Korean Journal of Community Nutrition

Research Articles

[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]
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

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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Original Articles

[English]
Dietary Factors Associated with Attention Deficit Hyperactivity Disorder (ADHD) in School-aged Children: Minji An, Hyojin An, Hwang Hyo Jeong, Ho Jang Kwon, Mina Ha, Yun Chul Hong, Soo Jong Hong, Se Young Oh; Korean J Community Nutr 2018;23(5):397-410. Published online October 31, 2018; DOI: https://doi.org/10.5720/kjcn.2018.23.5.397

Abstract PDF PubReader

OBJECTIVES
An association between dietary patterns and mental health in children has been suggested in a series of studies, yet detailed analyses of dietary patterns and their effects on ADHD (attention deficit hyperactivity disorder) are limited.
METHODS
We included 4569 children who had dietary intake data as part of the CHEER (Children's Health and Environmental Research) study conducted nationwide from 2005 to 2010. We assessed ADHD (Attention Deficit Hyperactivity Disorder) by the DuPaul's ADHD Rating Scales and dietary intake by a semi-quantitative food frequency questionnaire. Using intake data, we constructed five dietary patterns: â€œPlant foods & fish,â€â€œSweets,â€â€œMeat & fish,â€â€œFruits & dairy products,â€ and â€œWheat based.â€ RESULTS: The overall proportion of ADHD was 12.3%. Boys (17.8%) showed a higher rate of ADHD than girls (6.5%). The total intake of calories (85 kcal) and plant fat (2g) in the ADHD group was significantly higher than that of the normal group. ADHD was significantly negatively associated with dietary habits such as having breakfast and meal frequency, and positively associated with eating speed, unbalanced diet, overeating, and rice consumption. Regarding dietary patterns, the â€œSweetsâ€ category was relevant to high ADHD risk (OR 1.59, 95% CI: 1.18, 2.15 for Q5 vs. Q1) in a linear relationship. An inverse, non-linear association was found between â€œFruits & dairy productsâ€ and ADHD (OR 0.55, 95% CI: 0.39, 0.76 for Q4 vs. Q1).
CONCLUSIONS
Our study confirms both positive and negative associations between diet and ADHD in elementary school age children. Moreover, linear or nonlinear associations between diet and ADHD draw attention to the possible threshold role of nutrients. Further studies may consider characteristics of diet in more detail to develop better intervention or management in terms of diet and health.

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Correlation of attention deficit hyperactivity disorder with gut microbiota according to the dietary intake of Korean elementary school students
Tae-Hwan Jung, Hyo-Jeong Hwang, Kyoung-Sik Han, Regis Moreau
PLOS ONE.2022; 17(9): e0275520. CrossRef
Awareness and Practice of Sugar Reduction in School Foodservice and the Practice of Nutrition Education in Daegu
Suhyang Jang, Kilye Kim, Yeon-Kyung Lee
Korean Journal of Community Nutrition.2021; 26(3): 167. CrossRef
Effect of Nutrition Education on Reduced Sugar Intake in Elementary School Students
Young-Mi Seo, Ok-Jin Park, Min-June Lee
Journal of the East Asian Society of Dietary Life.2021; 31(1): 14. CrossRef
Analysis of the consumer perception and related education effect on the reduction of sugar for elementary school students in Seoul and Gyeonggi-do
Ki Nam Kim, Jung Sug Lee, Jee-Seon Shim, Hae Kyung Chung, Hae Rang Chung, Moon-Jeong Chang
Journal of Nutrition and Health.2020; 53(3): 303. CrossRef

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[English]
Field Application and Evaluation of Health Status Assessment Tool based on Dietary Patterns for Middle-Aged Women: Hye Jin Lee, Kyung Hea Lee; Korean J Community Nutr 2018;23(4):277-288. Published online August 31, 2018; DOI: https://doi.org/10.5720/kjcn.2018.23.4.277

