Korean Journal of Community Nutrition

Research Article

[Korean]
Status of Iodine Intake and Comparison of Characteristics according to Iodine-sourced Food Intake Patterns of Chinese Adults: A Study Encompassing Three Regions with Different Iodine Nutritional Statuses: Danying Zhang, Ho Kyung Ryu; Korean J Community Nutr 2022;27(6):503-514. Published online December 31, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.6.503

Abstract PDF: Objectives
This study examines the status of iodine intake and compares the characteristics (region and thyroid disease prevalence) according to the iodine-sourced food intake pattern in Chinese adults.
Methods
An online survey was conducted by enrolling 437 Chinese adults aged 18-65 years, living in three regions with different iodine nutritional statuses: Sichuan, Chongqing, and Guangdong.
Results
The prevalence of thyroid diseases in Sichuan, Chongqing, and Guangdong were 12.5%, 8.5%, and 2.8%, respectively. Conversely, the proportion of people who received thyroid disease-related examinations was a mere 37.5%. Among the subjects who underwent thyroid examination, the prevalence of thyroid disease in the three regions was 32.2%, 21.8%, and 8.0%, respectively. No differences were obtained in the total iodine intake by region, but the type of iodine source foods differed. Regardless of the region, the highest iodine content was obtained from seaweed. However, the iodine content from iodized salt and other foods differed significantly by region. Factor analysis revealed three food intake patterns according to the iodine food source. The study further determined regional differences and differences in the prevalence of thyroid disease according to food intake patterns.
Conclusions
High salt intake can also increase iodine intake, which is thought to have an effect on the occurrence of iodine-excess thyroid disease. Hence, efforts focused on improving salty eating habits need to be implemented.

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Original Articles

[English]
Effect of Nutrition Education on the Eating Habits and Quality of Life of Gastric Cancer Outpatients Undergoing Gastrectomy: YoonHee Jung, Joomin Lee; Korean J Community Nutr 2018;23(2):162-173. Published online April 30, 2018; DOI: https://doi.org/10.5720/kjcn.2018.23.2.162

Abstract PDF PubReader: OBJECTIVES
This study examined the effects of nutrition education on the nutritional status, including eating habits and quality of life in gastric cancer patients undergoing a gastrectomy.
METHODS
Thirty one out-gastric resection patients at C University Hospital in Gwangju, Korea were enrolled in this study. The patients received an individualized nutritional counseling session, and the effects were assessed before and after a 3-month nutrition education intervention. Nutrition education for gastric cancer outpatients included the dietary guidelines (e.g., food intake), the level of nutrient intake, and nutrition support.
RESULTS
The patients had significantly improved serum albumin and hematocrit levels after nutrition education. Of the dietary habits, the meal time and amount of food compared to the first education were increased significantly. Of the changes in the food intake frequency, fish and meat, and vegetables and fruits intake were increased, but not at a statistically significant level. The score of eating habits related to the gastrectomy was improved significantly after nutrition education from 31.7 to 34.5. The composite scores for the quality of life were also improved significantly after the nutrition education program.
CONCLUSIONS
The nutrition education for gastric cancer outpatients may be crucial and efficient for improving their lifestyle.

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[English]
Relationship between Eating Style and Food Intake of Healthy Female College Students during Chuseok Holidays: Seok Young Kim; Korean J Community Nutr 2016;21(2):131-139. Published online April 30, 2016; DOI: https://doi.org/10.5720/kjcn.2016.21.2.131

Abstract PDF PubReader

OBJECTIVES
The present study was conducted to investigate associations between eating style and food intake of 45 female college students during Chuseok holidays.
METHODS
A ten-day food record was obtained and divided into two parts. The first five days (September 20-24, 2015) were considered as a 'Normal Day (ND 1-5)' and the subsequent five days (September 25-29) as 'Holiday (HD6-10)'. The middle three days (September 26-28) of the holidays were considered as the 'Peak Holiday (PD7-9)'. Eating behaviors were measured using the Dutch Eating Behavior Questionnaire (DEBQ) and anthropometry was assessed in all study participants. Participants were grouped by cluster analysis according to the mean energy intake of the first three days of the Holiday.
RESULTS
Participants had a low-normal range of BMI and they were carefully restricting their food intake at Normal Day. Even the food intake did not exceed 2000 kcal per day during the Peak Holiday. External eating was the most prevalent type of eating behavior, followed by restrained eating and emotional eating. Normal energy and fat intake were correlated with the external eating subscale of the DEBQ. Restrained eating was associated with the weight, BMI, fat mass, waist, and hip girth of the subjects. Compared to the Normal Day, they overate during the Holiday with different eating styles including 'restraint', 'disinhibition', and 'fluctuation'. Therefore, neither eating behaviors nor anthropometry was associated with food intake during the Holiday. Although eating behaviors and anthropometric measures were not different among eating style clusters, the food intakes of disinhibition cluster were higher than those of restraint cluster during all the study periods.
CONCLUSIONS
Subjects can be classified with the restraint, disinhibition, and fluctuation clusters. However, eating behaviors and anthropometry were not different among three clusters.

Citations

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The Indicator of Emotional Eating and Its Effects on Dietary Patterns among Female Students at Qassim University
Razan M. Alharbi, Hend F. Alharbi
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[English]
The Relationships among Quality of Life and Stress, Health-related Habits and Food Intake in Korean Healthy Adults Based on 2013 Korea National Health and Nutrition Examination Survey: Su Bin Lee, Hyun Jin Choi, Mi Joung Kim; Korean J Community Nutr 2015;20(6):411-422. Published online December 31, 2015; DOI: https://doi.org/10.5720/kjcn.2015.20.6.411

