Korean Journal of Community Nutrition

Research Article

[English]
Sodium Reduction Practice and Importance-Performance Analysis of Sodium Reduction Methods in School Foodservice in Daegu: Su-Hyeon Kim, Eun-Kyung Shin, Yeon-Kyung Lee; Korean J Community Nutr 2020;25(5):386-395. Published online October 31, 2020; DOI: https://doi.org/10.5720/kjcn.2020.25.5.386

Objectives
The aim of this study was to investigate sodium reduction practices in school foodservice in Daegu. Methods The survey included 199 nutrition teachers and dietitians working at elementary, middle and high schools in Daegu. The survey topics included the following: the frequency of salinity measurement, workers in charge of the measurement, average salinity of the soup and stew served, frequency and difficulties of offering low-sodium meals, Importance-Performance Analysis (IPA) of sodium reduction methods in school foodservice and the need for political support in encouraging sodium reduction. Results The mean salinity of the soup and stew was higher in high school foodservice than in elementary and middle school foodservice. Middle and high schools have difficulties in offering low-sodium meals due to concerns of decreasing satisfaction for the meals. The results of the IPA of programs to reduce sodium in school meals showed that most of the items in the cooking and serving stages were in the 2nd quadrant (Keep up the good work), and all purchasing and menu planning stages occupied the 3rd quadrant (Low priority). To reduce sodium in school meals, government support is required in developing low-sodium recipes for school foodservice, encouraging education on sodium reduction for school foodservice officials and developing low-sodium food for institutional foodservice. Conclusions To encourage sodium reduction in school meals, the priority is to make low-sodium recipes available. Also, it is necessary to develop a program that calculates the sodium content in menus and processed foods through National Education Information System and to establish standards for sodium levels in school foodservice.

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충북지역 중등학생의 건강식생활 관련 식행동과 영양관리 정책에 대한 인식
은서 고, 영은 이
Korean Journal of Food and Cookery Science.2023; 39(3): 197. CrossRef
Importance-performance analysis of sodium reduction practices by school nutrition teachers and dietitians in the Republic of Korea
Youngmi Lee, Sooyoun Kwon, Meeyoung Kim
Nutrition Research and Practice.2023; 17(4): 812. CrossRef
Comparison of Sodium Reduction Practice and Estimated Sodium Intake by Salty Food Preference on Employees and Customers of Sodium Reduction Restaurant in Daegu, Korea
Su-Jin Lee, Keon-Yeop Kim, Yeon-Kyung Lee
Korean Journal of Community Nutrition.2022; 27(1): 27. CrossRef
Comparison of the Sodium and Sugar Reduction Practices at Samsam Foodservices and General Foodservices in Daegu
Sung-young Kwon, Kilye Kim, Yeon-Kyung Lee
Korean Journal of Community Nutrition.2021; 26(4): 270. CrossRef

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Original Articles

[English]
The Effect of Personality Type and Job Performance on Emotional Exhaustion and Job Satisfaction - Staff of the Center for Children's foodservice management -: Kyung Min Lee, Min Sun Jeon; Korean J Community Nutr 2018;23(6):496-505. Published online December 31, 2018; DOI: https://doi.org/10.5720/kjcn.2018.23.6.496

Abstract PDF PubReader: OBJECTIVES
This study examined the relationship between the personality traits and job performance of Centers for Children's Foodservice Management (CCFSM) staff on emotional exhaustion and job satisfaction. In addition, the characteristics of the center organization were examined to provide practical guidelines for the operation of the center. The aim was to determine management implications with an important meaning in human resource management to enhance the efficiency of the operation of Centers for Children's Foodservice Management (CCFSM).
METHODS
Out of 207 centers, there were 1,057 employees at 173 centers who agreed to participate in the study, the questionnaire was mailed on February 17, 2017 and collected by mail on March 31, 2017. Finally, 81 centers (46.82%) participated in the survey and 493 questionnaires were used.
RESULTS
Neuroticism among the five personality factors had a positive (+) influence on â€˜cynicismâ€™ and â€˜exhaustionâ€™ among the three subordinate factors of emotional exhaustion, negative (âˆ’) effects on the â€˜jobâ€™ among the six subscales of job satisfaction. In addition, openness showed a negative (âˆ’) effect on â€˜loss of professional confidenceâ€™ of emotional exhaustion and positive (+) relationship with the â€˜jobâ€™ of job satisfaction. Agreeableness appeared to have a negative (âˆ’) effect on all factors of emotional exhaustion and a positive (+) influence on all factors of job satisfaction. As a result of analyzing the effects of job performance on emotional exhaustion and job satisfaction, the planning and operations management team showed a positive (+) influence on all factors of emotional exhaustion and negative (âˆ’) influence on all factors of job satisfaction. On the other hand, the nutrition management team showed a negative (âˆ’) influence on all emotional exhaustion factors and a positive (+) influence on the factors of job satisfaction. The hygiene management team showed a positive (+) relationship with â€˜Emotional exhaustionâ€™ among the subordinate factors of emotional exhaustion and a negative (âˆ’) influence on the â€˜Educational opportunityâ€™ of job satisfaction.
CONCLUSIONS
The personality type and job performance of Centers for Children's foodservice management (ccfsm) staff significantly affected the emotional exhaustion and job satisfaction.

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[English]
Effects of an Education Program on Sanitation Status at Centers for Children's Food Service Management: Focusing on Jung-gu and Dong-gu regions of Daejeon Metropolitan City: Yu Jin Seo, Min Sun Jeon; Korean J Community Nutr 2015;20(6):447-459. Published online December 31, 2015; DOI: https://doi.org/10.5720/kjcn.2015.20.6.447

Abstract PDF PubReader

OBJECTIVES
This study aimed to assess the improvement of teachers' sanitation performance and food distribution environment at Centers for children's food service management after a sanitation education program.
METHODS
The subjects were 119 teachers working at child care centers registered in the Daejeon Center for Children's Foodservice Management in Dongu and Jung-gu, Daejeon. The sanitation education was provided three times from March to August in 2014, and the survey questionnaires were distributed before and after the education. The sanitation status of food service environment of the centers was examined by ATP(adenosine-5'- triphosphate) bioluminescence.
RESULTS
After the sanitation education, the teachers showed higher levels of sanitation knowledge. Also, sanitation performance and recognition level of the importance of it significantly improved after the education program. The mean variation scores of importance and performance after the education were 0.14 and 0.23. According to the Importance-Performance Analysis (IPA) results of 26 sanitation attributes about the food service environment, the selection attributes with relatively low performance and importance were mostly distributed in the children's and distributer's personal hygiene management area. However, all attributes except using a personal water bottle and cup were moved to high performance and importance level. Also, the ATP examination results showed that the sanitation status of the food service environment was improved after the education program.
CONCLUSIONS
The sanitation education program was effective in improving the recognition of the importance of sanitation and its performance with regard to food service management.

