Objectives Recently, food insecurity has been a major public health issue along with the food crisis caused by COVID-19, climate change, and the polarization of food supply due to socioeconomic disparities. Food insecurity is known to be related to the food choices and environment of the consumer. Therefore, this study aimed to evaluate the food security statuses of adults in Jeju and investigate their food purchase patterns, food policy recognition, and food environment satisfaction.
Methods Based on data from the 2022 Jeju Food Survey, 346 adults aged ≥19 years in Jeju were classified into food security and insecurity groups (quantitatively and qualitatively) using the questionnaire. Food purchase patterns, including purchasing frequency, items, and reasons, were surveyed for local and eco-friendly foods. The recognition and necessity of several food policies and satisfaction with diet and food environment (availability, accessibility, affordability, accommodation, and acceptability) were measured using the Likert scale.
Results Among the total participants, 47.4% were in the food insecurity group. The frequency of purchasing local and eco-friendly foods did not significantly differ by food security status. The insecurity group exhibited a higher recognition rate of basic rights to food (36.0%) than the security group (24.7%, P = 0.023). The recognition and necessity of specific food policies did not significantly differ by food security status, except for the policy of promoting food communities, for which the food security group exhibited higher recognition than the food insecurity group did (P = 0.004). The food insecurity group exhibited significantly lower scores regarding satisfaction toward diet and food environment factors (P < 0.05 for all).
Conclusions Overall, the food security group reported higher satisfaction with their diet and food environment than the food insecurity group. Further in-depth studies to investigate the determinants of food insecurity and effective promotional strategies for food policies are needed.
Objectives This study aimed to investigate the importance and performance levels of sustainable dietary education across the health, environment, and society domains as perceived by nutrition teachers and evaluate the needs and priorities for sustainable dietary education.
Methods An online survey was conducted for 151 nutrition teachers in Jeollanam-do. The survey included 20 questions across the health, environment, and society domains. The data were analyzed using a paired-sample t-test, the importance-performance analysis (IPA), the Borich needs assessment model, and the locus for focus model.
Results Overall, the average importance levels of the 20 items of sustainable dietary education were significantly higher than their average performance levels (4.44 vs. 3.68). The examination of each educational domain revealed that although the importance of education in the health domain was recognized and actively practiced by the nutrition teachers, the performance was comparatively lower in the environment and society domains. The Borich needs assessment and the locus for focus model identified education on biodiversity conservation, plant-based protein, and the use of local food as the top-priority group in the environment domain along with fair and ethical food, food security, regional food culture, food policy and trade, and family dining culture as the second-priority group in the society domain.
Conclusions The results of this study underscore the need to support the nutrition teachers’ perception and practice of sustainable dietary education in the environment and society domains. We believe that the educational needs and priorities proposed in this study will be considered in the future development and modification of sustainable dietary education programs.
Objectives The total population of Korea began to decline in 2019; in particular, the population in rural areas has been rapidly decreasing and is aging. Therefore, the government has designated depopulation areas and is seeking ways to support them. To assess whether health disparities exist between areas with population decline and those without, this study used community health survey data to observe temporal changes in health behaviors between the two types of areas. Methods: The analysis used Community Health Survey data from 2010 to 2019, and regional classification was divided by depopulation areas designated by the Ministry of the Interior and Safety. Trends in health behavior and chronic disease prevalence between depopulation and non-depopulation areas were analyzed. All analyses were conducted using complex sample analysis procedures in SAS 9.4 software. Results: The smoking rate steadily decreased in both depopulation and non-depopulation areas, whereas the high-risk drinking rate increased slightly. The walking practice rate did not improve in depopulation areas compared to non-depopulation areas. Furthermore, nutritional labeling usage rate was consistently lower in depopulation areas than in non-depopulation areas, with the gap being the largest. The prevalence of obesity, diabetes, and hypertension showed that the gap between depopulation and non-depopulation areas is continuously increasing. Conclusions: Health behaviors in depopulation areas have not improved, and the prevalence of chronic diseases is increasing rapidly. Therefore, the demand for health care services that support healthy lifestyle practices and chronic disease management in these areas is expected to increase.
Objectives This study aims to compare changes in physical factors, health behaviors, eating habits, and nutritional intake among Korean male and female adults over a period of three years (2019–2021) before and after the outbreak of coronavirus disease 2019 (COVID-19). Methods This study utilized raw data from the 8th Korea National Health and Nutrition Examination Survey (2019–2021). The participants in this study included 6,235 individuals in 2019, 5,865 individuals in 2020, and 5,635 individuals in 2021. Individuals whose daily energy intake was less than 500 kcal or exceeded 5,000 kcal were excluded from the study. Results In comparison to 2019, overweight/obesity rates, weight, waist circumference, weekend sleep hours, and resistance exercise days/week increased in both male and female during the COVID-19 pandemic. Regarding eating habits, the proportions of people skipping breakfast, not eating out, consuming health supplements, and recognizing nutritional labels increased in 2020 and 2021, whereas the rate of skipping dinner decreased. Total energy intake has continued to decrease for the two years since 2019. A comparison of nutrient intake per 1,000 kcal before and after the outbreak of COVID-19 revealed that intake of nutrients, including protein, phosphorus, iron, vitamin A, riboflavin, and niacin increased, while folic acid intake decreased. In male, calcium, phosphorus, riboflavin, and niacin intakes increased, whereas iron, vitamin C, and folic acid intakes decreased. In female, phosphorus, iron, vitamin A, and riboflavin intake increased significantly, while protein and niacin intake decreased significantly. Conclusions After COVID-19, the obesity rate, breakfast skipping rate, health supplement intake, and nutritional label use increased, while the frequency of eating out, dinner skipping rate, and total energy intake decreased. These environmental changes and social factors highlight the need for nutritional education and management to ensure proper nutritional intake and reduce obesity rates in the post-COVID-19 era.