Abstract PDF PubReader

OBJECTIVES
This study investigated the socioeconomic factors that affect quality of life (QL) in healthy adults and to study the relationship between QL and health-related habits and food intake.
METHODS
Subjects consisted of 1,154 healthy adults without any known disease, aged 19 to 65 years from the 2013 Korean National Health and Nutrition Examination Survey data. We used SPSS statistical program version 20.0 for data analysis.
RESULTS
The average age and QL score of the study population were 36.7 years and 0.99 points, respectively. Males had a significantly higher QL score than the females (p < 0.001), and employed subjects and those employed in permanent positions had significantly higher scores as compared respectively with unemployed subjects and those employed in temporary positions (p < 0.001, p < 0.05). The group that responded "almost every day" to the "frequency of binge drinking" and "frequency of disruption of daily life due to drinking" had significantly lower QL scores as compared to other groups (p < 0.05). Further, the scores were significantly higher for individuals who practiced "intense physical activities" and "walking" (p < 0.001). The groups that responded that they were "very stressed" showed significantly lower QL scores in comparison to the other groups (p < 0.05). There were no significant differences in QL scores according to anthropometric or biochemical indices. When subjects were divided into two groups based on average QL scores, the frequency of intake of "barbecued beef" was significantly higher while the frequency of intake of "fried eggs or rolled omelet," and "soy milk" was significantly lower in the high QL group.
CONCLUSIONS
Based on these findings, it is evident that in healthy adults without any known underlying illnesses, psychological factors such as economic activity, occupational environment, and stress are considered to have a greater impact on their QL than are nutrient intake, blood biochemical indices, and anthropometric status.

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Study on the relationship between dietary habits and the quality of life of some high school students in Seoul based on the nutrition quotient for adolescents (NQ-A)
Ho-Jung Kim, Jung-Sug Lee, Yookyung Kim
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[English]
Chinese Female Marriage Immigrants' Dietary Life after Immigration to Korea : Comparison between Han-Chinese and Korean-Chinese: Kana Asano, Jihyun Yoon, Si Hyun Ryu; Korean J Community Nutr 2014;19(4):317-327. Published online August 31, 2014; DOI: https://doi.org/10.5720/kjcn.2014.19.4.317

Abstract PDF PubReader

OBJECTIVES
This study was conducted to investigate Chinese female marriage immigrants' dietary life after immigration to Korea, focusing on comparison between Han-Chinese (traditional Chinese) and Korean-Chinese (Chinese of Korean descent).
METHODS
An in-person survey was conducted with women married to Korean men, having one child or more aged 1-6 years old, and having resided in Korea for at least one year before the survey. The data were collected from the 309 respondents comprising 151 Han-Chinese and 158 Korean-Chinese in the summer of 2013.
RESULTS
Overall, there was no significant difference in dietary practice, dietary acculturation, dietary behavior, dietary habits, and food intake between the Han-Chinese and the Korean-Chinese respondents. Over 50% of the respondents ate Korean food every day. The overall level of dietary acculturation was about 3.5 out of 5 points. The average score of healthy dietary behavior was a little bit higher than 3 out of 5 points. Approximately 3/4 of the respondents showed increasing frequency of eating out. The respondents reporting increase food diversity were over 70%. Decreased frequency of skipping meal was about 60% of the respondents. Over 50% of the respondents showed increasing consumption of Kimchi, vegetables, fruit, and meat.
CONCLUSIONS
Dietary life of Korean-Chinese female marriage immigrants was similar to that of Han-Chinese female marriage immigrants after immigration to Korea. The results from this study suggest that not only Han-Chinese but also Korean-Chinese should be targeted in various diet-related acculturation support programs as important multicultural populations in Korea.

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[English]
Menstruation and the Variability of Food Intake in Female College Students: Soohwa Kang, Youngmee Lee; Korean J Community Nutr 2013;18(6):577-587. Published online December 31, 2013; DOI: https://doi.org/10.5720/kjcn.2013.18.6.577

Abstract PDF PubReader

This study aimed to elicit the variability of appetite and food intake patterns in female college students during different menstrual phases. The craving for certain foods and physiological and psychological symptoms of menstrual phase (pre- and post-menstrual) were investigated by self-administered questionnaire. Three hundred and sixty six students who were 20.9 years old and had 19.8 kg/m2 of BMI volunteered to participate in this study. Most of the subjects (89.5%) experienced the premenstrual syndrome (PMS) such as irritation, bodily fatigue, nervosity. Symptoms such as tiredness, stomachache, changes in taste and increased appetite were pointed out to be experienced at the onset of the menstrual cycle. The variability of food intake in premenstrual phase, 11.0% of subjects had decreased food intake where as 68.8% had experienced increased intake. The postmenstrual phase, 20.1% had decreased food intake while 45.2% had experienced increased intake due to changes in the appetite. Before starting menstruation, most of the subjects craved for sweets. The group who had experienced abnormal appetite during menstrual phase was significantly high ratio in overweight and obese students (p < 0.05). We also observed an association between the PMS score and the variability of eating patterns during the menstrual phase. The students who experienced changing appetite and food intake had significantly high PMS score in the premenstrual phase (p < 0.01) and postmenstrual phase (p < 0.05). These results suggested a need for future study related to changes in the actual nutrient intake and activity level during the menstrual phase.

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[English]
The Difference of Perception about Nutritional Problems and Food intakes, Nutrition Knowledge Score and Realities of Nutrition Education between Parents and Preschool Teachers: Joo Hee Lee, Eun Jung Kang, Changim Kim; Korean J Community Nutr 2011;16(6):636-646. Published online December 31, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.6.636

Abstract PDF PubReader

This study was conducted to investigate the difference of perception about nutritional problems and food intakes and nutrition knowledge score and realities of nutrition education between parents and preschool teachers. This research can be summarized as follows: there was the statistical difference of perception (chi2 = 52.451, p = 0.000) about nutritional problem of preschoolers between parents and preschool teachers. Parents (56.4%) and teachers (58.5%) identified eating only what they want as the most common nutritional problem of children, but they had different perception about the other problems. To parents, "No nutritional problem" (16.3%) is the second and "Overindulgence of processed food" (11.1%) is the third problem of preschoolers. To teachers, "Overindulgence of processed food" (23.8%) is the second and "Obesity" (14.3%) is the third problem. The perception on food intakes of preschoolers was statistically different in meats (chi2 = 8.892, p = 0.030), fish (chi2 = 32.241, p = 0.000), beans (chi2 = 14.770, p = 0.005), vegetables (chi2 = 12.706, p = 0.013), fruits (chi2 = 14.438, p = 0.006) and milk & dairy products (chi2 = 28.591, p = 0.000) between parents and preschool teachers. However, nutritional knowledge was not different between parents and preschool teachers. While 96.6% of preschool teachers felt that it was necessary to educate preschoolers, only 41.5% of them said that they fulfilled nutrition education, showing that nutrition education was not adequately carried out on the spot. Therefore providing basic materials through which nutritional management guidance and proper nutrition education for preschoolers can be carried out by investigating and analyzing knowledge on their nutrition and meal guidance activities for preschooler teachers and parents.