Abstract PDF PubReader

OBJECTIVES
This study was performed to verify the validity and judgment criteria setting of a health status assessment tool based on dietary patterns for middle-aged women.
METHODS
A total of 474 middle-aged women who visited the Comprehensive Medical Examination Center at Hanmaeum Hospital in Changwon were enrolled (IRB 2013-0005). The validity was verified using clinical indicators for the diagnosis of metabolic syndrome (MS), and it was used to set the criteria for the tool. A logistic regression analysis was performed for validation. The area under-receiver operation (AUC), sensitivity, specificity, and Youden Index were calculated through ROC curve analysis. Statistical analysis was performed by SPSS 21, and p value < 0.05 was considered to be statistically significant.
RESULTS
The mean score of the group with no MS (73.3 points) was significantly higher compared to the group with MS (65.7 points) (p < 0.001). An analysis of the association between the tool scores and risk of MS showed a 0.15-fold reduction in the risk of MS every time the tool's score increased by one point. As the result of the ROC curve analysis, the assessment reference point was set to 71 points, indicating 77.0% sensitivity and 61.0% specificity. Risk of MS was significantly higher in the group with a score of less than 71.0 than a group with more than 71 points (OR=5.28, p < 0.001).
CONCLUSIONS
This study was the first attempt to develop a health status assessment tool based on the dietary patterns for middle-aged women, and this tool has proven its usefulness as an MS assessment tool through the application of middle-aged women in the field of health screening.

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Association of milk and dairy product consumption with the incidence of cardio-cerebrovascular disease incidence in middle-aged and older Korean adults: a 16-year follow-up of the Korean Genome and Epidemiology Study
Yeseung Jeong, Kyung Won Lee, Hyekyeong Kim, Yuri Kim
Nutrition Research and Practice.2023; 17(6): 1225. CrossRef

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[English]
Effects of Daily Stress on Dietary Pattern among Elementary School Children in Seongnam City: Sunra Kim, Seunghee Kye; Korean J Community Nutr 2017;22(6):475-484. Published online December 31, 2017; DOI: https://doi.org/10.5720/kjcn.2017.22.6.475

Abstract PDF PubReader

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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ACADEMIC STRESS IS ASSOCIATED WITH EMOTIONAL EATING BEHAVIOR AMONG ADOLESCENT
Nadia Ramadhani, Trias Mahmudiono
Media Gizi Indonesia.2021; 16(1): 38. CrossRef
Sugar-sweetened beverage consumption and influencing factors in Korean adolescents: based on the 2017 Korea Youth Risk Behavior Web-based Survey
Ayoung Kim, Jinhee Kim, Seunghee Kye
Journal of Nutrition and Health.2018; 51(5): 465. CrossRef

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[English]
Health Status Assessment Tool Development based on Dietary Patterns in Middle-Aged Women: Hye Jin Lee, Kyung Hea Lee; Korean J Community Nutr 2016;21(1):37-52. Published online February 29, 2016; DOI: https://doi.org/10.5720/kjcn.2016.21.1.37

Abstract PDF PubReader

OBJECTIVES
This study was performed to develop an assessment tool for middle aged women's health status based on dietary patterns, which will have practical applications in the working field of health and hygiene, aiming at improving the middle aged women's quality of life through their health improvement.
METHODS
As a first step, a literature review was conducted and the original data of '2008~2009 Korea Health and Nutrition Examination Survey' were reanalyzed. This analysis identified 65 preliminary questions that may be relevant to the study. After verifying the content validity by experts, the 65 questions were reduced into 51 questions. In order to secure higher validity of the candidate items, verification of their clinical validity was conducted among women aged between 45 and 60 years. Finally, an assessment tool was developed by applying weight and scoring.
RESULTS
Selected 51 questions were used to verify clinical validity and the results showed that 20 questions were relevant, nine questions ('regular meal time', 'regular amount of meal', 'intake frequency of dairy products', 'intake frequency of fruits', 'intake frequency of meat products', 'intake frequency of high cholesterol foods', 'intake frequency of salty foods', 'appetite', 'eat breakfast everyday') were related to dietary life. Eleven other questions ('self-rated health status', 'deep sleep', 'smoking', 'frequency of drinking', 'stress levels', 'health-related fitness levels', 'pounding of the heart', 'strange feelings on the skin', 'interfere with daily life', 'menopause will bring you a chance to see the life in a different perspective', and 'body mass index') were selected as valid questions. For the response scale for each question, 5 point Likert scale was used to make total 100 point score.
CONCLUSIONS
This study is the first attempt to develop a health status assessment tool for middle aged women based on their dietary patterns. We conclude that this tool is expected to be a useful and practical tool in the field.