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Intake of energy and macronutrients according to household income among elementary, middle, and high school students before and during the COVID-19 pandemic: a cross-sectional study Chae-Eun Jeong, Heejin Lee, Jung Eun Lee Korean Journal of Community Nutrition.2024; 29(3): 234. CrossRef
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Objectives This study sought to assess the effectiveness of community-based nutrition counseling on improving nutritional status, managing complex chronic diseases, and enhancing the quality of life for elderly individuals with chronic conditions, particularly in older adults with high levels of food insecurity and multiple chronic illnesses. Methods Thirty elderly subjects with diabetes and hypertension who were registered at local Senior Welfare Center received individualized nutrition counseling, based on their Nutrition Quotient for the Elderly (NQ-E) index. Over a 16-week period, they received tailored counseling and underwent various health and nutritional assessments. The final analysis included 28 participants after two dropped out. Data analysis was conducted using the SPSS v28.0. Results The subjects were over 70, with multiple chronic diseases including diabetes and hypertension and predominantly female. After 16 weeks, significant improvements were observed in the subjects’ grip strength, and HbA1c levels, as well as in their NQ-E scores, indicating improved dietary balance and diversity. There were no significant improvements in the ‘Moderation’ subdomain of the NQ-E index, suggesting that this aspect requires further attention in nutritional counseling. The subjects' nutritional risk scores (NSI) were also significantly decreased, indicating less nutritional risk. Lastly, as measured by the SF-36K, the subjects’ quality of life showed significant improvement in several domains including physical role performance and social function. Conclusions This study demonstrates that tailored nutrition counseling, based on the NQ-E index, can improve elderly health, manage chronic diseases, and enhance quality of life. This approach potentially broadens the scope of community nutritionists' roles within an aging society.
However, additional research is necessary to evaluate these interventions' long-term effects and sustainability.
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Objectives A mobile health intervention program was provided for employees with overweight and obesity for 12 weeks, and a process evaluation was completed at the end of the program. We investigated participant engagement based on app usage data, and whether engagement was associated with the degree of satisfaction with the program. Methods The program involved the use of a dietary coaching app and a wearable device for monitoring physical activity and body composition. A total of 235 employees participated in the program. App usage data were collected from a mobile platform, and a questionnaire survey on process evaluation and needs assessment was conducted during the post-test. Results The engagement level of the participants decreased over time. Participants in their 40s, high school graduates or lower education, and manufacturing workers showed higher engagement than other age groups, college graduates, and office workers, respectively. The overall satisfaction score was 3.6 out of 5. When participants were categorized into three groups according to their engagement level, the upper group was more satisfied than the lower group. A total of 71.5% of participants answered that they wanted to rejoin or recommend the program, and 71.9% answered that the program was helpful in improving their dietary habits. The most helpful components in the program were diet records and a 1:1 chat with the dietary coach from the dietary coaching app. The barriers to improving dietary habits included company dinners, special occasions, lack of time, and eating out. The workplace dietary management programs were recognized as necessary with a need score of 3.9 out of 5. Conclusions Participants were generally satisfied with the mobile health intervention program, particularly highly engaged participants. Feedback from a dietary coach was an important factor in increasing satisfaction.
Objectives This study was intended to investigate adults’ health behaviors and eating habits according to their levels of social media use. Methods From May 27 to July 11, 2022, an online survey was conducted of 452 male and female social media users in their 20s and 30s, and their eating habits and health behaviors were compared and analyzed according to their degree of social media use. For each of the three levels of food content use, the frequency of social media content use, and the total score range of average social media viewing time per day were divided into three parts, and a group with a score of less than 2 points was classified as low-use; a group with a score of 2 or more and less than 3 points was classified as middle-use; and a group with a score of 3 points or more was classified as high-use. Results The use of food content was higher in women than in men (P < 0.001), and higher in those in their 20s than in those in their 30s (P < 0.001). The group with a high level of food content use showed a higher rate of post-use hunger than the group with a low level (P < 0.01). The experience of eating after using food content was also higher in the group with a high level of use than in the group with a low level of use (P < 0.001). The group with a normal or high level of food content use had more negative eating habits than the group with a low level. Conclusions The study highlighted the need to provide desirable food content to people in their 20s and 30s with negative eating habits and to promote them so that they can use the right healthy nutrition–related content.
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Objectives The budget gap in the health sector of local governments affects the supply of health services, which can cause the health gap. This study classified local governments according to their financial characteristics, such as local financial independence and health budget level. It analyzed the health behaviors and disease prevalence of local residents to examine the effect of local government financial investment on the health of local residents. Methods To classify types according to the financial characteristics of local governments, financial independence and the health budget data for 17 local governments were collected from the local fiscal yearbook of the Ministry of Public Administration and Security. The prevalence of chronic diseases and healthy behavior was compared using the 16,333 data of adults between the ages of 30 and 65 years among the original data of the National Health and Nutrition Examination Survey (2016–2020). Results Cluster analysis was used to classify local governments into five clusters according to the health financial capacity type. A comparison of the prevalence of local residents by cluster revealed a similar prevalence of hypertension, diabetes, and hypercholesterolemia. On the other hand, the obesity rate (P < 0.01), high-risk drinking rate (P < 0.01), aerobic physical activity rate (P < 0.001), and healthy eating practice rate (P < 0.001) were significantly different. In addition, an analysis of the odds ratio based on the Seoul area revealed a higher risk of health behavior of non-Seoul residents. Conclusions It is necessary to review the universal health promotion project budget considering the degree of regional financial vulnerability from the viewpoint of health equity to narrow the health gap among regions.