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Relationship with the Perception of Foodservice, Nutritional Knowledge, and Foodservice Guidance of Day-Care Center Teachers in Gangwon Area
Seung-Lim Lee
Journal of the East Asian Society of Dietary Life.2024; 34(3): 203. CrossRef
Relationship between the Nutrition Quotient, Sustainable Diets, and Meal Guidance of Day-Care Center Teachers according to the Type of Day-Care Center : Focus on the Gangwon Area
Seung-Lim Lee, Ji-Hye Kim, Hye-Ji Oh, Myeong-Jong Kim
Journal of the East Asian Society of Dietary Life.2024; 34(4): 262. CrossRef
A Study of Food Safety Knowledge for Sustainable Foodservice Management of Childcare Centers in South Korea Using Importance–Performance Analysis
Jeong-Sil Choi, Se-Young Ju
International Journal of Environmental Research and Public Health.2022; 19(15): 9668. CrossRef
Evaluation of Food Safety Management Status of Children’s Foodservice Facilities Using Sanitary Check Scores and ATP Bioluminescence Assay in Gyoengbuk Area
Kyung-A Lee
Journal of the Korean Society of Food Science and Nutrition.2021; 50(2): 196. CrossRef
Comparison of Salinity and Sodium Content by the Salinity Measurement Frequency of Soups of Childcare Centers Enrolled in the Center for Children's Food Service Management in Daegu
Na-Yeong Lee, Yeon-Kyung Lee
Korean Journal of Community Nutrition.2020; 25(1): 13. CrossRef
Research trends in obesity & obesogenic environments in Korea
Myoungsook Lee
Nutrition Research and Practice.2019; 13(6): 461. CrossRef
Effects of Periodic Visiting Education Support on the Sanitation Management of Foodservice Facilities for Children in the Local Small City: A Focus on the Yecheon-gun Area
Hye-Jin Pak, Chan-Ick Cheigh
Food Engineering Progress.2019; 23(3): 200. CrossRef
Analysis of Sanitary Safety Management Improvement for Children’s Food service in Chilgok-gun Area
Suk-Hyeon Park, Hyeon-A Jung
Journal of the East Asian Society of Dietary Life.2018; 28(5): 345. CrossRef
The Effect of Personality Type and Job Performance on Emotional Exhaustion and Job Satisfaction - Staff of the Center for Children's foodservice management -
Kyung-Min Lee, Min-Sun Jeon
Korean Journal of Community Nutrition.2018; 23(6): 496. CrossRef
A study on the optimal variable transformation method to identify the correlation between ATP and APC
Hye-Kyung Moon, Jae-Kyoung Shin, Yang Sook Kim
Journal of the Korean Data and Information Science Society.2016; 27(6): 1465. CrossRef
A Comparison of Hygiene and Safety Management Execution depending on the Characteristics of Children's Food Service Facilities
Jin-Young Lee
The Korean Journal of Food And Nutrition.2016; 29(4): 573. CrossRef

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[English]
Job Satisfaction, Work Performance, Work Satisfaction, Perceived Needs and Self-Evaluation of Knowledge and Skills of Nutrition Teachers in Gyeonggi Area: Jae Yeon Lim, Kyung Won Kim; Korean J Community Nutr 2014;19(1):60-70. Published online February 28, 2014; DOI: https://doi.org/10.5720/kjcn.2014.19.1.60

Abstract PDF PubReader

The purpose of the study was to examine job satisfaction, work performance, work satisfaction, perceived needs and self-evaluation of knowledge and skills of nutrition teachers. Survey questionnaire was administered to 106 nutrition teachers in schools of Gyeonggi area. Subjects were categorized into high- or low-job satisfaction group, and study variables were examined by job satisfaction group. Overall job satisfaction was high, with a mean score of 14.9 out of 20. High-job satisfaction group had more favorable perception regarding human relations and workplace atmosphere compared to the counterparts (p < 0.001). Work performance, examined by 12 items, was not significantly different between the two groups. However, satisfaction regarding specific work of nutrition teachers was significantly different by job satisfaction (p < 0.001). High-job satisfaction group responded that they had more knowledge and skills in areas such as food purchase management, food sanitation and safety management, equipment and facility management, nutrition education, nutrition counseling (p < 0.01), and general management & marketing (p < 0.05). High-job satisfaction group also indicated that nutrition teachers need to have more knowledge and skills than the counterparts, regarding food purchase management (p < 0.001), nutrition education (p < 0.01), nutrition counseling, general management and marketing, and teaching practices (p < 0.05). In addition, study results showed significant positive correlations among study variables. This study suggested that job satisfaction of nutrition teachers might be increased by having favorable human relations and workplace atmosphere, increasing satisfaction with specific work of nutrition teachers, and by increasing the knowledge and skills required for the work of nutrition teachers.