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Food consumption frequency of Korean adults based on whether or not having chewing difficulty using 2013–2016 KNHANES by sex-stratified comparative analysis
Mi Jeong Kim
Nutrition Research and Practice.2020; 14(6): 637. CrossRef
Field Application and Evaluation of Health Status Assessment Tool based on Dietary Patterns for Middle-Aged Women
Hye-Jin Lee, Kyung-Hea Lee
Korean Journal of Community Nutrition.2018; 23(4): 277. CrossRef

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[English]
The Risk of Metabolic Syndrome by Dietary Patterns of Middle-aged Adults in Gyeonggi Province: You Sin Lee, Moo Yong Lee, Sim Yeol Lee; Korean J Community Nutr 2014;19(6):527-536. Published online December 31, 2014; DOI: https://doi.org/10.5720/kjcn.2014.19.6.527

Abstract PDF PubReader

OBJECTIVES
The aim of this study was to assess how nutrient intakes are related to risk factors for metabolic syndrome according to dietary patterns in the middle-aged adults.
METHODS
The subjects (n = 187; 47 men, 140 women) consisted of middle-aged adults over 30 years old in Ilsan area. The metabolic syndrome was diagnosed according to the data collected from each subject, including anthropometric measurements and blood analyses. The dietary patterns were derived from the average of two-day dietary intake data.
RESULTS
Factor analysis identified three major dietary patterns which were "Meats and alcohol", "Mixed grains, vegetables and fruits", and "Rice, Kimchi and fish & shellfish". The daily intakes of energy, protein, and sodium increased across quartiles of "Meats and alcohol" pattern scores (p < 0.05), whereas the intakes of carbohydrates, potassium, calcium, and fiber increased across quartiles of "Mixed grains, vegetables and fruits" pattern scores (p < 0.001). The "Meats and alcohol" pattern scores were positively correlated with protein and sodium intakes but inversely correlated with carbohydrates, fiber and potassium intakes which were adjusted for age, sex and energy (p < 0.05). The highest quartile pattern score of "Meats and alcohol" pattern had elevated odds ratio of abdominal obesity and metabolic syndrome (p < 0.05). The risk of hypertriglyceridemia decreased in the highest quartile of "Mixed grains, vegetables and fruits" pattern (OR 0.35, 95% CI 0.12-1.00).
CONCLUSIONS
Our results suggested that reducing the consumption of meat and alcohol along with increasing fruits, vegetables and mixed grains would be helpful for preventing the metabolic syndrome and chronic diseases.

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Association between the Korean Healthy Diet Score and Metabolic Syndrome: Effectiveness and Optimal Cutoff of the Korean Healthy Diet Score
Soo-Hyun Kim, Hyojee Joung
Nutrients.2024; 16(19): 3395. CrossRef
The Relationship between Meal Regularity and Oral Health and Metabolic Syndrome of Adults in Single Korean Households
Jin-Ah Jung, Hye-Won Cheon, On-Ju Ju
Journal of Dental Hygiene Science.2021; 21(3): 185. CrossRef
Metabolic Syndrome Risk by Dietary Fat Energy Ratio in Middle-aged Men - Using the 2012~2013 Korean National Health and Nutrition Examination Survey Data -
Eun-Sil Her
The Korean Journal of Food And Nutrition.2016; 29(6): 1030. CrossRef
Reduction of Plasma Triglycerides and Cholesterol in High Fat Diet-Induced Hyper-Lipidemic Mice by n-3 Fatty Acid from Bokbunja (Rubus coreanus Miquel) Seed Oil
Hyelin Jeon, Su-Jin Oh, Hyun Soo Nam, Yoon Seok Song, Kyung-Chul Choi
Journal of the Korean Society of Food Science and Nutrition.2015; 44(7): 961. CrossRef

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[English]
A Study on the Prevalence of Chronic Diseases, Health-related Habits and Nutrients Intakes according to the Quality of Life in Korean Adults: Jee young Chung, Mi Young Lee, Mi Joung Kim; Korean J Community Nutr 2010;15(4):445-459. Published online August 31, 2010