Objectives This study aimed to determine whether a mobile health (mhealth) intervention is effective in reducing weight and changing dietary behavior among employees with overweight and obesity. The study also investigated whether engagement with the intervention affected its effectiveness. Methods The intervention involved the use of a dietary coaching app, a wearable device for monitoring physical activity and body composition, and a messenger app for communicating with participants and an intervention manager. A total of 235 employees were recruited for a 12-week intervention from eight workplaces in Korea. Questionnaire surveys, anthropometric measurements, and 24-h dietary recalls were conducted at baseline and after the intervention. Results After the intervention, significant decreases in the mean body weight, body mass index, body fat percentage, and waist circumference were observed. Furthermore, the consumption frequencies of multigrain rice and legumes significantly increased, whereas those of pork belly, instant noodles, processed meat, carbonated beverages, and fast food significantly decreased compared with those at baseline. The mean dietary intake of energy and most nutrients also decreased after the intervention. When the participants were categorized into three groups according to their engagement level, significant differences in anthropometric data, dietary behaviors, and energy intake were observed following the intervention, although there were no differences at baseline, indicating that higher engagement level led to greater improvements in weight loss and dietary behavior. Conclusions The intervention had positive effects on weight loss and dietary behavior changes, particularly among employees with higher engagement levels. These results indicate the importance of increasing the level of engagement in the intervention to enhance its effectiveness. The mhealth intervention is a promising model for health promotion for busy workers with limited time.
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Objectives This study examined the changes in dietary habits, the prevalence of chronic diseases, and mental health problems in the regional areas of the Republic of Korea before and after the COVID-19 pandemic to provide evidence of the status of regional health inequalities. Methods This study analyzed Korean adults aged 19 or older who participated in the Korea Community Health Survey (n = 686,708) and Consumer Behavior Survey for Foods (n = 19,109) from 2018 to 2020. The participants were classified according to their residence area (Seoul metropolitan area, Metropolitan cities, Provinces); 2018-2019 were defined as before COVID-19, and 2020 as after COVID-19. The dietary behaviors, chronic diseases, and mental health problems were measured using a self-report questionnaire. Results After COVID-19, the eating-out usage rate in the Seoul metropolitan area and Provinces decreased compared to before COVID-19 (P < 0.001), and when responding that they eat out, the frequency of eating out with household members in the Seoul metropolitan area increased (P = 0.024). The deliveries/takeout usage rate in the Provinces decreased after COVID-19 compared to before (P < 0.001). After COVID-19, the prevalence of obesity decreased in all regions (P < 0.001), and the prevalence of hypertension increased significantly in the Provinces (P = 0.015). The prevalence of diabetes mellitus increased continuously before and after COVID-19 in all regions (P < 0.002). High-risk subjective stress levels increased significantly in the Seoul metropolitan area (P < 0.001), and sleep duration significantly increased in all regions (P < 0.001). Major depressive disorder was reduced significantly in Metropolitan cities (P = 0.042) and Provinces (P < 0.001). Conclusions After the COVID-19 pandemic, the prevalence of chronic diseases and mental health problems showed regional differences along with changes in dietary habits. It is necessary to reflect the regional differences in dietary habits in future policies resolving regional health inequalities.
Objectives With an increase in the population of the elderly in Korea, their nutritional status has become a cause for concern. This study was designed to compare the nutritional intake and health status of the Korean elderly according to their body mass index. Methods The subjects were 3,274 elderly people aged 65 and above who had participated in the 2016-2018 Korea National Health and Nutrition Examination Survey. The subjects were divided into four groups: underweight, normal, overweight, and obese, based on their BMI. The general characteristics, daily energy, and nutrient intakes, nutrient intakes compared to the recommended nutrient intake, percentage of participants whose nutrient intake was lower than the estimated average requirement (EAR), index of nutrient quality, the mean adequacy ratio (MAR), intakes by food group, and health status of the four groups were compared. Results Underweight elderly people showed lower energy, lipids, dietary fiber, vitamin C, riboflavin, niacin, phosphorus, sodium, and potassium intake and MAR score (P < 0.001) compared to the normal or obese elderly. The mean protein, riboflavin, niacin, vitamin C, phosphorus, and iron intake of the underweight elderly was lower than the EAR (P < 0.05). Underweight elderly people also had a lower intake of vegetables and fats, oil and sweets food groups than the other groups (P < 0.001). The prevalence of diabetes and dyslipidemia was higher in the obese group, but the percentage of anemia was higher in the underweight group. Conclusions Underweight elderly people were vulnerable to undernutrition and were at a higher risk of anemia.
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Objectives The purpose of this study was to examine the effects of the types of nutrition labeling on the processing fluency, health evaluation and purchase intentions of home meal replacements. Methods This online experimental study was conducted from December 29 to 31, 2019 and included 134 participants. The research design was 2 (Objective nutrition labeling: present vs. absent) X 2 (Evaluative nutrition labeling: present vs. absent) and each participant was randomly assigned to one of four groups. As stimuli, five types of ready-to-heat foods sold in the market were used. Results Processing fluency (4.91 points) and purchase intention (4.13 points) were significantly high when both evaluative nutrition labeling and objective nutrition labeling were presented, and healthfulness evaluation (4.47 points) was significantly high when only evaluative nutrition labeling was presented. All three variables were measured to be high when evaluative nutrition labeling was presented. The evaluative nutrition labeling that visually represented nutritional values was found to be more effective for processing fluency, healthfulness evaluation, and purchase intention than the objective nutrition labeling representing the nutritional value of the product in numbers and proportions. Conclusions These results show that it is necessary to develop various types of evaluative nutrition labeling to enable consumers to choose and purchase healthful home meal replacements. Also, consumer education and public campaigns are needed to encourage consumers to select healthier home-cooked meals using nutrition labeling.