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Development of Job Description of Nutrition Teacher by the DACUM Method
Ji-Hee Kim, Jin-A Cha
Journal of the Korean Dietetic Association.2016; 22(3): 193. CrossRef
Status and Need Assessment on Nutrition & Dietary Life Education among Nutrition Teachers in Elementary, Middle and High Schools
Na Gyeong Oh, Su Jin Gwon, Kyung Won Kim, Cheong Min Sohn, Hae Ryun Park, Jung Sook Seo
Korean Journal of Community Nutrition.2016; 21(2): 152. CrossRef
Study on Current Nutrition Education and Effective Education Plan for Nutrition Teachers in Kyeonggi Region
Seong Yeong Kim
Journal of the East Asian Society of Dietary Life.2016; 26(2): 181. CrossRef

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[English]
Analysis of Relative Importance of Key Performance Indicators for Center for Child-Care Foodservice Management through Analytic Hierarchy Process (AHP): Yun Hui Jeong, In Sook Chae, Il Sun Yang, Hye Young Kim, Hae Young Lee; Korean J Community Nutr 2013;18(2):154-164. Published online April 30, 2013; DOI: https://doi.org/10.5720/kjcn.2013.18.2.154

Abstract PDF PubReader

The objectives of this study were to assign reasonability to importance of weight selection issue in key performance indicator for performance evaluation of Centers for Child-care Foodservice Management (CCFSM) developed by using Balanced Scorecard (BSC), to draw key performance indicator (KPI) by perspective and to analyze differences in recognition on importance. From September 25 to October 9, 2012, we conducted a questionnaire-based study via e-mail, targeting chiefs and team leaders of nationwide 21 CCFSMs (43 persons), officials of local governments where CCFSM was established (21 persons), officials of Korea Food and Drug Administration (2 persons) and foodservice management experts (27 persons) in order to estimate the relative importance on 4 perspectives and 14 KPIs and analyzed its results by using 61 collected data. The results showed that relative importance of perspectives was estimated in order of importance as follows: business performance (0.3519), customer (0.3393), resource (0.1557), learning and growth (0.1531). Relative importance of KPIs was in order of importance as follows: Evaluation of sanitary management level in childcare foodservice facilities (0.1327), Level of customer recognition and behavior improvement (0.1153), performances of round visiting inspection on foodservice, sanitary, safety management, and foodservice consulting (0.0913). Our results showed that the recognition differences exist on the relative importance of perspectives and KPIs between officials of CCFSM, KFDA, local government and foodservice management experts. These observations will form the basis for developing evaluation systems, and it is considered that performance indicators developed on this basis will suggest direction of operation which CCFSM will have to perform.

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The Effect of Hygiene Guidance by Center for Children's Foodservice Management on Food Safety Improvement in Child-care Foodservices in Changwon
Jeong-Min Cheon, Jae-Kyoung Shin, Hye-Kyung Moon
Korean Journal of Food and Cookery Science.2018; 34(6): 653. CrossRef
Assessment of the Effectiveness and Perception of Education by Center for Child-Care Foodservice Management: Focus on Parents of Child-Care and Kindergarten in Seoul
Se-Young Ju, Wan-Soo Hong
Korean Journal of Food and Cookery Science.2018; 34(4): 404. CrossRef
Task Satisfaction, Job Satisfaction, Organizational Commitment, and Turnover Intension of Center for Children's Foodservice Management Employees
Eun Hye Park, Young Eun Lee
Journal of the Korean Society of Food Science and Nutrition.2015; 44(12): 1881. CrossRef
The Assessment of Food Safety Practices and the Effect of Visiting Education on Food Safety Improvement in Children's Foodservice Facilities
Jae-Eun Paik, Hyun-A Lee, Hyun-Joo Bae
Korean journal of food and cookery science.2015; 31(6): 764. CrossRef
Center for Children's Foodservice Management (CCFSM) Employees' Perception of Difficulties in Performing Tasks
Eun Hye Park, Young Eun Lee
Journal of the Korean Society of Food Science and Nutrition.2015; 44(4): 619. CrossRef

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[English]
Importance and Performance of Dietitian's Task at Long Term Care Hospital Foodservice in Busan . Kyungnam Area: Mal Sook Park, Eun Soon Lyu; Korean J Community Nutr 2011;16(5):602-612. Published online October 31, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.5.602

Abstract PDF PubReader

The purpose of this study was to evaluate importance and performance of dietitian's task at long term care hospitals foodservices in the Busan.Kyongnam area. The research was performed through using questionnaires and conducted from June 11 to July 16, 2010 for 186 dietitians at 141 long-term care hospitals. Seventy-two percent of hospitals had two dietitians and 69% of them had a dietitian's office. Fifty-two percent of dietitians has worked for less than 2 years at long term care hospital, and 37.1% of them worked additional tasks. Seventy-three percent of hospitals conducted a therapeutic diet program and the therapeutic diets frequently provided were diabetic diet > tube feeding diet > dysphasia diet > sodium controlled diet. Mean score for the importance (4.36/5.00) and performance (3.91/5.00) of dietitian's tasks were significantly different (p < 0.001). The importance and performance grid showed that the purchase-inspection management and sanitation-safety management were high scores to the importance and performance (doing great area), menu-foodservice management and cooking-working management were low scores to the importance and high scores to the importance (overdone area), and nutrition management was low scores to the importance and performance (low priority). Forty-three percent of dietitians agreed with the needs for role separation between foodservice dietitian and clinical dietitian.