Abstract PDF: This study was done to analyze the chronic diseases prevalence and dietary intake status according to the health related quality of life and to identify its significant properties. This study was conducted based on 2906 subjects ranging from 20~64 years old, out of 9704 total subjects from the 4th Korean National Health and Nutrition Survey in 2008. The average quality of life (QL) score was 0.915, where 983 subjects were below the average (low QL group) and 1923 subjects were above (high QL group). In the high QL group, there was more likely to be young, male, and with higher income and education. For high QL group, the self-related health score was high, and the subjective stress level was low. The prevalence of diabetes was significantly higher in the low QL group and anthropometric and biochemical measures were not shown differences between the two groups but waist circumference was significantly higher in the low QL group. The QL score was significantly negative correlated with the waist circumference and the body mass index. As for the recognition rate of Nutrition Guideline, there were no significant differences but high QL group had higher scores in "Eat a variety of foods", "Avoid too much Sodium", and "Enjoy meals and Eating a breakfast". Carbohydrate intake was significantly lower in the high QL group than in low QL group and the high QL group showed higher intake in legumes, meat and poultry, fruits, daily products and beverages. Overall results suggest that increased diabetes prevalence in people with low quality of life might be affected by the diets based on high carbohydrate, increased waist circumference, and lower rate of practice nutritional guideline.

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[English]
A Comparison of Cluster and Factor Analysis to Derive Dietary Patterns in Korean Adults Using Data from the 2005 Korea National Health and Nutrition Examination Survey: Yoon Ju Song, Hee Young Paik, Hyojee Joung; Korean J Community Nutr 2009;14(6):722-733. Published online December 31, 2009

Abstract PDF: The purpose of this study was to explore dietary patterns and compare dietary patterns using cluster and factor analysis in Korean adults. This study analyzed data of 4,182 adult populations who aged 30 and more and had all of socio-demographic, anthropometric, and dietary data from 2005 Korean Health and Nutrition Examination Survey. Socio-demographic data was assessed by questionnaire and dietary data from 24-hour recall method was used. For cluster analysis, the percent of energy intake from each food group was used and 4 patterns were identified: "traditional", "bread, fruit & vegetable, milk", "noodle & egg", and "meat, fish, alcohol". The "traditional" pattern group was more likely to be old, less educated, living in a rural area and had higher percentage of energy intake from carbohydrates than other pattern groups. "Meat, fish, alcohol" group was more likely to be male and higher percentage of energy intake from fat. For factor analysis, mean amount of each food group was used and also 4 patterns were identified; "traditional", "modified", "bread, fruit, milk", and "noodle, egg, mushroom". People who showed higher factor score of "traditional" pattern were more likely to be elderly, less educated, and living in a rural area and higher proportion of energy intake from carbohydrates. In conclusion, three dietary patterns defined by cluster and factor analysis separately were similar and all dietary patterns were affected by socio-demographic factors and nutrient profile.

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[English]
Study of Food Intakes and Eating Patterns among Preschool Children in Daegu Area: Assessment of Dietary Pattern and Dietary Diversity: Ju Young Seo, In Sook Lee, Bong Soon Choi; Korean J Community Nutr 2009;14(5):521-530. Published online October 31, 2009

Abstract PDF: This study was conducted to assess dietary pattern and dietary diversity of preschool children by investigating their food consumption. To accomplish this, dietary intake survey (24 hour-recall food diary) was administered to 508 children aged between 4 to 6 years old from 4 kindergartens in the Daegu area (415 were completed). By using CAN pro 3.0 for professionals, the dietary patterns and dietary diversity scores of each food group were examined by age and sex. Data were analyzed with SPSS 12.0, and chi-square t-test and Anova test, and Duncan's multiple range test used for verifying significance. For 4~5- year-old group, boys had significantly more fruit and meats than girls (p<0.05), but girls had more dairy food than boys with no ignificance. For 6-year-old group, boys had significantly more foods, milk and dairy foods than girls (p<0.05), and also boys had more vegetables and fruit than girls with no significance. For DDS (Dietary Diversity Score), the score of 6-year-old group was significantly higher than that of younger children (p<0.05) and the older the age was, the higher the score was. Dietary Pattern (GMVFD) was verified by 8 types, and the ratio of taking all five food groups (GMVFD = 11111) of the 6-year-old group was 48.8%. Children with older ages had more various foods than younger ones (p<0.05). In addition, the ratio of taking less than the minimal intake of dairy foods of girls (48.1%) was higher than that of boys (41.3%). As results, unbalanced diet, overeating and not eating unbalanced diet were revealed as the problematic dietary habits among preschool children, and those habits may change positively with knowledge on nutrition grow on. Therefore, nutritional characteristics and importance of preschool children should be taught to parents and caregivers, and it must be practical and ready to use in cooking for these children to healthy dietary habits.