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Objectives This study aimed to analyze the consumption values of fast foods among American consumers and compare the consumption values according to the levels of health consciousness. Methods An online survey using a self-administered questionnaire was conducted on 351 American consumers. Based on the median health consciousness score (3.83 out of 5 points), the subjects were classified into the low health-conscious group (Low group) and the high health-conscious group (High group). Factor analysis was used to extract factors for the five consumption values (functional, social, emotional, conditional, and epistemic values).
The differences in the consumption values between the two groups were analyzed. Results A total of 14 factors were extracted for the five consumption values and 9 factors among them (convenience, healthiness, and taste in functional values; health-conscious people, young, busy, obese people, low class, and budget restricted people in social values; guilt in emotional values; accidental situations in conditional values) showed significant differences between the two groups. The Low group had a higher perception of the factor of healthiness (P < 0.001) than the High group. The High group had a relatively higher perception of the factors of convenience (P < 0.001), taste (P < 0.001), and guilt (P < 0.001). In addition, the High group perceived the social values of fast foods more negatively. The High group consumed fast foods less frequently than the Low group and perceived their health status and healthiness of eating habits more positively. Conclusions The results reveal that the health consciousness level significantly influences consumption value perceptions about fast foods in American consumers. Policymakers and marketers can develop effective strategies based on the results of this study.
Objectives This study aimed to develop evaluation criteria for the elementary-school-based health promotion program using the RE-AIM framework and to examine their feasibility. Methods Previous evaluation studies on health interventions for elementary-school students using the RE-AIM framework were reviewed systematically to identify appropriate evaluation criteria. A diet and physical activity intervention based on the transtheoretical model was implemented in a pilot study using the “Happy Me” application. The feasibility of using the RE-AIM framework to evaluate it was examined. Results The review yielded the following evaluation criteria: “reach,” the ratio of participants out of the total target population; “efficacy/effectiveness,” the difference in outcomes between the intervention and control groups, or between a pre- and post-test; “adoption,” the rate of use of the program and participation in the next stage of the program; “implementation,” the progress on the program components; “maintenance,” the participants’ and teachers’ intention to continue using the program. The pilot study reached 76.6% of the targeted population. The intake of sugar-sweetened beverages decreased (P < 0.0001), and the duration of walking increased (P < 0.0001). Other indicators could not be evaluated; therefore, potential indicators were suggested. Conclusions This study produced feasible evaluation criteria for elementary-school-based health promotion using the RE-AIM framework. Nevertheless, the feasibility needs to be validated with a broader range of studies and long-term interventions.
Objectives This study compared the nutritional intakes of early and late preterm infants in a neonatal intensive care unit (NICU) and at home. The dietary problems and the need for community care services for premature infants were further investigated. Methods This is a cross-sectional and descriptive study on 125 preterm infants and their parents (Early preterm n = 70, Late preterm n = 55). The data were collected by surveying the parents of preterm infants and from hospital medical records. Results No significant differences were obtained between the early and late preterm infant groups when considering the proportion of feeding types in the NICU and at home. Early preterm infants were fed with a greater amount of additional calories at home and had more hours of tube feeding (P = 0.022). Most preterm infants had feeding problems. However, there was no significant difference between early and late preterm infants in the mental pain of parents, sleeping, feeding, and weaning problems at home. Many parents of preterm babies had no external support, and more than half the parents required community care to take care of their preterm babies. Conclusions Regardless of the gestational age, most preterm infants have several problems with dietary intake. Our study indicates the need to establish community care services for preterm infants.
Objectives This study examined the association between dietary behaviors and perceived health status among Korean adolescents from multicultural families. Methods This cross-sectional study included 2,459 Korean adolescents from multicultural families (aged 13 ~ 18 years) who participated in the 2017 ~ 2019 Korea Youth Risk Behavior Surveys. Information on the sociodemographic variables, dietary behaviors, and lifestyle variables was selfreported using a web-based questionnaire. The dietary behaviors analyzed in this study were the breakfast and food intake frequencies, including fruit, vegetable, milk, fast food, carbonated drink, sweet drink, and high caffeine/energy drinks. The adolescents’ health perception was self-rated as healthy, average, or unhealthy. The dietary behaviors associated with health perception were examined using a multiple logistic regression after adjusting for the confounding variables. Results In this study population, 7.6% of adolescents perceived their health status as unhealthy, and 25.4% perceived it as average. The adolescents who were girls, middle school students, and in households with a low economic status showed significantly higher percentages of poor health perception (P-values < 0.001). Skipping breakfast was significantly associated with a negative health perception. Compared to the adolescents who consumed fruits every day, those who did not consume fruits during the previous week showed a higher odd ratio (OR) for a negative health perception [OR = 2.29, 95% confidence interval (CI) = 1.32–3.97]. The adolescents who frequently consumed carbonated drinks ( 5 times/week) perceived their health status as unhealthy relative to those who did not consume carbonated drinks (OR = 2.15, 95% CI = 1.25–3.71). Skipping breakfast was significantly associated with an increased OR for a negative health perception in girls but not in boys. Compared to adolescents with a normal weight, those with overweight/ obesity (OR = 1.75, 95% CI = 1.21–2.52) and underweight (OR = 2.19, 95% CI = 1.25–3.82) showed higher ORs for negative health perception. Positive associations of overweight/obesity and underweight with negative health perception were observed in boys but not in girls. Conclusions Dietary behaviors and weight status were associated with the health perception in Korean adolescents from multicultural families. These findings suggest that nutrition interventions on breakfast intake and healthy food choices for this population might effectively improve their weight and perceived health status.
