Korean Journal of Community Nutrition

Research Articles

[English]
Regional differences in protein intake and protein sources of Korean older adults and their association with metabolic syndrome using the 2016–2019 Korea National Health and Nutrition Examination Surveys: a cross-sectional study: You-Sin Lee, Yoonna Lee; Korean J Community Nutr 2024;29(3):173-188. Published online June 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.3.173

Abstract PDF PubReader ePub: Objectives
The study aim was to analyze the regional differences in dietary protein intake and protein sources of Korean older adults and their association with metabolic syndrome.
Methods
Study participants were 1,721 older adults aged 65 and over who participated in 2016–2019 Korea National Health and Nutrition Examination Survey. Using 24-hour recall dietary intake data, protein intake and their food sources were examined. The association between protein intake and metabolic syndrome, obesity, and abdominal obesity were analyzed by multiple logistic regression.
Results
Total protein and animal protein intakes were higher in urban area (60.0 g, 24.4 g, respectively) than in rural area (54.6 g, 19.6 g, respectively). With increase of protein intake level, animal to total protein proportion was increased in both areas. Total protein and plant protein intake was negatively associated with the risk of obesity, abdominal obesity in both areas. Animal protein intake was negatively associated with the risk of obesity in both areas, and with abdominal obesity only in urban area. In urban area, plant protein intake was also negatively associated with the risks of metabolic syndrome, elevated triglyceride, and reduced high density lipoprotein-cholesterol. In urban area, the risk of metabolic syndrome was decreased when their protein intake was more than 0.91 g/kg and was lowest when their protein intake was more than 1.5 g/kg (P for trend < 0.001).
Conclusions
Korean older adults showed inadequate protein intake and those in rural area showed lower animal protein intake than in urban area. The risk of obesity and metabolic syndrome was decreased with the increase of protein intake level. These findings may help develop effective nutrition support strategy for older adults to reduce regional health disparity.

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[Korean]
Changes in nutritional status of Korean older adults during COVID-19 Pandemic by household income and demographic factors -using the Korea National Health and Nutrition Examination Survey(2019-2020): a cross-sectional study: You-Sin Lee, Yoonna Lee; Korean J Community Nutr 2023;28(4):302-316. Published online August 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.4.302

Objectives
The study aim was to identify changes in the nutritional status of older adults during the COVID-19 pandemic according to household income and demographic characteristics.
Methods
Study participants were 2,408 adults aged 65 and over who participated in the 2019–2020 Korea National Health and Nutrition Examination Survey (KNHANES). To examine changes in nutrient intake levels resulting from COVID-19, data of 2019 and of 2020 were compared. Study participants were divided into three groups based on household income level to compare these changes. The changes were compared according to household income level, age group, and household type.
Results
Percentages of recommended intakes for energy, protein, and most micronutrients were the lowest for the low-income group of both males and females in 2020. The Mean Adequacy Ratio (MAR) score was the lowest for the low-income group in both years. When comparing nutrient density for 2019 and 2020 by income group, the male low-income group experienced a decrease in nutrient densities of vitamin A, thiamine, calcium, and iron. For the same group, a decreased percentage for energy intake from protein was noted. Fruit intake was lowest in the low-income group for both males and females. Low-income males had the lowest intake levels for meat, fish, eggs, and legumes in both 2019 and 2020 and the lowest milk and milk product intake levels in 2020. Older adults living alone or single older adults with children had lower MAR scores than those living with a spouse. Older adults living alone experienced decreases in energy and thiamine and iron intake levels in 2020 compared to their intake levels in 2019.
Conclusions
Because of the COVID-19 pandemic, nutrition intake levels worsened for older adult males in the low-income group and older adults living alone. This finding shows the need for a more systematic nutritional support strategy for the vulnerable older adults population in national disaster situations.