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[English]
Changes in Food and Nutrient Intakes of College Students between 1999 and 2009: Han Byul Jang, Hwa Young Lee, Young Hee Han, Jeehye Song, Ki Nam Kim, Taisun Hyun; Korean J Community Nutr 2011;16(3):324-336. Published online June 30, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.3.324

Abstract PDF PubReader

The purpose of the study was to examine the changes of food and nutrient intakes of college students between 1999 and 2009. Dietary survey of 169 college students was conducted by a 24-hour recall method for three days in 2009. Food and nutrient intakes in 2009 were compared with the data from 106 students collected by the same methods in 1999. The intakes of cereals & grain products and vegetables in 2009 were lower than those of 1999, but the intakes of meats, eggs, milk & milk products, and manufactured food were higher. The intake of rice per person decreased greatly from 452.2 g in 1999 to 351.4 g in 2009 in males, and from 306.9 g to 237.2 g in females. While the intakes of protein, fat, thiamin, niacin, vitamin B6, phosphorus, potassium, zinc, and cholesterol were significantly higher, the intakes of dietary fiber were significantly lower in 2009 compared to 1999 both in males and females. The nutrients consumed less than the Recommended Intakes were vitamin A, riboflavin, vitamin C, and calcium in males and additionally folate, iron, and zinc in females in both 1999 and 2009. The ratio of carbohydrate, protein and fat as energy was 61 : 15 : 24 and 60 : 14 : 26 in 1999, and 54 : 16 : 30 and 56 : 15 : 29 in 2009 in males and females respectively, showing that carbohydrate intake decreased and fat intake increased greatly. Our data suggest that nutrition education is necessary for college students to help them consume more vegetables and fruits and less fat and cholesterol.

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[English]
Assessment of Food Consumption, Dietary Diversity and Dietary Pattern during the Summer in Middle Aged Adults and Older Adults Living in Gugoksoondam Logevity Area, Korea: Miyong Yon, Mee Sook Lee, Se In Oh, Sang Chul Park, Chung Shil Kwak; Korean J Community Nutr 2010;15(4):536-549. Published online August 31, 2010

Abstract PDF: The purpose of this study was to investigate food intake, dietary diversity and dietary pattern during the summer in middle aged and older adults living in Gugoksundam (Gurye, Goksung, Sunchang and Damyang counties), Jeonla Province located in southern part of Korea and known as one of the representative Korean longevity areas. Food intake and dietary diversity were assessed by using the data from 2 day-24 hour recall of 1,051 subjects (394 males and 711 females) aged 45 years and older (45-93 years in male, 45-105 years in female). The average ages of males and females were 70.7 years and 71.1 years, respectively. Average total daily food intake was significantly decreased with aging in both genders, and the average animal food intake ratio to total food intake was ranged 10~14% in 3 different age groups, 45~64 years, 65~74 years and 75 years and older. The contribution of each food group, in weight, to total food intake showed the descending order of grains, fruits, vegetables and alcohols in males, and grains, fruits, potatoes and meats in females. On daily intake amount of each food item, rice, watermelon, soju, kimchi, and potato were ranked on top 5 in descending order in males, and rice, watermelon, potato, kimchi and ylmukimchi in females. On intake frequency, rice, kimchi, onion, green pepper and potato were ranked on top 5 in descending order in both genders. Dietary variety score (DVS) and dietary diversity score (DDS) for the assessment of dietary diversity and balance were significantly decreased with aging in both genders. In food group intake pattern (DMGFV), 01101 type without consumption of dairy and fruits was the most prevalent, and only 3.6% of male and 3.9% of female subjects showed 11111 type, consumed all the 5 food groups a day. Dietary pattern of subjects was analyzed by cluster analysis with 18 food groups intake. Overall dietary pattern was classified into two clusters, one was more desirable and the other was less desirable. The percentage of subjects with more desirable dietary pattern was about 15% in male and 32% in female. In conclusion, most of our subjects living in Gugoksundam area were taking very simple diet with low amount of dairy products and fruits. These results indicate that nutrition intervention and education for older people living in rural areas should be focused on various food intake including dairy products and fruits.

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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]
Fitness of Diet-Related Factors Explaining the Self-Rated Health (SRH) in Rural Older Adults with Discriminant Analysis: Myeong Hwa Cha, Seong Ja Heo, Hyun Sook Youn; Korean J Community Nutr 2008;13(5):723-732. Published online October 31, 2008

Abstract PDF: The purpose of this study was to identify the influence of diet related factors, such as diet behaviors, food intake, and nutrient intakes, on self-rated health (SRH). Also, in order to determine fitness of classification for SRH reflecting diet related factors, this study surveyed older adults in Gyeongnam province. A total of 101 responses were collected using the interview survey method. The self- rated health of rural older adults was poor as reported by 49.5%. The level of self-rated health was found to be related to the frequencies of coffee and snack, use of sugar and vegetable in diet, the amount of total food intake, and cholesterol intake. The result of discriminant analysis, which was conducted to assess the adequacy of SRH classification and to determine the class of observation, showed frequency of coffee and use of vegetable in diet among 47 variables as predictive variables for explaining SRH. The fitness of self-rated health function was high to 47.7%. Therefore, diet-related factors were ascertained to be important variables to predict SRH.