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Objectives This study attempted to examine the association between health literacy and health-promoting behavior, and identify the major variables that affect the health-promoting behavior of university students. Methods This was a descriptive correlation study that identified the degree of health literacy and health-promoting behavior of 248 university students (119 male and 129 female) and examined the correlation between the two and factors influencing them. The questionnaire covering health literacy comprised 66 questions, and that for health-promoting behavior comprised 10 questions covering eating habits, 3 questions about physical activity, and 10 questions involving stress. Results The score for health literacy was 41.56 ± 18.38 out of 66 points, and that for health-promoting behavior was 65.27 ± 11.21 points (27.61 ± 6.72 points for eating habits, 7.23 ± 2.56 points for physical activity, and 30.44 ± 5.61 points for stress). Health literacy and health-promoting behavior had a significant positive correlation (r = 0.175, P < 0.01). The perceived health status (β = 0.391,P < 0.001) was the most important variable in healthpromoting behavior, followed by health literacy (β = 0.236, P < 0.001). Conclusions It is necessary to develop a systematic educational strategy and implement educational programs to improve health literacy as well as encourage health-promoting behavior and thus increase the perceived health levels of university students.
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Objectives This study was conducted to investigate the experience and perception among adult women regarding weight control and the consumption of weight-control foods or health functional foods based on their body mass index (BMI). Methods The subjects were 634 adult women from the Chungcheong province, Korea, and data were collected through a self-administered questionnaire from July 2021 through September 2021. The subjects were divided into four groups based on their BMI status: underweight (< 18.5 kg/㎡ , 7.6%), normal weight (18.5 ~ 22.9 kg/㎡ , 53.3%), overweight (23 ~ 24.9 kg/㎡ , 19.7%), and obese ( ≥ 25 kg/㎡ , 19.4%). Results Over the past 3 years, almost two-thirds (68.6%) of the adult women had tried weight control measures, despite the fact that a significant proportion of them were normal or underweight. More importantly, 57.6% of subjects reported the consumption of weightcontrol foods, with a lower proportion in the underweight (35.4%) group compared to the normal (56.2%), overweight (62.4%), and obese (65.0%) groups. The food items used for weight control were mostly salads, chicken breasts, low fat (soy) milk, slimming tea, protein shakes, low-calorie cereals, and energy/protein bars among others. In addition, one-third (31.1%) of the subjects reported the use of health functional foods containing ingredients for fat reduction. A significantly higher proportion of these was from the overweight (36.0%) and obese (38.2%) groups compared to the underweight (20.8%) and normal weight (28.1%) groups. Products containing Garcinia cambogia extract, green tea, or Cissus extract, were popular among users. Subjects who were obese had a poorer perception of their health and body. Most subjects felt the need for correct information regarding weight control, but this number was significantly more in the higher BMI groups. Conclusions Our results suggest that the use of weight-control foods or health functional foods is popular among adult women, especially those who are obese. Thus, nutrition education courses covering facts about weight control and practice need to be developed and provided based on the BMI status of subjects.
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Objectives This study aimed to develop and assess the content validity and internal consistency of a questionnaire on the feasibility of mobile dietary self-monitoring applications. Methods We developed a feasibility questionnaire to assess the overall usage, convenience, usefulness, and satisfaction of mobile dietary applications. The initial draft of the questionnaire contained 17 items with yes/no, multiple-choice, and open-ended questions and 52 items on 5-point Likert scales. To validate the content, ten experts evaluated the relevance of the items for each subscale using a 5-point scale. We calculated the item-level content validity index (I-CVI) and scale-level content validity index (S-CVI). A total of 102 adults answered the questionnaires which reflected the experts' reviews. We conducted an exploratory factor analysis to determine the underlying structure of responses and categorized convenience, usefulness, and satisfaction. We also calculated Cronbach's alpha coefficient to examine the internal consistency of items in each subscale. Results The S-CVI score of the items was 0.86, and we removed items with an I-CVI score of < 0.80. We combined, revised, or separated some remaining items and added one item as per the experts' comments. As a result, we included 16 items about overall usage and 42 sub-questions. Based on the responses of the 102 adults, we performed exploratory factor analysis using the principal axis method. We retained items with a factor loading of > 0.40, resulting in a final set of 35 questions (convenience: 15, usefulness: 12, satisfaction: 8 items). The Cronbach's alpha values of the three scales were 0.93, 0.91, and 0.91 for 1) usefulness, 2) convenience, and 3) satisfaction, respectively. Conclusions We developed a feasibility questionnaire for mobile dietary self-monitoring applications and examined its content validity and internal consistency. Our questionnaire has the potential to measure the feasibility of mobile dietary self-monitoring applications.
Objectives This study examined trends in the health status and dietary behavior changes by region using the raw data from the 2008 ~ 2019 Community Health Survey. Methods This study analyzed the data of 2,738,572 people among the raw data of the Community Health Survey from 2008 to 2019. The regional differences in health status and dietary behavior were examined by classifying the regions into capital and non-capital regions, and the non-capital regions were classified into metropolitan cities and provinces. A chi-square test was conducted on the body mass index (BMI), diagnosis of diabetes and hypertension, frequency of eating breakfast, salty taste in usual diet, recognition of nutrition labeling, reading of nutrition labeling, and utilization of nutrition labeling. Results In determining obesity using the BMI, the normal weight by year decreased, and the obesity rate by year was 34.6% in 2019, which increased by 13% compared to 2008.