Citations

Citations to this article as recorded by

Development of Protein Enhanced Diet for Socially Vulnerable Elderly
Jihye Hong, Hyung-Geun Jeon, Seulgi Kim, Gitae Park
Journal of the East Asian Society of Dietary Life.2024; 34(1): 39. CrossRef

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[English]
Qualitative Study on the Perception of Community Food-accessibility Environment among Urban Older Adults: Narae Yang, Kirang Kim; Korean J Community Nutr 2020;25(2):137-149. Published online April 30, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.2.137

Abstract PDF

Objectives
This study explored the community food environmental factors affecting food purchasing using a qualitative research methodology for the elderly as well as the various food environments under their socioeconomic diversity.
Methods
For the qualitative data collection, this study interviewed 20 elderly people aged 65 years or more, who participated in a public health program or lunch services operated by the senior welfare center in Seoul. Five dimensions, such as availability, physical accessibility, affordability, acceptability, and accommodation suggested in previous studies, were used to identify the community food environmental factors.
Results
The elderly participants showed overall similarities to the concepts derived from existing studies on the five dimensions of food accessibility environment. In addition, other important food accessibility environmental factors that were not present in previous studies, such as acceptability for a product of domestic origin, delivery service to home, and small-packaged food sales, were derived. On the other hand, the concept of some subjects differed depending on the household income and specifically for the physical accessibility concept. This showed that the close distance factor from a grocery store at home might not apply to older adults in low-income households in Korea.
Conclusions
This study found that five dimensions of the food environment suggested by previous studies could also be applied to vulnerable older adults in Korea. On the other hand, the socioeconomic characteristics of individuals and households would affect the perspectives of their local food environments differently. The findings of this study could help in the development of tools for evaluating the community food environment.

Citations

Citations to this article as recorded by

Spatial Disparity of Neighborhood Food Environment by Socioeconomic Status: Application of Urban Network Analysis
Taekyung Seong, Sugie Lee
Land.2024; 13(6): 865. CrossRef
Development and Validation of a Perceived Community Food Accessibility Measurement Questionnaire for Korean Older Adults
Jisoo Hong, Narae Yang, Kirang Kim
Nutrients.2023; 15(19): 4301. CrossRef
A relationship between food environment and food insecurity in households with immigrant women residing in the Seoul metropolitan area
Sung-Min Yook, Ji-Yun Hwang
Journal of Nutrition and Health.2023; 56(3): 264. CrossRef
Regional Difference in the Effect of Food Accessibility and Affordability on Vegetable and Fruit Acquisition and Healthy Eating Behaviors for Older Adults
Dong Eun Lee, Kirang Kim
International Journal of Environmental Research and Public Health.2022; 19(22): 14973. CrossRef
Analysis of Accessibility Changes to Neighborhood Food Environment and Food Desert Phenomenon in Seoul, Korea : Focused on the High-density Areas of Low-income Older Adults
Taekyung Seong, Sugie Lee
Journal of Korea Planning Association.2021; 56(1): 137. CrossRef
Effects of Perceived Food Store Environment on Malnutrition and Frailty among the Food-Insecure Elderly in a Metropolitan City
Yu-Mi Kim, Narae Yang, Kirang Kim
Nutrients.2021; 13(7): 2392. CrossRef
Analyzing Socio-Economic and Geographical Factors that Affect the Health of the Elderly
Zacharias Dermatis, Athina Lazakidou, Athanasios Anastasiou, Panagiotis Liargovas
Journal of the Knowledge Economy.2021; 12(4): 1925. CrossRef
Analysis of Awareness, Knowledge, and Behavior about Food Hygiene·Safety Among the elderly
Mi Sook Lee, Sim-Yeol Lee
Korean Journal of Community Nutrition.2021; 26(3): 200. CrossRef
Nutritional Status according to the Frailty Status of the Elderly at Home in Seo-gu, Gwangju, Korea
Ye Eun Kim, Young-Ran Heo
Korean Journal of Community Nutrition.2021; 26(5): 382. CrossRef

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Original Articles

[English]
Investigation on Influencing Environmental Factors on Health Status of Korean Septuagenarians Dwelling in Longevity Region in Jeonla Province: Chung Shil Kwak, Miyong Yon, Mee Sook Lee, Se In Oh, Sang Chul Park; Korean J Community Nutr 2014;19(2):142-162. Published online April 30, 2014; DOI: https://doi.org/10.5720/kjcn.2014.19.2.142