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[English]
Dietary Behaviors and Seasonal Diversity of Food Intakes of Elderly Women Living Alone as Compared to Those Living with Family in Gyeongbuk Rural Area: Young Jee Lim, Young Sun Choi; Korean J Community Nutr 2008;13(5):620-629. Published online October 31, 2008

Abstract PDF: The purpose of this study was to assess dietary habits and seasonal variation and diversity of food intakes of elderly women living alone as compared to those of elderly women living with family in a rural area. Forty nine elderly women living alone and forty one elderly women living with family who reside in Goryeong-gun, Gyeongbuk, were interviewed using questionnaires in summer 2005, and their food intakes were assessed secondly in winter and thirdly in spring 2006. The average ages were 74.7 years for elderly living alone and 72.8 years for elderly living with family. Tooth status and bone fracture experience were similar between the groups. The prevalence of musculoskeletal disease was 61.2% and that of circulatory disease was 32.7% of the subjects. Average of total score of mental depression of the subjects was 5.94 out of 12 points, and it was not significantly different between the two groups. Skipping meals was more frequent and mealtime was more irregular in the elderly women living alone as compared with the elderly women living with family. Consumption of dietary supplements was also less in the elderly women living alone. Food intakes by the elderly women living alone tended to be lower than those by the elderly women living with family. Dietary diversity score was significantly lower with the elderly women living alone as compared with the elderly women living with family only in summer (p < 0.01). Percentages of the subjects who have taken meat group and vegetable group were significantly lower in the elderly living alone compared with the elderly living with family during summer. Therefore, it is necessary to develop food assistance or supporting program suited for the season within a community for elderly women living alone.

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[English]
Food Intake Patterns and Blood Clinical Indices in Female College Students by HDL-cholesterol Levels: Ha Na Jung, Jung Hee Kim; Korean J Community Nutr 2008;13(1):100-110. Published online February 29, 2008

Abstract PDF: Recently, a lot of epidemiological studies revealed that low HDL-cholesterol level was a better predictor of risk for coronary heart disease than total cholesterol. This study investigated the anthropometric parameters, clinical blood indices, and dietary factors influencing serum HDL-cholesterol level by using a cross-sectional study for Korean female college students. The subjects were 94 female college students. They were divided into three groups according to their serum HDL-cholesterol levels, low HDL-cholesterol (< 50 mg/dL, n = 20), medium HDL-cholesterol (50< or =, < 60 mg/dL, n = 39) high serum HDL-cholesterol groups (60< or = mg/dL, n = 35). This study examined their demographic data and dietary intake throughout a questionnaire. Clinical blood indices were measured using an automatic blood chemistry analyzer (Selectra E), after 12 hours of fasting. BMI, body weight, fat mass, and waist circumferences were significantly increased according to low serum HDL-cholesterol levels. Serum lipid analysis showed a significantly higher level of TG, LDL-/HDL-Ratio, atherogenic index in the low HDL-cholesterol group. Serum levels of GPT, uric acid and alkaline phosphatase in the low HDL-cholesterol group were significantly higher than in the other group. The average consumption of energy was 1627 kcal and 77.76% of estimated energy requirement (EER). The mean ratio of calories from carbohydrate : protein : fat was 57 : 15 : 28. The low HDL-cholesterol group was significantly higher than the other groups in eggs, fat and oils consumption. Interestingly, milk and diary products consumption of low HDL-cholesterol group was half (p < 0.05) of those of the other groups. In conclusion, serum HDL-cholesterol levels appeared to be decreased by increasing BMI, fat mass, waist circumference, and serum TG level. In addition, some dietary factors seemed to be related to serum HDL-cholesterol levels. However, further research is needed to elucidate the exact relationship between serum HDL-cholesterol level and dietary factors.

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[English]
A stydy on Nutritional Status and Eating Behaviors of Underweight Adolescent Boys Using 2001 NHANS of Korea: Min kyung Kwon, Young sook Park; Korean J Community Nutr 2007;12(3):235-246. Published online June 30, 2007

Abstract PDF: This study was performed to identify nutritional status and eating behaviors of underweight male adolescents aged 15 to 19 years. The subjects selected by using the data of KNHANS-2001 were 32 underweight boys and 135 normalweight ones. We found that weight, waist and hip circumference of the underweight group were significantly different to normal-weight group, but height and waist-hip ratio were not. Their serum indices belonged within normal ranges and showed no difference between the two groups. Their energy and nutrient intakes were mostly poor. The level and proportion of the subjects below EAR, NAR and INQ of each nutrient were not significantly different between the two groups. There were no difference of frequencies of skipping meals, snacking and eating-out between the two groups, either. When comparing frequencies of food intakes, the underweight group consumed significantly more of fermented fishes and less milk than the normal-weight group. And the former had significantly more rest/sleep, nodoes and supplementation and less regular excercise than the latter. The underweight group perceived more correct self-images than the normal-weight group and they tried more to increase their body weight during weight control practice (p < 0.001). It was concluded that the underweight group showed no different biochemical indices, nutrient intakes, and dietary behaviors to the normal-weight group, but they revealed significantly higher non-active activities like rest and supplementations.

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[English]
Comparison of Food Intakes and Serum Lipid Levels in Overweight and Obese Women by Body Mass Index: Ok Hyun Kim, Hana Jung, Jung Hee Kim; Korean J Community Nutr 2007;12(1):40-49. Published online February 28, 2007

Abstract PDF: This study was done to investigate the health-related habits, dietary intakes and serum lipid levels in overweight and obese women by body mass index (BMI). Subjects were 137 pre-menopausal women aged 19 to 49 years. They were divided by 3 groups, overweight (23 < or = BMI < 25), obese (25 < or = BMI < 30) and morbidly obese (BMI > or = 30) according to their BMI. Body composition was determined by bioelectrical impedance analysis (BIA) method. Dietary intakes were examined by 3-day record method and nutrient intakes were analyzed by the Computer Aided Nutritional analysis program for professionals (CAN-pro 3.1). Serum lipid levels were measured using automatic biochemical analyzer (Selectra E). The average age, height, weight, and BMI of subjects were 31.7 years old, 159.3 cm, 69.4 kg, and 27.4 kg/m(2), respectively. Their average consumption of energy were 12 kcal and 86.4% of estimated energy requirement (EER). Their mean ratio of carbohydrate : protein : fat was 55.2 : 14.6 : 30.2. Particularly, the fat consumption of subjects tended to be elevated with increasing BMI. There was no significant difference in nutrient intakes among 3 groups. But the mean intakes of Ca, Fe, vitamin C and Na of all the subjects were 70.1%, 87.2%, 75.7% of recommended intake (RI) and 258.9% of adequate intake (AI), respectively. The intakes of vegetables and seaweeds were significantly higher in morbidly obese group while the intake of fruits was higher in overweight group compared to the other groups. Serum lipid analysis showed that there were no significant differences in the levels of total cholesterol, triglyceride and LDL-cholesterol among the groups. But the serum HDL-cholesterol level of the overweight group was significantly higher than that of the other groups. LDL-/HDL-cholesterol ratio and AI index were significantly higher in the morbidly obese group compared to the other groups. In addition, The systolic blood pressure of morbidly obese group was significantly higher compared to the other groups. Overall data suggest that morbidly obese women have to more concern about reducing systolic blood pressure and serum lipid levels by decreasing their fat consumption and salt intakes as well as loosing body fat. In addition, all the subjects participated in this study have to be careful about their meals and health-related behaviors in order to prevent obesity-related chronic diseases.