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Nutrition Care Management Practices for In-Patients with Dysphagia in Korean Clinical Settings
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Clinical Nutrition Research.2019; 8(4): 272. CrossRef
Importance and Performance of Nutrition Management for In-Patients with Dysphagia Perceived by Dietitians at Clinical Settings in Seoul and Gyeonggi Areas
Kyung-Eun Lee, Dasom Kim
Journal of the East Asian Society of Dietary Life.2019; 29(5): 421. CrossRef
Status of Foodservice Operations in Long-term Care Facilities for the Elderly : Focus on the Gwangju Metropolitan City
Gyusang Han, Eunju Yang
Journal of the East Asian Society of Dietary Life.2018; 28(5): 337. CrossRef
Importance-Performance Analysis of Clinical Nutrition Management in Convalescent Hospitals in the Gyeongnam Area
Seon-Jeon Lee, Eunju Park
Journal of the Korean Dietetic Association.2016; 22(1): 53. CrossRef
Job importance, job performance, and job satisfaction in dietitians at geriatric hospitals or elderly healthcare facilities in Jeju
Hye-Sook Kang, Yunkyoung Lee, In-Sook Chae
Journal of Nutrition and Health.2016; 49(3): 189. CrossRef
Comparison of Health Status and Mini Nutritional Assessment according to Self-esteem of Elderly in Care Hospital
Eun-mi Kim, Jin Kwon
Journal of the East Asian Society of Dietary Life.2015; 25(4): 631. CrossRef
Effect of Job Satisfaction and Self-Esteem on Psychological Burnout in Dietitians at Geriatric Hospital in Busan
Jae-Soo Suh, Ju-Hyun Kim, Jeong-Sook Lee
Journal of the Korean Dietetic Association.2015; 21(4): 261. CrossRef
Foodservice Satisfaction of Patients over 60 according to the Type of Foodservice Operation: The Case of B Hospital
Shin Hey Lee, Jung Hwa Choi
The Korean Journal of Community Living Science.2015; 26(4): 683. CrossRef
Clinical Nutrition Services of a Long-term Care Hospital in Korea
Mi Hyang Um, Eun Soon Lyu, Song Mi Lee, Seung Min Lee, Eun Lee, Jin A Cha, Mi Sun Park, Ho Sun Lee, Mi Yong Rha, Yoo Kyoung Park
Korean Journal of Community Nutrition.2015; 20(3): 220. CrossRef
Dietitians' Perception of Importance about Standards of Foodservice Management Associated with Long-Term Care Hospital Accreditation
Joo-eun Lee
Journal of the Korean Society of Food Science and Nutrition.2015; 44(10): 1558. CrossRef
Job Satisfaction Level and Related Factors among Korean Hospital Dietitians
Eun Hee Jang, Eun Soon Lyu, Song Mi Lee, Yoo Kyung Park, Eun Lee, Jin A Cha, Mi Sun Park, Ho Sun Lee, Mi Young Rha, Seung Min Lee
Journal of the Korean Dietetic Association.2014; 20(4): 257. CrossRef
Development of Job Description of Clinical Dietitians in Hospitals by the DACUM Method
Jin-A Cha, Kang-Eun Kim, Eun-Mi Kim, Mi-Sun Park, Yoo-Kyoung Park, Hee-Joon Baek, Song-Mi Lee, Soo-Kyong Choi, Jung-Sook Seo
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Na-Young Kim, Gyeong-Mi Seong, Jeong-Sook Lee
Journal of the Korean Dietetic Association.2012; 18(4): 356. CrossRef

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[English]
Korean and Chinese University Students' Importance and Performance Analysis for Quality Attributes by Coffee Type in Daejeon: Hye Young Kim, Hye Kyung Chung, Hae Young Lee; Korean J Community Nutr 2011;16(4):511-524. Published online August 31, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.4.511

Abstract PDF PubReader

The purposes of this study was to investigate importance and performance for coffee quality attributes in Korean and Chinese university students by 3 types of coffee; coffee in coffee houses, coffee in vending machines and canned/bottled coffee. Survey was done for 360 students in Daejeon with developed questionnaires including general information, favorite type of coffee and 15 quality attributes of coffee. Finally, data from 168 Korean and 126 Chinese university students was used for statistical analysis by SPSS 18.0 package program. Results of this study were as follows: for favorite type of coffee, the rates of coffee in coffee houses, coffee in vending machines and canned/bottled coffee were 43.0% 34.8% and 22.2% in Korean students and 8.7%, 78.0%, and 12.2% in Chinese students, respectively. Comparing Chinese students and Korean students showed higher importance for several quality attributes of coffee in coffee house (p < 0.05), but lower importance for most quality-attributes of coffee in vending machine (p < 0.05) and canned/bottled coffee (p < 0.05). According to importance and performance analysis, strategies for increasing satisfaction were to improve 'price' of canned/bottled coffee in Korean students, and 'taste', 'volume', 'concentration' and 'variety' of canned/bottled coffee and 'freshness' of coffee in vending machine in Chinese students. These results suggested that differentiated marketing plans between Korean and Chinese university students should be needed in coffee industry.

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Korean Journal of Community Nutrition.2013; 18(5): 467. CrossRef
Importance-Performance Analysis of Quality Attributes of Coffee Shops and a Comparison of Coffee Shop Visits between Koreans and Mongolians
Mi-Na Jo, Bolorerdene Purevsuren
Journal of the Korean Society of Food Science and Nutrition.2013; 42(9): 1499. CrossRef
IPA Analysis according to the Attributes of the Franchise Coffee Shop Selection of College Students in Busan
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Journal of the Korean Society of Food Culture.2013; 28(2): 195. CrossRef
Analysis of University Student' Perception of Coffee Shop Prices through Price Sensitivity Measurements
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Journal of the Korean Society of Food Science and Nutrition.2012; 41(8): 1182. CrossRef
A Study on the Differences in Dietary Satisfaction with Age in North Korean Refugees
Eun-Jung Lee, Yong-Qin Pei
Journal of the Korean Society of Food Culture.2012; 27(6): 636. CrossRef
Survey on Consumption of Coffee Beverages and Energy Contribution Ratios of Coffee Beverages and Accompanying Snacks by College Students in Daejeon City and Chungnam Province in Korea
Young-Hee Lim, Sun-Hyo Kim
Journal of the Korean Society of Food Culture.2012; 27(3): 240. CrossRef
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 Journal of Community Nutrition.2011; 16(3): 324. CrossRef
The Antecedents of Coffee Satisfaction by Lifestyle Segments for Korean and Chinese University Students in Korea
Hye-Kyung Chung, Hye-Young Kim, Hae-Young Lee
Korean Journal of Community Nutrition.2011; 16(6): 782. CrossRef

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[English]
Factors Influencing Job Satisfaction of Dietitians(Nutrition Teachers) of School Foodservice in Daejeon/Chungnam Province: Wang Mi Shin, Jang Il Han, Seong Ai Kim; Korean J Community Nutr 2009;14(6):798-806. Published online December 31, 2009

Abstract PDF: The objective of this study was to investigate how to improve job satisfaction for dietitians and nutrition teachers by identifying influencing factors in Daejeon and Chungnam Province, South Korea. A survey was conducted among school foodservice dietitians and nutrition teachers from selected primary, middle and high school in the area. This survey consisted of general characteristics, status of their job, job satisfaction, work satisfaction and work performance. In this study we found current state of general characteristics and status of their job according to frequency analysis and the level of work satisfaction, work performance and job satisfaction using descriptive statistics. The t-test, ANOVA and Duncan-test were also conducted in order to searching for tendency of job satisfaction according to the general characteristics and the status of their job. Pearson's correlation was carried out in order to find correlation with job satisfaction. Also, factors, which influenced job satisfaction according to regression analysis, were drawn. We describe the difference of job satisfaction between irregular dietitians and nutrition teachers as well. Besides we discussed the improvement of dietitians' (nutrition teachers') work environment to raise their job satisfaction through this study.