Abstract PDF PubReader

OBJECTIVES
To evaluate the critical environmental factors on healthy-aging of Korean people, we investigated the significant factors influencing health status of septuagenarians living in rural area of Jeonla province, known to be one of the representative longevity regions in Korea.
METHODS
We divided subjects into healthy group (36M/25F) or poor-health group (26M/73F) based on self-reported health status, body mass index, a number of prescription, and blood test data. General characteristics, physical measurements, lifestyle, dietary behavior and nutrient intake, physical health and mental health data were statistically compared between the two groups.
RESULTS
Average age was not different between healthy group and poor-health group in men and women, respectively. In men, significantly favorable factors to health were observed to be higher education, regular exercise, higher grip strength and walking function, body mass index (> or = 18.5 kg/m2), moderate frequency of drinking and eating-out, non-smoking, normal red blood cell (RBC) count, higher serum dehydroepiandrosterone-sulfate (DHEAS) level, good digestive function and appetite, normal hearing function, regular meals, adequate vegetable and fruit intake, diverse food intake, adequate energy and nutrients (protein, vitamin B1, B6, C and E, folate, niacin, P, Zn and K) intake, higher mini-nutrient status assessment (MNA) score and low level of depression. On the other hand, in women, those were literacy, living arrangement, moderate frequency of drinking, healthy teeth, higher grip strength and walking function, bone mineral density, normal RBC and white blood cell (WBC) count, higher DHEAS concentration, higher MNA score, normal cognition and memory function, having snack and adequate fruit intake.
CONCLUSIONS
These results could be useful to plan effective strategies to increase health-life expectancy of Korean old people living in rural areas.

Citations

Citations to this article as recorded by

Development and Validation of the Yonsei Lifestyle Profile-Satisfaction (YLP-S) Using the Rasch Measurement Model
Kang-Hyun Park, Ickpyo Hong, Ji-Hyuk Park
INQUIRY: The Journal of Health Care Organization, Provision, and Financing.2021; 58: 004695802110176. CrossRef
Comparative analysis of dietary behavior and nutrient intake of elderly in urban and rural areas for development of “Village Lunch Table” program: Based on 2014 Korea National Health and Nutrition Examination Survey data
Youngmi Lee, Yourim Choi, Hae Ryun Park, Kyung Hee Song, Kyung Eun Lee, Chang Hee Yoo, Young Suk Lim
Journal of Nutrition and Health.2017; 50(2): 171. CrossRef
A Study on the Body Composition, Physical Activity Level, Basal Metabolic Rate, and Daily Energy Expenditure of Elderly in Busan
Hwa-Jae Lim
Korean Journal of Community Nutrition.2016; 21(2): 178. CrossRef
The Comparative Analysis of Health Risk Factor according to HbA1c Level of Elderly Women Dwelling in Jeonla Province - Blood Health Status, Food Habit and Nutrient Intake -
Se In Oh, Chung Shil Kwak, Mee Sook Lee
The Korean Journal of Food And Nutrition.2016; 29(3): 392. CrossRef
Changes in the Nutrition Status of Elderly Females in Health Promotion Programs of Health Centers in Chungbuk Province
Myoung-Sook Kim
The Korean Journal of Community Living Science.2015; 26(2): 225. CrossRef
A Study on the Blood Health Status and Nutrient Intake in Elderly Women Dwelling in Longevity Region in Jeonla Province according to Family Arrangement
Se In Oh, Chung Shil Kwak, Miyong Yon, Mee Sook Lee
The Korean Journal of Food And Nutrition.2014; 27(5): 940. CrossRef

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[English]
Associations between Serum 25-hydroxyvitamin D and Consumption Frequencies of Vitamin D Rich Foods in Korean Adults and Older Adults: Areum Yu, Jihye Kim, Oran Kwon, Se Young Oh, Junghyun Kim, Yoon Jung Yang; Korean J Community Nutr 2014;19(2):122-132. Published online April 30, 2014; DOI: https://doi.org/10.5720/kjcn.2014.19.2.122

Abstract PDF PubReader

OBJECTIVES
This study was conducted to investigate the vitamin D status and to determine the association between serum 25-hydroxyvitamin D [25(OH)D] concentrations and consumption frequencies of vitamin D rich foods in Korean adults and older adults.
METHODS
Subjects were 10,374 adults and 2,792 older adults participating in the 2008-2009 Korea National Health and Nutrition Examination Survey (KNHANES). Consumption frequencies of vitamin D rich foods were estimated by using a qualitative food frequency questionnaire (FFQ). Eleven food items such as beef, egg, mackerel, tuna, yellow corvina, pollack, anchovy, mushroom, milk, yogurt, and ice cream were selected as vitamin D rich foods based on previous research.
RESULTS
The proportions of deficiency (< 12 ng/mL), inadequacy (12-20 ng/mL) and sufficiency (> or = 20 ng/mL) of serum 25(OH)D concentrations from June to November and December to May in adults were 8.8%, 42.3%, 48.8%, and 28.2%, 52.8%, 19.1%, respectively. The proportions of deficiency, inadequacy and sufficiency of serum 25 (OH)D concentrations from June to November and December to May in older adults were 10.1%, 32.4%, 57.5%, and 24.1%, 45.4%, 30.5%, respectively. The mean serum 25(OH)D concentrations in adults were positively related to the consumption frequencies of mackerel, anchovy, all fish, milk and milk.dairy products. The mean serum 25(OH)D concentrations in older adults were positively related to the consumption frequencies of yellow corvina and negatively related to the consumption frequencies of ice cream.
CONCLUSIONS
Our results suggest that Korean adults were more deficient in serum 25(OH)D concentrations than older adults. The consumption of vitamin D rich foods may affect vitamin D status in Korean adults. Further studies are required to confirm these findings.