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[English]
Relationship between Nutritional Status and Facial Sebum Content of Young Women: Young Sook Park, Farrah Rou, Sunga Jaegal; Korean J Community Nutr 2006;11(5):587-597. Published online October 31, 2006

Abstract PDF: This study was performed in order to identify nutritional factors affecting on skin sebum content with 131 female university undergraduates in 2003. We measured the sebum contents of 4 facial spots to classify their skin types. Daily energy and nutrient intakes of the subjects were not deficient except in calcium and iron, which were 466.2 mg (66.6% RDA) and 8.5 mg (53.4%RDA) relatively. We observed no significant difference of energy and nutrient intakes among the 3 skin types. But significantly higher consumption of grains and slightly higher frequencies of several food groups (excepting starches) were shown in oily skin types, so they might have higher nutrient intakes. Serum indices and food preferences mostly revealed no difference among the 3 skin types. But in the oily skin type, serum phosphorus levels were significantly lower than others, suggesting phosphorus-rich food consumption like soft drinks and grains could lead to a dry skin type rather than an oily one. Also in the oily skin type, sweet taste preference was slightly lower than others; moreover, sweet intake was lower samely significantly. There was mostly no significant relationship between facial sebum contents and nutrient intakes, dietary behavior, food frequency and food preference except in some factors. Animal protein intake showed a significant negative relationship toward facial sebum content. On the other hand, in normal skin type, fishes consumed was slightly higher than others, so that higher animal protein consumption presumably leads to normal skin type. Frequency of fried food and bacon and preference of fried foods showed slightly negative relationships toward facial sebum content. Regular meal times showed significantly increased facial sebum content.

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[English]
Food Intake and Clinical Blood Indices of Female College Students by Body Mass Index: Ok Hyun Kim, Jung Hee Kim; Korean J Community Nutr 2006;11(3):307-316. Published online June 30, 2006

Abstract PDF: This study was conducted to investigate the relationships among body composition, dietary intake, and clinical blood indices in college students by body mass index (BMI). Their body compositions were determined by means of BIA (Bioelectrical Impedance Analysis) method. Their dietary intake was determined using a 3-day record method and their hematological indices were determined by semi-automated microcell counter (Sysmex F-520). Their serum lipid levels were measured using biochemical analyzer (Spotchem). Subjects were classified as underweight, normal or overweight groups according to their BMI. The subjects were 69 healthy college students aged 20 to 26 years. The average age, height, weight, and BMI was 21.3 years, 162.6 cm, 54.4 kg, and 20.6 cm/m2, respectively. Their average consumption of energy was 1693 kcal, 84.7% of RDA and their mean ratio of carbohydrate: protein: fat were 54.5 : 16.4 : 29.0. There was no significant difference in nutrient intake among the groups except beta-carotene and vitamin C. The beta-carotene intake was significantly higher in the underweight group. Vitamin C intake was significantly higher in the overweight group. The mean intakes of Ca, Fe, Zn and folate of subjects were 74.8% to 83.2% of RDA. Especially, intakes of Ca, Fe, Zn and folate were lower in the abnormal weight groups. The overall mean values of the hematological indices in female college students were within the normal range and there was no significant difference among the groups. However, anemic subjects with hemoglobin (<12 g/dl) and hematocrit (<36 g/dl) accounted for about 11% of the subjects. The overall mean values of the serum lipid levels were within the normal range and there was no significant difference among the groups. But serum HDL-cholesterol level of the overweight group was lower than that of the other groups. LDL-/HDL-cholesterol ratio and AI index were significantly higher in the overweight group compared to the other groups. Based upon this study, it is necessary for college women to be educated regarding consuming more Ca, Fe, Zn, folate and less fat and cholesterol in order to have better health promotion.

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[English]
Effects of School-based Nutrition Education for Korean Food Guide on Food Intake Frequency of Adolescents: Joung Sook Kim, Myoung Soon Park, Young Sun Cho, Joung Won Lee; Korean J Community Nutr 2005;10(5):582-591. Published online October 31, 2005

Abstract PDF: The purpose of this study was to examine the effect of nutrition education about the Korean food guide to middle school students on food intake measured by food frequency. Three hundred first graders were sampled from two coeducational middle schools located in the small city of Chungnam area, and divided into 167 (74 boys, 93 girls) education groups of one school and 133 (70 boys, 63 girls) non education groups of the other school. Nutrition education was given to the education group for a total of 16 hours and no education to the non education group during the same period. After education, average nutrition knowledge scores of education group increased from 6.40 +/- 2.17 to 6.81 +/- 1.56 significantly, especially boys with a high range of increase and girls no increase. Dietary habit scores improved significantly from 46.2 +/- 6.5 to 49.1 +/- 6.2 in both boys and girls of education group. Of the knowledge and dietary habits, ability of choosing a balanced meal, biased eating to some food, and taking diverse foods at every meal improved significantly in education group. In non education group no significant increases of either nutrition knowledge scores and dietary habit scores were shown. In addition education group showed significant increases after education, in the intake frequencies of rice noodle loaf bread, kimchi, green and yellow vegetables, and soybean soybean curds by 0.27, 0.23, 0.40 and 0.32 servings per day, compared with non education group. These changes were greater in girls than in boys. According to these results, it can be concluded that nutrition education about the Korean food guide improved effectively not only student's nutrition knowledge and dietary habits, but also healthy food intake ability. It is necessary to prepare long-term and continuous school-based nutrition education programs for the students to get into a habit of healthy food intake.