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[English]
Factors Related to Sanitary Management Performance Based on HACCP System in School Foodservice: Seoul, Gyeonggi, Kangwon and Choongchung Areas in Korea: Gyoung Mi Kim, Sim Yeol Lee; Korean J Community Nutr 2009;14(6):817-830. Published online December 31, 2009

Abstract PDF: The purpose of this study was to analysis the sanitary management performance based on HACCP system for school foodservice. This study was carried out from September 2008 until December 2008 and is targeted towards schools' dietitians that work at schools with school foodservice. The regional distribution of this research is as follows; 377 schools in Seoul, 648 schools in Gyeonggido, 160 schools in Kangwondo, 438 schools in Choongchungdo equaling 1,623 schools in total. When school foodservices were put through sanitation management achievement level analysis applied by the HACCP system, results displayed that management of temperature (3.96 points), time (4.08 points), and cross-contamination (4.07 points) were all below the average achievement level. HACCP system's achievement level based on the TQM showed that areas for strategy development, leadership, information and analysis had low achievement levels. Achievement levels for CCP are quality check, delivery/distribution process, sterilization/cleansing of food's contact surface. As a result of multiple regression analysis of the factors that influenced sanitation management achievement level of school foodservice HACCP system; sanitary job standard showed 35.6% and CCP achievement levels showed 26.8% explanatory rate. In particular, Kangwondo's number of foodservice provided to per cook was small. Also, the better the processing management was assessed, the higher the sanitary job standard achievement level became resulting to a explanatory rate of 39.5%. Elementary schools showed a higher explanatory rate of 37.0% than middle and high schools. CCP achievement levels in middle and high schools with self-operated foodservice had a 28.0% variable explanatory rate, which was the highest. The better the drainage system, leadership and assessments turned out to be, the higher the CCP achievement levels became. In summary, to revitalize HACCP system that is based on the TQM, it is considered that proper database of HACCP system for school foodservice's sanitation management be constructed and more emphasis should be put on strategy development to improve customers' satisfactory level. In addition, improvements in achievement levels of time, temperature, and cross-contamination for sanitary job standard and CCP achievement level are essential.

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[English]
Performance and Importance Analysis of Dietitian's Task in Public Health Nutrition Areas: Hae Ryun Park, Jin A Cha, Young Suk Lim; Korean J Community Nutr 2008;13(4):540-554. Published online August 31, 2008

Abstract PDF: The purpose of this study was to analyze task performance and importance level of the dietitian who is working in the public health nutrition area. Work oriented job analysis methodology was employed for the study purpose. Subjects of 38 dietitians currently working at health centers in 2002 were recruited. Based on the focus group interview with 7 public health nutritionists and 7 professors, information about task elements was collected. Questionnaires measuring work performance and self-perception of importance of the selected task elements were administered. The results of this study can be summarized as follows; 1) The tasks with high performance and importance level among 20 tasks are developing nutrition education material (B1), nutrition services for adults and the elderly (C3), writing the proposal for nutrition services (A2), evaluating service effect (A4), improving professionalism (E1), and self management (E2). 2) The task elements with high performance and importance level among weekly task elements are nutrition education for diabetes (C56), nutrition counseling for adults (C47), nutrition for hypertension (C53), managing and keeping records (C80), nutrition education for kindergarten and nursery school children (C42), searching for nutrition education materials (B26), and searching for media (B27). 3) The number of task elements with high performance and importance level among monthly task elements are 13 in the planning and evaluation of public health nutrition service, and 5 in developing nutrition education materials. The tasks of a dietitian in the public health center show a very wide spectrum. However dietitians recognize most of the tasks are important even though they cannot perform those tasks adequately.

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[English]
Foodservice Management and Food Sanitation Management in the Welfare Institutions for the Disabled in Korea: Hye Sang Lee; Korean J Community Nutr 2008;13(4):520-530. Published online August 31, 2008

Abstract PDF: The purpose of this study was to investigate the characteristics of the foodservice management practices, the equipment ratio of sanitary facility/equipment, and dietitians' perceptions of (i) the barriers to sanitary management and (ii) the sanitary management performance level in the welfare institutions for the disabled in Korea. The survey was conducted during the period from September 7 to October 15, 2006. A total of 91 institutions (response rate 74.6%) were analyzed by using SPSS (windows ver. 14.0). The average number of meals served per day per an institution was 379. The majority (93.4%) of dietitians made decisions in procurement. The major part of the purchase was made through private contract. The factors affecting menu planning were nutrition, food preference, and cost, in the order of importance. Among the food items, fruits were infrequently served, while protein source foods and green leaf vegetables were almost daily served. The equipment ratio of sanitary facilities/equipment was 45%, which was relatively low. Most dietitians perceived 'limited availability of facilities and equipment'and 'the lack of support from financing department'as the major barriers in implementing a desirable sanitary system. Sanitary management performance in 'the food ingredient'was perceived as the lowest, while that in 'the uniform'showed the highest. The results of this study suggest that a proper supporting program on securing the facility/equipment and adequately trained employees are needed for successful sanitary management. Also, a more frequent supply of fruits for the disabled is recommended.