In addition, the diabetes diagnosis rate and hypertension diagnosis rate continued to increase with the year. Both diabetes and hypertension diagnosis rates were higher in the non-capital regions than in the capital region. Eating breakfast five to seven times per week was most common and showed a significant decreasing trend by year (P < 0.001). The percentage of respondents who said they eat slightly bland foods increased from 19.5% in 2008 to 19.9% in 2010 and then to 22.1% in 2013. The percentage then decreased to 19.9% in 2019, but showed an overall increasing trend (P < 0.001). According to the region, the capital region had a higher percentage than the non-capital region. The nutrition labeling's recognition rate and utilization rate increased yearly, whereas the reading rate decreased. Conclusions The study results presented the primary data necessary to develop nutrition education programs and establish strategies for local nutrition management projects to improve disease prevention and dietary problems.
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Objectives This study investigated the association between the frequency and pattern of eating alone and the mental health status according to region in Korean adults. Methods The data of 10,040 Korean adults aged ≥ 19 years from the Korea National Health and Nutrition Examination Survey (KNHANES) 2017 and 2019 were used.
Participants were divided into 4 groups based on their frequency of eating alone: none (all meals together), 1, 2, and 3 meals/day alone. The regions were divided into urban and rural areas. Mental health status was assessed by stress recognition, depressive symptoms, and suicidal ideation. Multivariable logistic regressions were conducted to estimate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) on the association of the frequency and pattern of eating alone with poor mental health after controlling for covariates. Results Among Korean adults, 74.1% ate more than one meal a day alone. Individuals having 3 meals a day alone tended to be less educated, single, single person households, or living in urban areas (all P < 0.05). In rural areas, those having 3 meals/ day alone had higher odds of stress recognition (AOR: 1.55, 95% CI: 1.02-2.35) than those having all meals together. In urban areas, individuals eating alone 3 times/day had higher odds of stress recognition (AOR: 1.60, 95% CI: 1.31-1.96), depressive symptoms (AOR: 1.61, 95% CI: 1.23-2.12), and suicidal ideation (AOR: 2.14, 95% CI: 1.42-3.22) compared to those having all meals together. Urban residents having dinner alone had higher odds of depressive symptoms (AOR: 1.29, 95% CI: 1.05-1.58) and suicidal ideation (AOR: 1.66, 95% CI: 1.19-2.33) than those having dinner with others. Conclusions Our findings showed that the frequency and patterns of eating alone were differentially associated with increased odds of poor mental health according to region of residence. Nutrition education is needed for those frequently eating alone, particularly those living in urban areas, to highlight the advantages of eating together and to ensure that they have balanced and healthy meals even if they eat alone.
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Objectives The purpose of this study was to analyse the relationship between eating behaviour and healthy dietary competency of single and multi-person households, to improve healthy eating behavior. Methods This study was conducted on 6,355 adult household members who participated in the Food Consumption Behavior Survey 2020. The subjects were divided into age groups comprising young people in their 20s and 30s, middle-aged people in their 40s and 50s, and the elderly in their 60s and above. The eating behavior and healthy dietary competency of single-person and multi-person households were then analyzed. Results The average age of the members in the single-person households was found to be higher. Single-person households were also found to have a lower marriage rate and lower monthly household income than multi-person households across the age groups of young, middle-aged, and elderly people (P < 0.05). Among each of the age groups, single-person households had significantly higher rates of skipping breakfast and eating breakfast, lunch, and dinner alone than multi-person households (P < 0.05). Young single-person households had lower average scores on healthy dietary competency than multi-person households (P = 0.032). When adjusted for age, gender, marriage, education, occupation, and household income, single-person households had a higher risk of delivery/take-out, eating out, or skipping meals compared to multi-person households (P < 0.05). In multi-person households, the risk of skipping meals, eating alone, eating out, or delivery/take-out decreased as healthy dietary competency improved (P< 0.05). On the other hand, in single-person households, as healthy dietary competency increased, the risk of delivery/take-out or eating alone decreased (P< 0.05). Conclusions The results of this study suggest that healthy dietary competency and eating practices can be improved by providing customized dietary education by age group for single and multi-person households.
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Objectives This study aimed to investigate the changes in the eating habits and lifestyle of middle-aged women in Gwangju during the COVID-19 pandemic.
Methods: A total of 428 middle-aged women aged between 40 and 60 participated in a survey relating to general information, food and lifestyle, health functional food, and menopausal symptoms. The correlation between the variables was analyzed.
Results: In the positive habits, the intake of nutritional supplements for immunity enhancement increased the most, followed by the use of media to learn healthy eating tips, and diets including healthy food. Negative habits increased in the order of frequency of taking delivery orders, levels of stress or anxiety, and time spent sitting or watching movies. In the case of recommended foods, the intake increased the most in the order of eggs, fruits, vegetables, milk/dairy products, and seaweed. Non-recommended foods increased in the order of meat, bread, rice, and noodles. The awareness of health functional foods was in the increasing order of interest, knowledge, consumption experience, and purchase amount. The type of health functional food intake was in the increasing order of probiotics, multivitamin and mineral supplements, vitamin C, collagen, and omega-3. Menopausal symptoms were in the increasing order of bone and joint pain, poor sleep quality, emotional ups and downs, loneliness, and feeling of emptiness. In the correlation of major variables, positive habits showed a significant positive correlation with recommended food intake and the recognition of health functional foods. Negative habits showed a significant positive correlation with non-recommended food intake and a significant positive correlation with menopausal symptoms. Recommended food intake showed a significant positive correlation with health functional food recognition and intake and menopausal symptoms.
