes like obesity in developed countries. AFH eating is also emerging in lowincome countries, but its influence on overall diet quality is under-researched. We examined the prevalence of AFH eating and its influence on the dietary patterns of Ugandan adults.
Methods
This cross-sectional study employed a web-based survey to interview Ugandan adults aged 18 ~ 65 years. A qualitative food frequency questionnaire was used to assess the food group intake, which was then converted into daily intake frequencies. Principal component analysis was used to derive dietary patterns. The participants were then classified based on the tertiles (T) of dietary pattern scores.
Results
About 75% of the 375 participants reported eating AFH. The young men, food insecure, and urban dwellers were more likely to eat AFH  5 times/week. Three dietary patterns emerged; the animal-based, beverage pattern; the high fat, sweet pattern; and the traditional, plant-based pattern. Participants who frequently ate AFH were 2.85 times and 5.64 times more likely to be in the second and third tertiles, respectively, of the animalbased, beverage pattern compared to the rare eaters (OR = 2.85, 95% CI: 1.35-6.06 for T2 vs T1; and OR = 5.64, 95% CI: 2.50-12.73 for T3 vs T1). The odds of being in the second tertile of the high fat, sweet pattern was significantly higher for frequent AFH eaters compared to the rare eaters (OR = 2.61, 95% CI:1.23-5.52).
Conclusions
The prevalence of AFH eating was high. Frequent AFH eating was common among the young, male, food insecure, and urban dwellers, and was associated with unhealthy dietary patterns.

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Difficulties in eating out of home while diagnosed with inflammatory bowel disease: A qualitative interview study from China
Tingting Yin, Ran Ye, Qiuqin Wang, Lulu Wang, Wenjing Xu, Wenjing Tu, Guihua Xu, Yogesh Kumar Jain
PLOS ONE.2023; 18(12): e0288908. CrossRef

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[Korean]
Regional Differences in Dietary Total Fat and Saturated Fatty Acid Intake and Their Associations with Metabolic Diseases among Korean Adults: Using the 2016~2019 Korea National Health and Nutrition Examination Surveys: SuJin Song, Jae Eun Shim; Korean J Community Nutr 2021;26(6):495-507. Published online December 31, 2021; DOI: https://doi.org/10.5720/kjcn.2021.26.6.495

Abstract PDF

Objectives
This study examined regional differences in the intake of dietary total fat and saturated fatty acid (SFA) and their food sources among Korean adults. We also investigated the associations of SFA intake with metabolic diseases by region.
Methods
This study included 13,926 adults ( 19y) who participated in the 2016 ~ 2019 Korea National Health and Nutrition Examination Surveys. The regions were divided into urban and rural areas according to the administrative districts where the participants lived. Using dietary data obtained from a 24-h recall, intake of total fat and SFA and their food sources were assessed by region. Metabolic diseases included obesity, abdominal obesity, and elevated total cholesterol and their association with SFA intake by region were examined using multiple logistic regression.
Results
Of the participants, 19.6% lived in rural areas. In urban areas, the total fat and SFA intakes were higher than in rural areas: 21.2% of energy (%E) came from total fat and 6.9%E from SFA in urban areas, whereas 18.0%E came from total fat and 5.8%E from SFA in rural areas. The percentage of participants who exceeded the dietary reference intakes for total fat and SFA in urban areas was 16.5% and 41.9%, respectively, but 43.4% of participants in rural areas showed lower intake levels for total fat compared to the reference level. Young adults did not show regional differences in fat intake, and the percentage of subjects who exceeded the reference for SFA was high both in urban (58.5%) and rural (55.7%) areas. Among middle-aged and older adults, intake of fatty acids except for n-3 fatty acid was significantly higher in urban areas than in rural areas. About 69% of older adults in rural areas showed a lower intake of total fat compared to the reference level. The food sources for total fat and SFA were meat, soybean oil, eggs, and milk in both areas. The intake of fat from eggs, milk, mayonnaise, and bread was higher in urban areas, but the intake of fat from white rice and coffee mix was higher in rural areas. The SFA intake was positively associated with elevated serum total cholesterol in urban areas (4th quartile vs. 1st quartile, OR: 1.22, 95% CI: 1.06-1.40, P for trend: 0.043), but not in rural areas.