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[English]
Analysis for Internal Audit and External Audit of the Sanitation/Safety Management Performance for the School Foodservice in Gyeongbuk Area: Hye Sang Lee; Korean J Community Nutr 2006;11(3):374-382. Published online June 30, 2006

Abstract PDF: The purpose of the study was to investigate the effects of the characteristics of dietitians, the characteristics of school food services, equipment ratio of HACCP facility/equipment and perception of barriers to HACCP implementation on external and internal audit of food safety/sanitation management performance in school food service. An e-mail survey was conducted with 144 dietitians in Gyeongbuk Province. A response rate was 57.6% (N=83) and data was analyzed using SPSS windows (ver. 12.0). Dietitian perceived facilities/equipment-related and stakeholder-related as the big barriers in implementing a HACCP system. Total scores of sanitation/safety management performance for external and internal audit were similar at 92 and 91 out of 100, respectively. "Facilities/equipment" and "HACCP system" categories in both external and internal audit were rated the lowest. As dietitian perceived facilities/equipment-related (p<0.001) and stakeholder-related (p<0.05) barriers to HACCP implementation were greater, the scores of the external and internal audits were significantly lower. As dietitian perceived barriers for all categories were greater, the scores of internal audits were significantly lower (p<0.05). As a result of multiple regression analyses, the scores of the external audit was positively associated with career as a school food service dietitian, but was negatively associated with barriers related to facility/equipment, while the scores of the internal audit was negatively associated with barriers related to facility/equipment and employees. This study suggests that supporting programs on securing the facilities/equipment and employee training are needed for successful HACCP implementation in school food service.

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[English]
Evaluation of the Perceived Performance on Sanitary Management of Cooked Foods in Foodbanks: Yun Kyung Hwang, Ki Hwan Park, Kyung Ryu; Korean J Community Nutr 2006;11(2):240-252. Published online April 30, 2006

Abstract PDF: A survey was implemented to suggest basic data for assuring the safety of cooked foods in foodbank operations. A questionnaire consisted of total 48 items including general characteristics, basic inputs and perceived importance/performance of sanitary management. One hundred twenty-eight responses among the 267 nationwide foodbanks were used for the statistical analysis. About forty-one percent of foodbanks was operated a period of 1-3 years and 43.0% of them were managed by social welfare organizations. The number of staff was only 0.5 person per operation with the whole responsibility and 1.0 with additional work, and thus most of the work was managed by volunteers. Job satisfaction was shown to be moderate and was affected by specialty and salary mostly. The facilities and equipment in foodbanks were not enough to operate and freezers/refrigerators were the top priority to supplement. Most of the respondents attended a nationwide level sanitary education program (79.7%), but complained not enough frequency of education (90%). The sanitary status of the donated foods was considered as satisfactory but some safety practices had to be improved, including personnel expenses and operating costs in the district level, a sanitary awareness of the donors and a general management of the facilities and equipment. An assessment on sanitary management resulted in an overall average of 4.45 out of 5 points in importance and 3.85 in performance showing the high level of sanitation perception in foodbank managers. From the IPA analysis, the fields found to be improved were sanitation management during cooking and temperature control as well as cleanliness and sanitation of both transport vehicle and refrigerator/freezer. To secure the food safety in foodbanks, consequently, personnel support, supplement of facilities and equipment, intense sanitation education and development of sanitation management program is needed.

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[English]
Development of Internal Branding Performance Measure and Analysis on the Difference of Internal Branding Performances between Local and International Hotels: Mi Kyung Choi; Korean J Community Nutr 2006;11(1):116-123. Published online February 28, 2006

Abstract PDF: The purposes of this study were to develop a tool for assessing internal branding performance and to identify the difference of internal branding performance between local and international hotels. The internal branding performance measure was developed through literature studies and face-to-face in-depth interviews with managers in various departments of 5 deluxe hotels. The questionnaires were distributed to 460 employees in food and beverage departments of 11 deluxe hotels in Seoul, and a total of 398 questionnaires were used for analysis (86.5%). The statistical analyses were completed using SPSS Win (12.0) for descriptive analysis, reliability analysis and t-test, and AMOS (5.0) for confirmatory factor analysis. The results of this study showed that the measure developed in this study was reliable and valid for assessing internal branding performances of hotels. In addition, the internal branding performances of hotels were high at understanding of brand dimensions and relatively low at work and organizational culture and human resource management dimensions, and local hotels showed lower levels of performance than international hotels at the dimensions of work and organizational culture (t = -3.801, p < 0.001) and human resource management(t = -5.397, p < 0.001). In conclusion, it is considered that a strong internal branding strategy should be established for successful brand management, and the practical measure for internal branding performance would be a key factor.

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[English]
Development of Performance Indicators Based on Balanced Score Card for School Food Service Facilities: Tongkyung Kwak, Hyeja Chang, Jiyong Song; Korean J Community Nutr 2005;10(6):905-919. Published online December 31, 2005

Abstract PDF: This study raised the necessity of developing performance indicators for measuring the management efficiency and effectiveness of school food service, and as a means of helping its implementation, a balanced score card (BSC) approach developed by Norton and Kaplan was adopted. This study established BSC in seven phases through literature: Phase 1 Defining a school food service and the scope of working activities, Phase 2 Establishing the vision of a school food service, Phase 3 Setting strategic goals, Phase 4 Identifying critical success factors (CSFs), Phase 5 Developing Key Performance Indicators (KPIs), Phase 6 Extracting cause and effect relationship, and Phase 7 Completing a preliminary BSC. The preliminary BSC was turned into a survey, which was administered to food service related people working at the Office of Education and School Food Service including 16 offices, 209 dietitians, 48 school administrators both from self-operated and contract-managed, and 9 experts in areas related to school food service. They were asked questions about strategics from 4 different perspectives, 12 CSFs, 39 KPIs, and the cause and effect relationships among them. As a result, among the CSFs based on 4 different perspectives, all factors other than "zero sum on profit/loss" from the financial perspective turned out to be valid. In terms of KPIs, manufacturing cost percentages, casualty loss count/reduction rates, school foodervice participation rates, and sales goal achievement rates were found to be valid from the financial perspective, while student satisfaction index, faculty satisfaction index, leftover ratio, nutrition educational performance count, index of evaluating nutrition education, customer claim count/reduction rate, handling customer claim count/reduction rate, and parent satisfaction index were found to be valid from the customers' perspective. Besides, nutritional requirement sufficient ratio, nutritional management score, food poisoning outbreak count, employee safety accident count, sanitary inspection assessment index, meals per labor hour (productivity index), computerization ratio, operational management index, and purchase management assessment index were also found to be valid from the perspective of internal business processes. From the perspective of innovation and learning, employee turnover ratio/rate of absenteeism, annual education and training count, employee satisfaction index, human resource management assessment index, annual menu-related customer feedback, food service information index for employees and parents/schools were also found to be valid. The significance of this study is to present indices for measuring overall performance of school lunch food service operations without putting any limitation on types of school food service management, and to help correctly assess the contribution of the current types of school food service management to schools and students.