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[English]
Nutritional Status of the Nonagenarian Population in Longevity Belt in Korea: Mee Sook Lee; Korean J Community Nutr 2005;10(3):290-302. Published online June 30, 2005

Abstract PDF: The nutrients intake and health-related habits of nonagenarian subjects in Korean representative longevity belts of Damyang, Gokseong, Kurye, Sunchang were evaluated for the purpose of providing the information on the desirable food selection and dietary pattern of elderly population. A survey was conducted with 91 subjects (26 males and 65 females) and their food intakes were measured by the combination of one meal weighing and 24-hr recall, and their general background information was collected by visit. The mean age of the subjects was 93.6 +/- 2.2 (male) and 97.6+/- 4.6 (female). The average smoking rate was 20.9%; the rate of regular drinking was 26.4%. The average energy intake was 1,284.9 kcal comprising 77.1% of RDA for elder people over 75. The energy ratio of carbohydrate, protein and fat were 66.5 :18.2 :15.3. The average intake of protein, calcium, iron and zinc were 107.4%, 59.9%, 106.3% and 60% of RDA respectively. The lower intake of vitamins as low as 70% was found except vitamin B6 and niacin. The majority of the subjects consumed rice as staple diet and mostly consumed white plain rice rather than mixed grain rice. The animal and plant food intakes were 88.4 :11.6 in males and those of females were 83.0 :17.0 showing a tendency of plant-based meals. Nutrients that showed NAR over 0.7 were protein, iron, vitamin B6, niacin and phosphate, but those with INQ over 1. Nutrient with INQ below 0.7 was only vitamin E. Even though their nutritional quantity did not appear to be enough, but their nutritional quality was relatively high. The adding dairy products, nuts and fruits for the purpose of proving sufficient vitamin and minerals can achieve the optimal nutritional intake patterns. Further research on RDA of this age population should be followed.

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[English]
Food and Nutrient Consumption Patterns of Korean Adults Based on their Levels of Self Reported Stress: Young Ok Kim; Korean J Community Nutr 2003;8(3):340-348. Published online June 30, 2003

Abstract PDF: Differences in food and nutrient intake among Korean adults based on different stress levels were investigated using information obtained from 7,370 adults who participated in the 1998 Korean National Health and Nutrition Survey. The twenty-four hour recall method was used for this dietary survey. Data pertaining to indivisual stress levels were collected by means of interviews as part of the National Health Behavior Survey. Following the analysis of variance, Duncan's Multiple Range Test was used to test the differences in food and nutrient intake among groups with different levels of stress. Eighty-three percent of the study subjects were reported to have a certain level of stress. Unlike the observations made in European and American studies, there were no significant differences observed in food and nutrient intake based on the stress levels among Korean adults of either sexes. These results may imply that even though stress was clustered with other health related behavior, the association between food intake and stress among Koreans was very weak.

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[English]
Identification of the Dietary Intake Patterns of Korean Adults according to Their Exercise Levels: Young Ok Kim; Korean J Community Nutr 2002;7(6):769-780. Published online December 31, 2002

Abstract PDF: The purpose of this study was to identify the differences in dietary consumption patterns according to the exercise level of Korean adults. The study subjects were the 7,370 Koreans aged 20 years and older of the 1998 Korean Health and Nutrition Survey. The dietary assessment was conducted by means of the 24 hour recall method. Data for individual exercise behavior were collected by interviews as part of the National Health Behavior Survey. Following the analysis of variances the Duncan's Multiple Range Test was used to test the differences in food and nutrient intakes among groups with different levels of exercise. Current exercise practices were reported by 22% of the male subjects and 15% of the female subjects. Unlike observations from the American and European studies, a greater amount of meat intake was observed more frequently among high exercises group than among middle and low exercisers in the case of the male subjects. This was reflected in the increasing levels of protein and fat intake in proportion to the exercise levels. However, the food and nutrient intake patterns of female exercisers were quite different from those of the males. The least intake of fatty foods was observed among the high exercisers. Energy intake from fat was the lowest among the high exercisers. These results may imply that the motivation to exercise was quite different between male and female Koreans. This dietary pattern may have a risk of undernution. Summerizing the results, whatever the motivation of the exercise, the Korean exercisers of both sexes had unhealthy dietary pattern. Therefore, nutritional education should be conducted to encourage the eating of a balanced diet along with exercise, among Koreans of both sexes, in order to promote a healthy lifestyle.

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[English]
A Study of the Nutritional Intake from Lunch-Box of Middle School Girls in the Chonbuk Area: Mi Ran Kim, Hee Sook Sohn, Sook Bae Kim, Youn Soo Cha; Korean J Community Nutr 2002;7(6):824-832. Published online December 31, 2002

Abstract PDF: The present study was conducted to evaluate nutritional intake by lunch-box of middle school girls who live in Chonbuk area. Anthropometric measurements and food intake from lunch-box over a three day period were investigated in a total of 110 middle school girls from rural (n = 37) and urban (n = 73) areas. The results are summarized as follows : 1. Not all the steamed rice in the lunch-box had enough mixed-cereal. 2. In the survey of food intake by food groups, 70.5% of the food came from the cereal group. 3. The intake of protein, phosphate, Vitamins B1 and B2, niacine and Vitamin E were adequate, however, the intake of other nutrients was significantly lower than those of one-third of the Korean RDA. 4. Protein, lipid, and zinc intakes of the students from the rural area were significantly lower than those of students from the urban area, however, the carbohydrate and dietary fiber intakes of those in the rural area were significantly higher than those of the students in the urban area. 5. The percentage of calories from carbohydrate : protein : lipid ratio was 67.6 : 12.2 : 16.9 for students in the rural area and 59.2 : 14.9 : 22.5 respectively for those in the urban area. In Summary, the intake of calcium, iron, Vitamins A, B6, and D, folate and zinc from lunch-box in middle school girls was much lower than that of one-third of the Korean RDA. The intake of carbohydrate and dietary fiber of the students in the rural area was significantly higher, but that of protein, lipids, and zinc was lower than that of the students in the urban area. Therefore, nutritional education programs for both students and their parents should be provided to improve the daily food intake from lunch-box.