Citations

Citations to this article as recorded by

Estimated dietary vitamin D intake and major vitamin D food sources of Koreans: based on the Korea National Health and Nutrition Examination Survey 2016–2019
Ki Nam Kim, Jung-Sug Lee, Jee-Seon Shim, Mi Ock Yoon, Hyun Sook Lee
Nutrition Research and Practice.2023; 17(3): 451. CrossRef
Impacts of serum vitamin D levels on sleep and daytime sleepiness according to working conditions
Hyuk Joo Lee, Hayun Choi, In-Young Yoon
Journal of Clinical Sleep Medicine.2020; 16(7): 1045. CrossRef
Serum 25-hydroxyvitamin D and cognitive function in Korean older adults living in rural area
Ye Som Shin, Bo Youl Choi, Mi Kyung Kim, Yoon Jung Yang
Journal of Nutrition and Health.2019; 52(5): 465. CrossRef
Vitamin D intake, serum 25OHD, and bone mineral density of Korean adults: Based on the Korea National Health and Nutrition Examination Survey (KNHANES, 2011)
Mi-Yeon Kim, Mi-Ja Kim, Sun Yung Ly
Journal of Nutrition and Health.2016; 49(6): 437. CrossRef
Relationship of vitamin D status and obesity index in Korean women
Ji-Young Park, Young-Ran Heo
Journal of Nutrition and Health.2016; 49(1): 28. CrossRef
The relationship between Physical Growth and Major Sources of Serum Vitamin D among Hospitalized Children of Changwon City
Haeyoung Kang, Eunsil Her, Kyung-Hea Lee
Korean Journal of Community Nutrition.2015; 20(3): 197. CrossRef

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[English]
Clients' Handling and Consumption of Home-delivered Meals at Home and Their Perceptions on Home-Delivered Meal Services for Older Adults: Jung Yeon Park, Kyung Eun Lee, Na Young Yi, Tong Kyung Kwak; Korean J Community Nutr 2010;15(3):379-392. Published online June 30, 2010

Abstract PDF: The purposes of this study were to investigate recipients' handling and consumption of home-delivered meals at home and to assess their perceptions on home-delivered meal services for older adults. A total of 312 elderly people who received home-delivered foodservice were surveyed using an individual interview technique. A statistical data analysis was completed using SPSS (ver. 14.0). It was found that 90.2% (n = 166) of the lunch box recipients received services for six days per week, and 76.6% (n = 95) of the side-dish recipients got services once per week. More than half of the clients reported that they cooked meals by themselves on days when meals were not delivered. The two hundred thirty-two (75.3%) ate their meals as soon as they were delivered. It was found that 66.8% of the lunch box recipients and 7.3% of the side-dish recipients left delivered meals on the counter (at room temperatures) before eating. Only 11.4% of the lunch box recipients and 48.4% of the side-dish recipients kept delivered meals in the refrigerator before eating. Less than half of the lunch box recipients consumed all foods they were served at once. The reasons the recipients did not eat their all meals delivered at once were "saving for next meals" and "big portion size". Of those clients who left delivered meals, 19% of the lunch box recipients and 9.7% of the side-dish recipients ate leftovers without reheating. An average score of quality of delivered meal services was 3.5 out of 5 points. The results suggest that the clients of the home-delivered meal service should be provided information on proper handling and consumption practices with delivered meals at home. The findings of the study will be used to develop nutrition and food safety management guidelines for senior foodservice.