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[English]
Selecting Instructional Contents for Nutritional Education Program for Junior/Senior High School Students Through Instructional Analysis and Analysis of Entry Behaviors and Learner Characteristics: Yeo Hwa Kang, Il Sun Yang, Hye Young Kim, Hae Young Lee; Korean J Community Nutr 2004;9(4):464-471. Published online August 31, 2004

Abstract PDF: For the purpose of developing 'Web-Based Nutritional Education Program', this study did instructional analysis, analysis of entry behaviors and learner characteristics to select instructional contents for nutritional education program for junior/senior high school students. Survey questionnaires were distributed from October 21, 2002 to October 26, 2002 to a total of 564 junior/senior high school students in Seoul. The total number of questionnaires collected and used in our study was 479, which is 84.9% of the total questionnaires distributed. As a result of the curriculum analysis of 'Techonolgy-Home economics', subjects related with 'food and nutrition' in the 7th educational course study result, lessons including the contents of food and nutrition were 'nutrition and meal of adolescent' in 7th grade, 'family meal management' in 9th grade and 'practice of home life' in 10th grade. According to the curriculum analysis, 'nutrition' and 'food' were chosen for the superior subjects of nutrition education program and four subordinate subjects per superior one were developed. Then, entry behaviors and learner characteristics were analyzed: life characteristics, internet usage, anthropometrics data and nutritional knowledge. Students were interested in using computer and preferred passive activity to dynamic activity. According to the analysis of internet usage, WBI for students should composed active parts such as game, moving image, immediate reply and follow-up by e-mail, bulletin board and community activity. Students' BMI were in normal range but they were lacked nutritional knowledge. We wrote performance objectives that were specific behavior skills to be learned, the conditions under which they must be performed and the criteria for successful performance. The next step for developing the WBI nutrition education program would be based on the results mentioned above.

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[English]
Development of Dietary Supplement for the Growth and Exercise Performance Improvement: Seung Won Yoon, Eun Hee Jung, Dong Sik Yang, Hong Seok Lee, Yoo Sik Yoon; Korean J Community Nutr 2003;8(3):349-355. Published online June 30, 2003

Abstract PDF: We developed a dietary supplement using natural herbs and nutrients for the growth and exercise performance improvement. It called 50-22 supplement containing distilled extracts of natural herbs to remove bitterness and the addition of Vitamin B1, B6, Ca and xylitol. We investigated on the effect of 10-22 supplementation on the maximal exercise performance, IGF-1 (insulin like growth factor-1) concentration and antioxidant activity in SD rat model. In result, JR-22 supplement group was better than control group about 10% in exercise performance test and increased about 63% of IGF-1 concentration in blood. In addition, the oxidative damage induced by exercise was reduced by JR-22 supplementation. Therefore, we suggested that 50-22 supplementation enhanced effectively exercise performance and IGF-1 concentration and reduced to oxidative stress in muscles. Also, we analysed biochemical factors in blood for the safety of JR-22 supplement. We known that there is no change of blood lactic acid, ammonia, inorganic phosphorous ion and creatine kinase activity.

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[English]
Study on Hygiene Knowledge and Recognition on Job Performance Levels for HACCP Application for Employees at Contract Foodservices: Hye Kyung Moon, Jam Ok Hwang; Korean J Community Nutr 2003;8(1):71-82. Published online February 28, 2003

Abstract PDF: In this study, hygiene knowledge and recognition on job performance levels of foodservice employees at different degrees of HACCP application had been compared. As for the comparison of hygiene knowledge for HACCP application, foodservice employees at "Appointed" showed significantly higher HACCP knowledge (p < 0.01). As for recognition on job performance levels, this status also assured the significant difference between the comparison groups (p < 0.01): "Appointed" showed the highest point of 4.24 while "Voluntary applying" and "Non-applying" showed 3.39 and 2.53 respectively. The "Appointed" group showed the well performance of most of the surveyed items. "Voluntary applying" group showed unsatisfactory performance in various log recordings and some part of surveyed items. As for "Non-applying", many items were performed under the average score as they do not apply HACCP.

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[English]
Effects of Job Characteristics, Job Performance and Organizational Commitment on Job Satisfaction of Hospital Dietitians in the Taegu Kyungpook Area: Min Ji Lee, Yeon Kyung Lee; Korean J Community Nutr 2000;5(4):672-682. Published online December 31, 2000

Abstract PDF: The purpose of this study was to identify the effect of job characteristics, job performance and organizational commitment on job satisfaction of hospital dietitians. The first survey was carried out on 74 hospital dietitians to determine their demographic characteristics, job characteristics, organizational commitment, and job satisfaction. The second survey was carried out on 47 hospital foodservice dietitians to determine their job performance. Thirty-two percent of the subjects were aged between 26 and 30, and 62.2% had Bachelor's degrees. The dietitians felt most satisfied by their co-workers, followed by the work-itself, supervision, pay, and promotion possibilities. Dietitians who had a higher education were satisfied with pay and supervision. The longer the length of employment, the more the satisfaction with the work-itself and pay, plus the higher the monthly wage the more the satisfaction with the work-itself, pay, supervision, and co-workers. lob satisfaction was high in the group that scored high on autonomy, feedback, task identity, and friendship of in the job characteristic inventory. The job performances of nutrition counseling(r= 0.469, p<0.01), nutrition education(r= 0.446, p<0.01) and management of therapeutic diet(r= 0.394, p<0.01) were positively correlated with job satisfaction. The R2 for the multiple regression model was 0.677, indicating that 67.7% of the variance in job satisfaction could be accounted for by feedback, organizational commitment, nutrition counseling performance, and nutrition education performance. In conclusion, the level of job satisfaction for hospital dietitians would appear to improve with increased feedback, organizational commitment, and opportunity for nutrition counseling and nutrition education.