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[English]
Regional Differences in Dietary Supplement Use and Related Factors among College Students Participating in Nutritional Education Programs via the Internet: Jin Oh Kwak, Cheong Hee Lee, Hea Eun You, Hyun I Sung, Kyung Ja Chang; Korean J Community Nutr 2002;7(5):639-653. Published online October 31, 2002

Abstract PDF: The purpose of this study was to investigate the regional differences in dietary supplement use and related factors among college students participating in nutritional education programs via the internet. The subjects in this study were 797 college students (male: 518, female: 279). A cross-sectional survey was conducted using a self-administered questionnaire about dietary supplement use, demographic characteristics, health-related lifestyles, nutrient intake, and data were collected via the internet and by mail. Dietary supplements were taken by 82.2% of subjects (males: 76.3%, females: 85.3%). There was a significant regional difference in supplement use (p < 0.01). The supplements, used most frequent by male students in the Seoul and Incheon areas were lactic acid beverages and gagogi, in that order. Male students in the Kyunggi area used gagogi and lactic acid beverages in that order. Lactic acid beverages and Chinese medicine were used most frequently by male students in the Chungcheong area. Male students in the Kyungsang area used lactic acid beverages and water-soluble vitamins, in that order. Male students in Seoul and Kyungsang areas showed significantly higher percentage of keep on taking supplements compared to other areas (p < 0.05). Both male and female students in the Seoul area had more frequent medical examinations, in comparison to students in other areas (p < 0.05). Male students in the Kyungsang and Seoul areas took significantly more calcium (p < 0.05) and iron (p < 0.05), in comparison to students in other areas. Female students in the Kyunsang area took significantly more Vitamin A, phosphorous and iron (p < 0.05), while those in the Seoul area took significantly more Vitamin C (p < 0.01) and calcium (p < 0.05). Male students in the Chungcheong area took significantly less seaweed, in comparison to students in other areas (p < 0.05). Male students in the Seoul area had the highest amount of animal fat and oil, while those in the Incheon area ate the lowest amount of animal oil and fat (p < 0.05). Female students in the Kyunggi area ate the highest amount of fruit, while those in the Incheon area ate the lowest amount of fruit (p < 0.05). Female students in the Incheon area ate the highest amount of seaweed, while those in the Kyunggi area ate the lowest amount of seaweed (p < 0.01). Therefore, it can be concluded that it is necessary to develop dietary supplements to optimize the nutritional status of college students in different areas of Korea.

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[English]
A Study on the Intake Patterns of Health Food of the Elderly Aged over 60 Years in the Chuncheon Area: Hee Seoup Rhee, Hai Sook Lee, Jung Ae Yee, Keum Jee Kang; Korean J Community Nutr 2001;6(4):635-644. Published online October 31, 2001

Abstract PDF: This study was carried out to investigate the intake patterns of health food according to the kind of disease of the elderly aged over 60 years living in the Chuncheon area. This study was conducted by using a questionnaire from December 1999 to the March 2000. The data was analyzed using a SPSS program. The results were summarized as follows : The poorer the self-perceived health condition, the lower the level of activity of daily living(ADL) and instrumental activities of daily living(IADL) were the higher. the frequency score of health food intake. The incidence of disease, such as arthritis(44.7%), hypertension(18.8%), digestive diseases(17.1%), diabetes(10.5%) were found to be higher. than other chronic diseases among the elderly. The frequency score of health food intake was not significantly different according to self-perceived health status, disease status, or the level of ADL and IADl.. The must important source of information for health food intake was the recommendation of friends and relatives(68.7%). Twenty eight point two percent of the elderly considered health foods to be effective, however 8.3% of the elderly considered them to be ineffective. The elderly with chronic diseases had taken health floods in the descending order of neuralgia-arthritis, hypertension, digestive disease, diabetes. The elderly with digestive diseases, diabetes, renal disease, neuralgia-arthritis and respiratory disease were inclined to habitually take health floods once or twice per year. Intake of Korean traditional folk food was as high as intake of registered health food and Chinese tonic medicine. The most frequently taken health food was tonic medicine, which is fo11owed by pumpkin, ginseng products, herbal tea formula with black goat, deer antler and Kye-so-ju. Intakes of health food such as tonic medicine, blood of the deer, royal jelly, aloe were found to be higher among the elderly with chronic diseases such as diabetes, hypertension, and digestive disease. However, intakes of ginseng products, deer antler, pumpkin, herbal tea formula with black goat and Kye-so-ju were found to be higher among the healthy elderly. The elderly with neuralgia-arthritis had taken sixteen kinds of health foods. From these results, a wide consumer education program should be developed to convince people of the importance of well-balanced diet and to choose proper health foods according to the elderly's health conditions. Also, comprehensive and scientific research into Korean traditional folk foods are needed for the correct use.

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[English]
A Study on Nutrient Intake, Food Behavior and Health Conditions according to Food Intake Diversity in the Elderly in a Local City: In Sook Kim, Hyeo Hee Yu, Yoon Sook Kim; Korean J Community Nutr 2001;6(2):205-217. Published online May 31, 2001