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[English]
Evaluation of Nutrition Education for Diabetes Mellitus Management of Older Adults: Hyun Joo Kang, Eun Mi Shin, Kyung Won Kim; Korean J Community Nutr 2009;14(6):734-745. Published online December 31, 2009

Abstract PDF: Diabetes mellitus is the prevalent disease among older adults. The purpose of this study was to implement and evaluate the nutrition education program for diabetes mellitus patients aged 60 and over. The one group pretest and posttest design was employed to evaluate the program effectiveness. Nutrition education program for diabetes mellitus patients was carried out at the public healthy center in Guri city. The 38 out of 63 patients completed education program. They received four sessions of group education during four weeks. Nutrition education materials (booklet, leaflet) for older adults were provided to participants. Data about blood glucose, blood pressure, nutrition and diabetes mellitus knowledge, dietary behavior, dietary intake by 24-hour recalls were collected before and after nutrition education to evaluate the program effectiveness. All data were statistically analyzed using SAS package (ver.8.2) and significant difference was evaluated by chi-square-test, paired t-test and Wilcoxon signed rank test. Study results showed that blood pressure and blood glucose were slightly decreased after nutrition education but they did not reach statistical significance. There were positive changes in nutrition knowledge and dietary behavior. The total score of nutrition and diabetes knowledge increased significantly (p < 0.001), and the total score of dietary behavior was improved (p < 0.05) after nutrition education. Dietary intakes of most of nutrients examined were not significantly different between preand post-test. Based on study results, it appears that nutrition education program for the aged diabetes mellitus patients might effectively increase nutrition knowledge, dietary behavior and diet quality. This nutrition education program can be used at the public health centers or senior centers for the management of diabetes mellitus for older adults.

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[English]
Development of Nutrition Education Materials for Healthy Aging: Yun Ahn, Kyung A Kim, Hyunjoo Kang, Kyungwon Kim; Korean J Community Nutr 2006;11(6):740-749. Published online December 31, 2006

Abstract PDF: The objective of this study was to develop nutrition education materials for older adults, 'nutritional management for healthy aging'. A booklet and four leaflets were developed based on lesson plans. Topics of the lesson plans included eating habit assessment, Korean food guide pyramid, meal planning, eating sensibly and weight management. The titles of the leaflets were 'Eating right for healthy aging', 'Eat calcium-rich foods', 'Enjoy fruits & vegetables' and 'Weight management'. Illustrations and icons appropriate to the texts were designed using Illustrator 9.0 and Photoshop 6.0. Booklet (letter size, 5 chapters, 44 pages) and leaflets (B4 size, 6 sections) focused on modifying undesirable eating habits, providing practical tips for desirable behaviors, and behavioral modification such as recording in a food diary, goal setting and increasing self-efficacy. The drafts were pilot-tested by interviews with older adults(n=10), and minor changes were made. The characteristics of revised materials are as follows; i) materials focused on providing desirable eating behaviors for healthy aging, ii) messages were simple and specific, iii) large fonts(13 pt) were used and materials included interesting pictures and illustrations, iv) materials provided tips for balanced diets and recipes for older adults, v) materials included sections for participation of learners including assessment of nutritional risk factors and obesity, meal planning and games. The revised materials are self-explanatory and can be used by older adults and in nutrition education for older adults.

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[English]
Perception of Foodservice Quality Attributes of Older Adults: Compared by Lifestyle and Dining Frequency in Continuing Care Retirement Communities: Sunhee Seo; Korean J Community Nutr 2006;11(2):261-270. Published online April 30, 2006

Abstract PDF: The purpose of this study was to identify the differences of older adults' perceptions of foodservice quality attributes of current offerings in Continuing Care Retirement Communities (CCRCs) in terms of their lifestyles (length of residency, special diet, housing option, travel frequency, dine out frequency), dining frequency, and demographics in the dining room of CCRCs. The survey was administered to residents in three CCRCs. Data was analyzed for 140 surveys using t-test, ANOVA, and factor analysis. This study found female older adults perceived the following attributes were more important than male ones: presentation of food, color and garnish, texture of vegetables, taste and flavor of food, and respectful attitude of serving staff. Older adults who have a special diet perceived the seasoning and bite sized pieces were more important than those who have a general diet. Also, there were significant differences between frequent visitors and occasional visitors in the dining room of CCRCs. By knowing the differences by residents' demographics and residential characteristics, the foodservice manager can establish strategies to increase the dining frequency of residents in the dining rooms of CCRCs.

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