Conclusions: This study suggests that it is necessary to establish social measures to reduce the negative effects of the COVID-19 pandemic on middle-aged women and to ensure effective self-management through a healthy lifestyle since the pandemic has a long-term impact.
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Objectives This study investigated the different perceptions of customers toward traditional and non-traditional fast-food restaurants regarding restaurant healthfulness, corporate reputation, and the impact of corporate reputation on loyalty intentions through corporate social responsibility (CSR) motive. Methods An online survey was conducted on U.S. residents who were aware of fast food restaurants’ CSR activities. Participants selected one fast food restaurant participating in CSR activities, coded as either traditional (n = 117) or non-traditional (n = 48), and answered questions about the selected restaurant’s healthfulness, reputation, CSR motives, and loyalty intentions. The participants’ perceptions of healthfulness and corporate reputation of the two types of fast-food restaurants were compared. A mediation path of corporate reputation – CSR motive – loyalty intention was analyzed. Results Non-traditional fast-food restaurants (5.02 ± 1.26) were perceived to be more healthful than traditional ones (3.93 ± 1.72). The participants perceived that compared to traditional fastfood restaurants, non-traditional ones had a better overall corporate reputation (P = 0.037), were more concerned about their customers (P = 0.029), better workplaces (P = 0.007), more environmentally and socially responsible (P < 0.001), and offered higher quality products and services (P = 0.042). Significant positive correlations were shown between restaurant healthfulness and corporate reputation (P < 0.001 for all reputation items). The suggested mediation path was supported with 95% CIs excluding zero, implying that when fast-food restaurants had a better reputation overall, were customer oriented, good employers, strong companies with a good product and service quality, social and environmental responsibility, the participants were more likely to perceive their CSR activities to be sincere and were hence loyal to that restaurant. Conclusions Overall, participants were more favorable towards non-traditional fast-food restaurants which had a healthier image and better reputation than traditional ones. Therefore, fast food restaurants need to consider offering healthy food and enhance their image, which would maximize the return on their investment in CSR.
Objectives Driven by a growth of single-person households and individualized lifestyles, solo dining in restaurants is an increasingly recognizable trend. However, a research gap exists in the comparison of solo and group diners’ menu-decision making processes. Based on the self-control dilemma and the temporal construal theory as a theoretical framework, this study compared the ordering intentions of solo vs. group diners with healthy vs. indulgent (less healthy) entrées. The mediating role of consumption orientation and the moderating role of amount of menu nutrition information were further explored to understand the mechanism and a boundary condition. Methods A scenario-based online survey was developed using a 2 (dining social context: solo vs. with others) × 3 (amount of menu nutrition information: no nutrition information vs. calories vs. calories/fat/sodium), between-subjects, experimental design. Consumers’ level of nutrition involvement was controlled. A nationwide survey data (n = 224) were collected from a crowdsourcing platform in the U.S. Data were analyzed using multivariate analysis of covariance, independent t-test, univariate analysis of covariance, and moderated mediation analyses. Results Findings reveal that solo (vs. group) diners have less (vs. more) intentions to order indulgent menu items due to a more utilitarian (vs. more hedonic) consumption orientation in restaurant dining. Findings also show that solo (vs. group) diners have more (vs. less) intentions to order healthy menu items when the restaurant menu presented nutrition information including calories, fat, and sodium. Conclusions The findings contribute to the literature of foodservice management, healthy eating, and consumer behavior by revealing a mechanism and an external stimuli of solo vs.
group diners’ healthy menu-decision making process in restaurants. Furthermore, the findings provide restauranteurs and health professionals with insights into the positive and negative impacts of menu nutrition labelling on consumers’ menu-decisions.
Objectives This study was conducted to investigate the relationship between watching Mukbang (eating broadcasts) and dietary and health behavior in adults who watch Mukbang Methods: The questionnaire was administered on a self-written basis through online and offline formats to 800 adults (400 men and 400 women). The contents of the survey consisted of general characteristics, Mukbang viewing time per week, breakfast intake frequency, preference for menus when viewing Mukbang , delivery food intake frequency per week, late meal intake frequency per week, and health behavior. The subjects were divided into three groups according to Mukbang viewing time. Results The body weight of viewers was significantly higher whenMukbang viewing time was over 14 hours for both men and women. In particular, based on the BMI (body mass index), those who watched Mukbang for more than 14 hours were found to be overweight. People with more than 14 hours of Mukbang viewing time per week were found to prefer mostly carbohydrate-rich food and meat, while those with less than 7 hours of Mukbang viewing time per week showed a higher preference for vegetables and fruits. An analysis of the frequency of breakfast eaten showed that the rate of skipping breakfast was the highest for those who watched Mukbang for more than 14 hours per week, and the rate of eating breakfast daily was the highest in the case of fewer than 7 hours of viewing. In the case of high Mukbang viewing time per week, the frequency of food delivery and night eating was high. When Mukbang viewing time was high, the viewer’s interest in health was low and the frequency of exercising too was low. Conclusions Viewers with high Mukbang viewing time showed undesirable health and eating behavior. Thus, it is believed that proper nutrition education on improving eating habits and raising the awareness of correct eating habits is necessary for such viewers.