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[English]
Comparison of Dietary Patterns by Sex and Urbanization in Different Economic Status: Jihyun Choi, Hyun Kyung Moon; Korean J Community Nutr 2008;13(3):346-358. Published online June 30, 2008

Abstract PDF: The purpose of this study is to find differences in dietary patterns through menu analysis by economic status. The data was obtained from the 1998 and 2001 National Health and Nutrition Survey of Korea. The main variables were economic status, sex, and area by urbanization. The economic status was classified into low, middle, high, and top classes using a poverty line based on the 1998 and 2001 minimum standard cost of living. The areas were divided into metropolis, small city, and rural areas. The dishes of 3 meals were classified into 29 categories by cooking method. The most frequent pattern was "rice + soup + kimchi". The frequency of this Korean basic dietary pattern was the lowest in the top income class and metropolis areas, while the highest in the low income class and rural areas. The frequency of Korean recommended dietary pattern, that is, "rice + soup or stew + kimchi + side dish" was the highest in the top income class. The metropolis group preferred side dishes using meat and a cooking method that saved time, but the rural group preferred side dishes using vegetables and cooking methods that take a longer time. In comparison of dietary pattern between male and female by economic status, the higher economic status, the male's dietary patterns showed more side dishes than those of female. But the main side dish was kimchi in male low class. onsequently, the major dietary pattern in Korea is rice-style, though the western pattern is increasing in the top income class, especially in metropolis areas. Therefore, to make a better dietary pattern, we should develop and spread low-priced recipes of various side dishes and teach financial skills such as ability to make a food budget for lower income classes. Also, we should emphasize the importance of the balance between meat and vegetables and traditional diet and western diet for the top income class, especially in the metropolis areas.

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[English]
Major Dietary Patterns and Their Associations with Socio-Demographic, Psychological and Physical Factors Among Generally Healthy Korean Middle-Aged Women: Seung Min Lee, A Rim Oh, Hong Seok Ahn; Korean J Community Nutr 2008;13(3):439-452. Published online June 30, 2008

Abstract PDF: This study was conducted to identify major dietary patterns of generally healthy Korean middle-aged women and to examine associations of the dietary patterns with socio-demographic, psychological, and physical characteristics. Data were drawn from the 2001 Korean National Health and Nutrition Examination Survey (KNHANES), which is an ongoing national surveillance system. Healthy female subjects aged 40-64 years and provided the health interview examination and food frequency questionnaire (FFQ) data were included. We conducted factor analysis based on daily mean intake frequency of 26 food groups and identified 3 major dietary patterns, healthy, convenient, and alcoholanimal. The healthy pattern was characterized by higher intakes of fish, seafood, poultry, mushroom, seaweed, vegetable, tomato, potato, and fruit, the convenient pattern by processed meat and fish, ramen, noodle and rice cake, sweet snack, egg, bread, and fast food, and the alcohol-animal pattern by alcohol, poultry, meat, and fish. The healthy pattern was significantly related with higher socio-economic status, more stable family structure, healthier mentality, and sounder status of anthropometric and biochemical variables. Those with higher factor scores for the convenience pattern were found to be younger and having higher socio-economic status, higher subjective levels of health, and lower subjective levels of worry on health. Several physical characteristics significantly improved as the levels of the convenience pattern increased. The alcohol-animal pattern was significantly associated with several socio-demographic characteristics including a low education level, a young age, a small family size, and blue-collar jobs. Public health policy makers can utilize the study findings to select prior target populations with higher needs and to tailor dietary behavioral messages to lower chronic disease risks among Korean middle-aged women.

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[English]
Dietary Pattern by Sex and Age with Menu Analysis Using 1998, 2001 National Health and Nutrition Survey of Korea: Jihyun Choi, Hyun Kyung Moon; Korean J Community Nutr 2007;12(6):798-814. Published online December 31, 2007

Abstract PDF: The purpose of this study is to compare menu patterns by sex and age (3-6, 7-12, 13-19, 20-29, 30-49, 50-64, 65 over years old) between the 1998 and 2001 National Health and Nutrition Surveys of Korea. Frequently consumed menu patterns were investigated using the 24-hour recall data for 19,809 subjects (1998:10,102; 2001:9,707). To analyze patterns, dishes were classified into 29 categories by cooking method (KHIDI 2003). The results are as follows: the most frequent menu patterns were "rice + soup + kimchi" and "rice + stew + kimchi" in both men and women in both 1998 and 2001. Intake frequency of these menu patterns, a traditional Korean menu pattern, was higher with increased age. Intake frequency of "noodles" and "bread" increased in 2001 in both men and women, compared to 1998. And these patterns increased in the younger age groups, especially women in their twenties. Menu patterns of 2001 showed greater variety than those of 1998. Overall, the men's menu patterns showed more side dishes than those of women; intake frequencies of "seasoned vegetables", "stir-fried foods", and "grilled foods" were higher in men than in women. In short, so far the main menu pattern has been "rice-style" in both men and women, and in all age groups in Korea, whereas the Western menu pattern is increasing in younger age groups. The diet of 2001 showed more side dishes than that of the 1998 menu pattern; however, certain groups such as female and males in adolescents and young adults were still a simple menu pattern. Consequently, to make recommended menu patterns and nutrition education programs for Koreans should take into consideration sex and age.