Abstract PDF: This survey was carried out to study the difference of nutrient intake, food behavior and health condition according to food intake diversity in the elderly(age 65 year over and 74 year under) in a local city. A diet survey with one day 24-recall method was used for 216 subjects(65 male & 151 female). Based on a food intake diversity examination, including an evaluation of KDDS(Korean's Dietary Diversity Score ; counts the number of food groups consumed daily from total five food groups(cereal, meat, vegetable, dairy, and oil groups)), Meal Balance(apply the KDDS at breakfast, lunch and dinner), and DVS(Dietary Variety Score ; total number of foods consumed), subjects were clustered according to food intake diversity. Food intake diversity patterns of male and female clusters were classified each into threes(Male-low group(24.6%), middle group(33.8%), and high group(41.5%)/Female low group(41.7%) middle group(37.1%), and high group(21.2%). The averages of KDDS, Meal Balance and DVS were 3.0, 7.5, 14.8 in the male middle group, and 4.5, 10.2, 25.7 in the male high group, 2.7, 6.3, 14.3 in the female low group, 4.0, 8.6, 18.0 in the female middle group, and 4.5, 10.5, 25.7 in the female high group respectively. The average dairy intake of nutrients below the RDA were energy, protein, Ca, Fe, Vitamin A, Vitamin B2 and niacin in the male low group, energy, protein, Ca, Fe, Vitamin A, Vitamin B2 in the male middle group and energy, Ca, Vitamin B2 in the male high group but a little. Also the female low group had intakes of all nutrients except Vitamin C, the middle group had intakes of energy, protein, Ca, Fe, Vitamin A, Vitamin B2, and the female high group had intakes of energy, Ca, Vitamin A below the RDA respectively. Food intake diversity increasing, nutrient intake, food behavior and health condition proved to be good. This study explored the usefulness of cluster analysis in identifying food intake diversity of three groups of the elderly in relation to their nutrient intake, food behavior and health conditions.

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[English]
The Study of Associations among Serum Lipids, Anthropometric Measurements, Food Intake Frequency and Nutrient Intake in Healthy Adults: Da Hong Lee, In Sook Kim; Korean J Community Nutr 2000;5(4):642-653. Published online December 31, 2000

Abstract PDF: The purpose of this study was to investigate the association among food intake frequency, nutrient intake, anthropometric measurements, and serum lipids in 100 women and 85 men aged 40-74yrs residing in Jeonju City. Food intake frequency and nutrient intake were obtained from one-day dietary recalls. The results were as follows : The mean height, body weight and BMI were 161 cm, 62.5 kg, and 24 kg/m2 respectively. The mean of SBP and DBP were 118 mmHg, 77 mmHg respectively. The mean of TC and TG were 185.5 mg/dl, 153 mg/dl respectively. The mean daily energy and carbohydrate intake was 85. 7%, 91% of RDA for Koreans respectively and that protein intake was 118.5% of RDA. The TC levels of subjects less than 75%, 75-125%, more than 125% of RDA energy were 176 mg/dl, 192 mg/dl, 185 mg/dl respectively(p<0.01). The TC levels less than 75%, 75-125%, more than 125% of RDA protein were 180 mg/dl, 190 mg/dl, 175 mg/dl respectively(p<0.05). TC levels less than 75%, 75-125%, more than 125% of RDA fat were 181 mg/dl, 193 mg/dl, 194 mg/dl respectively(p<0.05). Of the subjects, 18% ate mushrooms. The BMI of the mushroom eaten was 24 and that of non-mushroom eaten was 25(p<0.05). Of the subjects, 28% consumed milk and milk produce. The mean level of TC and TG in milk and milk products eaters were 181 mg/dl, 131 mg/dl and that of non milk and milk products eaters were 197 mg/dl, 159 mg/dl(p<0.001, p<0.05). Of the subjects, 58% ate fish. The HDL-C of the fish eaten was 50 mg/dl and that of non-fishes eaten was 45 mg/dl(p<0.05).

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A Study on the Balance of Iron and Zinc in Korean Children: In Seon Choi, Kyung Hwa Lee, Seung Ho Oh; Korean J Community Nutr 1998;3(1):12-20. Published online February 28, 1998

Abstract PDF: In this study, the food intake, feces and urine of 14 primary school age boys and girls were collected and intake and excretion of iron and zinc were measured. The boys and girls were 8-12 years old and measurement continued for four weeks during which they maintained their normal living pattern. Each boy's and girl's daily intake and excretion of iron and zinc were measured and apparent digestibility and balance were also calculated. The results are as follows. Mean daily intake of iron was 14.9+/-0.6 mg for the boys and 12.4+/-0.5 mg for the girls. Mean daily intake of zinc was 11.8+/-1.2 mg for the boys and 11.5+/-0.4 mg for the girls. Mean daily fecal loss and apparent digestibility of iron was 6.1+/-0.3 mg and 58.8+/-2.0% for the boys and 6.8+/-0.1 mg and 44.1+/-2.0% for the girls. Mean daily fecal loss and apparent digestibility of zinc was 9.3+/-0.2 mg and 14.4+/-5.1% for the boys and 9.7+/-0.4 mg and 14.3+/-4.3% for the girls. Mean daily urinary loss of iron was 1.1+/-0.1 mg and showed the positive balance of 7.86+/-0.6 mg for the boys and 0.5+/-0.1 mg and showed the positive balance of 5.14+/-0.4 mg for the girls. Mean daily urinary loss of zinc was 0.5+/-0.1 mg and showed the positive balance of 1.03+/-0.6 mg for the girls.

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[English]
A Glance at the Health Status and Food Intake of North Koreans: young sook Park, Kee Choon Rhee, Ki Young Lee, Eun Young Rhee, Soon Hyung Yi, Dea Nyun Kim, youn Shil Choi; Korean J Community Nutr 1997;2(3):396-405. Published online August 31, 1997

Abstract PDF: We performed this study to understand the health status and food intake of North Koreans. Information was collected by individual closed in-depth interviews of 11 escapers from North Korea as well as books, newspapers and North Korean movies. Interviews were done from October, 1996 to May, 1997, covering their heights and weights, their appearance and disease, food system and intake of various main/side foods, concern about health and hygiene. North Korean's height and BMI were lower than those of South Koreans. Difference of BMIs between North and South Koreans was profound in middle aged women than in other age groups. Childrem showed many malnutrition appearances of moon face, large abdomem, arrow-like legs, flaky skin, decolored hair, etc.. Main foods in North Korea were rice-shaped corn, corn flour, wheat flour and wet noodle, and side foods were kimchi and/or soups and steamed soy paste. Food supply system there seemed not to work normally for many years, so foods, especially in cities, has been extremely short in government-operating shops, but some in private market. Many housewives were eager to make and sell simple snack food products, We noticed that North korea schools didn't check students' health even though their medical policy was based on preventive medicine. Their living environmental hygiene was shown to be oyt of control.

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