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Objectives This study evaluated the dietary habits and health behaviors of Korean adults according to their physical activity.
Methods: Adults aged 19~64 years, who participated in the 2016~2018 National Health and Nutrition Examination Survey, were enrolled in this study. The subjects were classified into the physical inactivity group, aerobic physical activity group, strength exercise group, and combined exercise group.
Results: Significant differences in skipping breakfast, frequency of eating out, dietary supplements, and alcohol drinking status were observed among physical activity groups (P < 0.001). The combined exercise group had the highest % KDRI of protein, vitamin A, thiamin, riboflavin, niacin, calcium, potassium, and iron (P < 0.001). The physical inactivity group had the highest obesity rate (35.1%), and they perceived their body image type to be obese. In the combined exercise group, 47.8% of respondents said they were in good health (P < 0.001). The health-related quality of life score of the physical inactivity group was the lowest, with a score of 0.94. The metabolic syndrome risk rate of the combined exercise group was lower at 0.62 times (95% CI, 0.51-0.75) than the physical inactivity group.
Conclusions: The physical activity type was associated with metabolic syndrome.
These results can be useful for supporting dietary education and physical activity programs for adults.
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Objectives The purpose of this study was to discover the changes in obesity prevalence and dietary habits in Korean adults residing in various residential areas during the last 10 years.
Methods: Data on Korean adults aged 19 years and above was obtained from the 4th (2007-2009) and the 7th (2016-2018) Korea National Health and Nutrition Examination Survey. The subjects were classified into metropolitan 4th : n=5,977, 7th : n=6,651), urban (4th : n=4,511, 7th : n=5,512) and rural (4th : n=3,566, 7th : n=2,570) based on their residence. The general characteristics, nutrient intake, intake amount, food groups, and healthy dietary factors were analyzed. The association between residential areas and obesity prevalence were analyzed by multiple logistic regression.
Results: In urban and rural areas, the obesity rate increased in the 7th survey compared to the 4th survey, excluding the metropolitan area. The carbohydrate intake decreased, and lipid intake increased in the 7th survey compared to the 4th survey. Over the same period, the intake of cereals and vegetables decreased, and the intake of meat and processed foods increased. Rural residents had a higher intake of cereals and vegetables, and a lower intake of milk and processed foods than those in metropolitan areas and urban residents. The proportion of subjects who practiced a healthy diet increased in the 7th survey compared to the 4th survey. In the 4th survey, there was no relationship seen between the prevalence of obesity and the subject’s residential area, but in the 7th survey, the odds ratio of obesity was higher in rural areas than in the metropolitan areas, confirming the regional gap (OR: 1.16, 95% CI=1.00-1.36, p=0.044).
Conclusions: This study showed that the obesity prevalence increased in rural residents compared to metropolitan residents, indicating a gap between the regions. The nutrient intake and intake of food groups changed in the 10 years under consideration, and there were differences seen between regions. Therefore, it is necessary to formulate a policy that will reduce obesity prevalence and health inequalities between regions.
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Objectives This study sought to assess the prevalence and duration of weight-control or health functional food use, associated weight-control behavior, perception, and knowledge among university students.
Methods: The subjects were 442 university students in Cheonju, Korea, and data was collected by a self-administered questionnaire. Both X2 and t-tests were conducted for categorical and mean comparisons.
Results: An estimated 62.7% (female 69.0%, male 54.8%) had ever attempted weightcontrol. Among these, an estimated 59.2% of females and 38.9% of males had used weight-control or health functional foods with significant gender difference. The weightcontrol foods commonly used included chicken breast, protein powder, low-fat milk and soymilk, and meal replacement drinks, while garcinia cambogia extract and green tea extract were frequently used as health functional foods. One of 10 (10.3%) consumers of weight-control foods reported ≥ 7 months use, with less frequent long-term consumption of health functional foods (4.2%). The average degree of satisfaction was 3.24 ± 0.92 for weight-control foods and 2.72 ± 0.97 for health functional foods on a 5-point scale, meaning ‘slightly satisfied’ and ‘slightly dissatisfied’, respectively. Females or students with an experience of weight-control reported poorer perceptions of their health and body image as well as a higher need for weight control. Besides, both male and female subjects felt a high need for correct information regarding weight-control methods.
Conclusions: Our results provide a better understanding of the characteristics associated with the use of weight-control or health functional foods among university students and will be useful in developing a nutrition education program by incorporating correct body image, knowledge, and practical yet desirable practices for weight control.
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Objectives A cross-sectional study was conducted to investigate the associations between food groups and hearing loss.
Methods: Data of 1,312 individuals were used from the Korea National Health and Nutrition Examination Survey 2013. Hearing loss was determined with a pure tone average (PTA) of greater than 25 dB in either ear. The PTA was measured as the average hearing threshold at speech frequencies of 0.5, 1, 2, and 4 kHz. The dietary intake was examined with a food frequency questionnaire with 112 food items. The food items were classified into 25 food groups. A weighted logistic regression was used to investigate the association.
Results: Individuals in the highest tertile of vegetables and nuts food groups were less likely to have hearing loss than those in the lowest tertile [Odds Ratio (OR) = 0.58 (95% Confidence interval (CI) 0.38-0.91), P = 0.019; OR = 0.59 (95% CI 0.39-0.90), P = 0.020, respectively], after adjusting for confounding variables of age, sex, body mass index, drinking, smoking, diabetes, hypertension, and physical activity.
Conclusions: In this cross-sectional study, we observed that high intake of vegetables and nuts food groups revealed significant inverse associations with hearing loss, after adjusting for confounding variables among 1,312 participants.