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[English]
The Association of Dietary Patterns with Bone Mineral Density in Middle-aged Women: A Cohort of Korean Genome Epidemiology Study: Seon Joo Park, Younjhin Ahn, Hyo Mi Kim, Seong Eun Joo, Kyung Soo Oh, Chan Park; Korean J Community Nutr 2007;12(3):352-360. Published online June 30, 2007

Abstract PDF: Several nutrients are known to affect bone mineral density (BMD). However, these nutrients are combined with food intake and dietary patterns and little is known about the association of dietary patterns and BMD. The objective of this study was to investigate the association of dietary patterns with BMD in Korea Genome Epidemiology Study subjects. Among 2,884 women (40-69 yr) recruited at baseline study (2001), 861 subjects with BMD measurements at baseline and a 4-year follow up study (2005) completed the semi-quantitative food frequency questionnaire. BMD was measured by the Quantitative Ultrasound method. One hundred three food items were combined into 17 food groups and 4 dietary patterns were identified by factor analysis. Cluster analysis using factor score classified each subject into one of three dietary pattern groups named 'Rice and kimchi eating' (n = 617), 'Contented eating' (n = 124), and 'Healthy and light eating' (n = 120). The 'Healthy and light eating' group, characterized by higher intake of fruit, vegetables, fish, milk and dairy products, and younger age, more exercise, higher education, and higher income than other groups. The tibia BMD of the 'Healthy and light eating' group was higher than the other groups after adjusting for the age. After the adjustment for the age BMI and exercise, the 'Healthy and light eating' group showed significantly lower odds of tibia osteopenia/osteoporosis risk compared to the 'Rice and kimchi eating' group both at the baseline [OR(95% CI) : 0.50(0.30-0.84)] and follow-up [OR(95% CI) : 0.59(0.36-0.97)] examinations. The dietary pattern with low calorie and high intakes of fruit, vegetables, fish, milk and dairy products may have beneficial effects on BMD in middle-aged women.

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[English]
Development of a Simple Evaluation Questionnaire for Screening the Dietary Patterns of Overweight Young Adults: Young Sook Park, Joung Won Lee; Korean J Community Nutr 2002;7(5):675-685. Published online October 31, 2002

Abstract PDF: A study was performed to develop as a screening tool, the Simple Evaluation Questionnaire for screening Overweight Dietary Patterns in people in their 20's. We used the data from the 20 to 29 year old subjects who participated in the three surveys: the health behavior survey, the dietary habit survey and the food intake survey - as part of the National Health and Nutrition Survey of 1998. The 1,493 adults were classified into two body fatness groups, that of normal (including the underweight), and the overweight (including the obese) on the basis of their relative body weight (RBW). When comparing general variables between the two groups, significant differences (11 variables) were found in gender, sadness/depression state, stress level, age, number of diseases, age when overweightedness started, maximum body weight, sleep length, presently a smoker, everyday smoking habits, number of alcoholic drinks in the past month, and the number of alcoholic drinks when drunk, as well as snacking frequency and fatty food consumption. There were significant differences between the two groups in the three variables of daily soup/kuk, pan fried fish/meat/poultry and cooked fish paste/ham/dried squid in terms of cooked food intake, and 11 variables of food size, cooked rice, stews, vegetables and kimchi at breakfast, panfried foods and beverage/teas at lunch, cooked rice and stews (liquid) at dinner, cooked fish paste/ham/dried squid at snacks and cooked fishpaste/ham/dried squid at snack between lunch and dinner. In terms of raw food intake, we observed significant differences (8 variables) in daily food intake and grains, grains/vegetables/fishes (shellfish) at breakfast, meat at lunch and milk at snack after dinner. After developing questions with indicators and analyzing the indicators by logistic regression analysis using 34 variables, including these 33, plus eating-out frequency, we chose 10 questions for the simple evaluation of dietary patterns for the overweight category, in order to give each one point each. Among them we assigned an additional point to one question and two points to another question. The average scores of the overweight and normal groups, as shown by the questionnaire developed, were 5.97 +/- 2.36 and 7.36 +/- 2.21, respectively. A score of seven points was selected as the cut-off point. We examined the sensitivity, specificity and positive predictive value of the questionnaire to the results of 49.3%, 75.4% and 68.8%, respectively. The total score categorized as an overweight dietary pattern was 30.2%.