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Korean Journal of Community Nutrition.2024; 29(3): 173. CrossRef
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[Korean]
Association of Dietary Quality with Subjective Health-Related Perception and Chronic Diseases According to Age Segmentation of Korean Elderly: Sojeong Lee, Seungmin Lee; Korean J Community Nutr 2021;26(5):363-381. Published online October 31, 2021; DOI: https://doi.org/10.5720/kjcn.2021.26.5.363

Abstract PDF

Objectives
This study examined the Korean elderly’s dietary intake status, subjective health-related perception and chronic disease prevalence among age groups. Associations of dietary quality with subjective health-related perception and chronic diseases were also examined.
Methods
Based on data from the 7th National Health and Nutrition Examination Survey, a total of 3,231 elderly were selected and categorized into 4 age groups of ‘65 ~ 69’, ‘70 ~ 74’, ‘75 ~ 79’ and ‘over 80’. Nutrient intakes, proportions of those with insufficient nutrient intakes, Korean Healthy Eating Index (KHEI), some subjective health-related perceptions and prevalence of major chronic diseases were compared according to the age groups. Differences in the subjective health-related perceptions and odds ratios of the chronic diseases according to the quartile levels of KHEI within the same age group were analyzed.
Results
With the increase of age, several nutrient intakes (P < 0.001) and KHEI scores significantly decreased (P < 0.01). In women, activity restriction increased (P < 0.05), and EQ-5D score decreased with age (P < 0.001). Prevalence of hypertension (P < 0.0001), hypercholesterolemia (P < 0.05) and anemia (P < 0.01) significantly increased, while hypertriglyceridemia (P < 0.01) significantly decreased only in men. Obesity prevalence decreased, while underweight prevalence increased (P < 0.05). Subjective health status, EQ-5D score and PHQ-9 score significantly improved as KHEI score increased in certain age groups of women (P< 0.05). Odds ratio of hypercholesterolemia significantly increased with the increase of KHEI score in 65 ~ 69-year-old women. However, hypertension and anemia significantly decreased with the increase of KHEI score in 75 ~ 79-year-old women (P < 0.05).
Conclusions
The study findings suggest that nutrition management and policy for the Korean elderly need to apply a segmented age standard that can better reflect their dynamic characteristics.

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Association between Healthy Eating Index and Mental Health in Middle-Aged Adults Based on Household Size in Korea
Ji-Myung Kim, EunJung Lee
International Journal of Environmental Research and Public Health.2022; 19(8): 4692. CrossRef
Blood Biochemical Characteristics, Dietary Intake, and Risk Factors Related to Poor HbA1c Control in Elderly Korean Diabetes Patients: Comparison between the 4th(2007-2009) and the 7th(2016-2018) Korea National Health and Nutrition Examination Surveys
Sung-Won Oh, Sook-Bae Kim
Korean Journal of Community Nutrition.2022; 27(5): 406. CrossRef
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 Journal of Community Nutrition.2022; 27(5): 422. CrossRef

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[Korean]
Association between Sugar-Sweetened Beverage Intake and Dietary Quality using Nutritional Quotient among Adults in Daegu, Korea: Kilye Kim, Yeon-Kyung Lee; Korean J Community Nutr 2021;26(5):350-362. Published online October 31, 2021; DOI: https://doi.org/10.5720/kjcn.2021.26.5.350

Abstract PDF

Objectives
This study investigated an association between sugar-sweetened beverage (SSB) intake and the dietary quality of adults in Deagu, Korea.
Methods
A questionnaire survey was conducted in 1,022 adults aged 19 ~ 49 years (502 men and 520 women) in the Deagu area of Korea. Daily intake of SSB was obtained by the food frequency questionnaire, and the dietary quality was assessed using the nutrition quotient (NQ) for Korean adults. Multiple logistic regression analysis was used to estimate the association between dietary quality and daily intake of SSB in adults.
Results
Daily intake of SSB was 463.6 mL/d for total subjects, and the highest intakes were sweetened coffees (192.7 mL/d), followed by carbonated drinks (77.1 mL/d). Higher intake of SSB was associated with higher intake frequency of fast food or sweet and greasy bread, processed beverage, ramyon, eating out or delivery food and night snack, and also associated with lower frequency of water, breakfast intake and nutrition label checking in men or women. Men and women who had a higher intake SSB had significantly greater odds for being in the low grade of NQ (P for trend = 0.0006 for men, P for trend = 0.0007 for women), especially in the moderation factor (P for trend < 0.0001 for men and women).
Conclusions
This study showed that high SSB intake was significantly associated with low dietary quality among adults. These study results suggest that nutrition education programs and guidelines should be provided to adults for improving their consumption of SSB and related diets.

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Frontiers in Nutrition.2022;[Epub] CrossRef

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