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[English]
The Development of a Simple Evaluation Questionnaire for Screening the Overweight-type Dietary Pattern in 30 to 49 Year Old Adults: Young Sook Park, Jae La Han, Joung Won Lee, Han Suk Cho, Jaeok Koo, Joung Hee Kim, Jin Sook Yoon; Korean J Community Nutr 2002;7(4):495-505. Published online August 31, 2002

Abstract PDF: A study was performed to develop as a screening tool the Simple Evaluation Questionnaire for Screening the Overweight-type Dietary Pattern in 30 to 49 Year Old Adults. We used the data from the 30 to 49 year old subjects who participated in the three surveys - the health behavior survey, the dietary habit survey and the food intake survey - as the National Health and Nutrition Survey 1998. The 3,598 adults were classified into to two body fatness groups of normal (including underweight) and overweight (including obese) on the basis of their relative body weight (RBW). When comparing variables between the two groups, significant differences were found in gender, education, job, employment status, perceived health status, sadness / depression state, stress level, age, number of diseases, age when overweigh-tedness started, maximum body weight, sleep length, drinking pattern (yes / no), amount of alcoholic drinks, frequency of intoxication or drunkeness, amount of alcoholic drinks when drunk, intensity of exercise, frequency of exercise, exercise duration, skipped meals, small meals and drug supplements. In terms of food intake, there were significant differences in the daily food intake in terms of breakfast, dinner, daily kimchi and dairy products. In terms of mealtimes, we found differences in the amount of cooked rice at breakfast, kimchi at lunch, soup / kuk at dinner, fresh vegetables for snacks, fried foods for snacks between breakfast and lunch, and fruits / juices for snacks between lunch and dinner. After developing questions with indicators and analyzing the indicators by logistic regression analysis three times, we chose 10 questions for a simple evaluation of dietary patterns for the overweight-type category in order to give one point each. Among them we selected two questions to add one additional point and one question to add two additional points. The average scores of the overweight and normal groups, as shown by the developed questionnaire, were 5.97 +/-2.36 and 7.36 +/-2.21, respectively. A score of seven points was selected as the cut-off point. We examined the sensitivity, specificity and positive predictive value of the questionnaire to the results of 67%, 59% and 62%, respectively.

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[English]
A Study on Dietary Patterns, Dietary Behaviors and Life Styles before and after Breast Cancer Surgery: Kyung Ja Chang, Sei Hyun Ahn; Korean J Community Nutr 1998;3(5):722-728. Published online November 30, 1998

Abstract PDF: The purpose of this study was to compare dietary patterns, dietary behaviors and life styles before and after breast cancer surgery in Korea. The subjects were 220 females who underwent surgery for stage I-III breast cancer at general hospitals. Food intake, eating habits, snacks, eating-out, use of nutritional supplements and healthy foods, and drinking and smoking habits were studied using a questionnaire. SAS program was used for statistical analysis of the data. The results are as follows : 1) Most subjects were housewives aged more than 40 years. 2) After breast cancer surgery, intakes of fruits and vegetables were increased and those of meat, salty and spicy foods were decreased. 3) There was a significant difference in takes of caffeine beverages, snacks, fast foods and instant foods before and after breast cancer surgery. 4) There was a significant difference in meal regularity and skipping breakfast before and after breast cancer surgery. 5) The frequency of eating-out was decreased and low-fat foods, such as Japanese foods, were preferred after breast cancer surgery. 6) Nutritional supplements and natural healthy foods were used more after breast cancer surgery. 7) Most subjects were non-smokers and drank little alcohol and the rate of regular drinking significantly decreased after breast cancer surgery. Therefore, there was a significant difference in dietary patterns and behaviors resulting form breast cancer. Further more, dietary factors may be a contributing factor in the incidence at breast cancer in Korea.

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