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[English]
Customer Perception Levels towards Service Quality Attributes of University Residence Hall Foodservice by Importance-Performance Analysis: Ilsun Yang, Hyeaung Kang, Chihyun Weon; Korean J Community Nutr 2000;5(4):662-671. Published online December 31, 2000

Abstract PDF: The purpose of this study was to analyze university students' perception of service quality attributes in residence hall foodservice. Questionnaires were hand delivered to 1,210 university students residing in a residence hall. A total of 1,011 was usable, resulting in an 83.6% response rate. The survey was conducted between October, 1998 and May, 1999. A statistical data analysis was completed using the SAS/Win 6.12 for Descriptive Analysis, chi2-test, t-test, ANOVA, Spearman Correlation, and Common factor Analysis, and Importance- Performance Analysis(IPA) was completed. Significant negative correlations between importance and performance were found with 'abundance of foods'(p<0.001), 'discontent handling'(p<0.001), and 'availability of new menus'(p<0.01). factors including food, menu, sanitation, atmosphere, facilities, employee's attitude, and convenience were rearranged and a new dimension was created with the service. Employee's attitude and service factors received the highest scores in customer perception of importance and performance. Food, menu, and convenience factors were included in Quadrant A. female students had significantly higher importance mean scores than males, while males had significantly higher Performance mean scores.

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[English]
A Survey of the Customer Satisfaction of Military Foodservice for their Improvement: Hye Sang Lee, Young Soon Han, Jae Man Lee; Korean J Community Nutr 2000;5(3):522-528. Published online September 30, 2000

Abstract PDF: The purpose of this study was to provide basic reference materials for improving the quality of the military foodservice so that they can satisfy the customers needs. The questionnaires employed in this study were developed based on the IPA(Importance Performance Analysis). The questionnaires for the military customers(Group A which is the smaller size then Group B which is larger in size ; a criteria for the classification is the number of soldiers served in the foodservice facilities) consist of demographic variables, concerns about the military foodservice, and service practices. A total of 656 military customers answered the questionnaires. A statistical data analysis was conducted using the SPSS/win package program for descriptive analysis, a chi2-test and t-test. The results of this study could be summarized as follows : The IPA in case of Group A showed the following attributes in Quadrant A("focus here") : (1) availability of the meals that the customers prefer, (4) taste of the food, (16) cooking methods that the customers prefer, (17) the overall quality of the breakfast. The IPA in case of Group B showed the following attributes in Quadrant A("focus here") : (11) cleanliness, (12) kindness of the foodservice personnel, (15) the overall quality of the service, (17) the overall quality of the breakfast. The opinion of the Group A on the improvement of military foodservice was significantly different from that of Group B in the areas of meals/service improvement, problems in military foodservice, improvement in service methods, etc.(p<0.05).

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[English]
A Longitudinal Study of the Iron and Zinc Intakes of Korean Infants from 1 to 3 Months-Breast-Fed vs Formula-Fed Infants: Kyungsuk Choi, Sumi Mo, Haymie Choi, Jaeok Koo; Korean J Community Nutr 1999;4(1):30-36. Published online March 31, 1999

Abstract PDF: This study was carried out to longitudinally investigate the iron and zinc intakes and correlation with growth performance of 25 male breast-and formula-fed infants from 1 to 3 months postpartum, longitudinally. There were four groups breast fed(BF) and three formula fed groups((FFM, FFN and FFP). Milk intakes and the concentration of iron and zinc from human milk and the formulas were measured. The iron content of human milk was 2.07+/-1.05(0.63~5.65) microgram/ml. The zinc content was 2.43+/-1.14(0.70~5.30) microgram/ml. Both were not significantly different among postpartum months. The average iron intake of the breast-fed and formula-fed infants was 1.6+/-0.7mg/day and 8.4+/-2.3mg/day, respectively. The iron intake of breast-fed infants was higher than previous reports. And that of formula-fed infants was higher than the RDA. The average zinc intake of the breast-fed group was 1.9+/-0.9mg/day and formula-fed infants' was 2.7+/-0.7mg/day, which was higher than the RDA. There was no correlation between these mineral intakes and the growth performance during 1 to 3 postpartyum months. So, extensive studies of the iron content of human milk and wide cross-sectional studies for establishing iron and zinc recommended dietary allowances for infants are needed.

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[English]
Evaluation of Growth between Breast-Fed and Formula-Fed Korean Infants from 1 to 3 Postpartum Months: Compared with the Korean Standard and NCHS Reference: Kyungsuk Choi, Jaeok Koo; Korean J Community Nutr 1998;3(4):533-541. Published online October 31, 1998

Abstract PDF: This study compares the growth performance(weight-for-age Z-score, height-for-age Z-score, weight-for-height Z-score) of one- to three-month-old Korean infants(n=232) with the Korean standard(1994) and NCHS reference(1983). The weight-for-age Z-scores(WAZ) by the Korean standard were -2~1,5 for males and -3~1 for females. The NCHS reference, WAZ results were -1~2.5 and -2.5~3.5 for males and females, respectively. The WAZ compared Korean standard showed no subjects with overnutrition. But 1.3% of the infants showed signs of malnutrition. Comparison with NCHS reference revealed that 0.4% of the infants were malnourished and 7.0% of the infants were overnourished. The WAZ of formula-fed infants were distributed higher than breast-fed infants, but that was not significant. The height-for-age Z-score(HAZ) by the Korean standard were -4.5%~1.5% for males and -4~1.5% for females. According to the NCHS reference, HAZ were -2.5%~2.5% and -3~3 for males and females, respectively. When the WAZ was compared with the Korean standard, there was no overnutrition but 16% of the infants showed signs of malnutrition. The NCHS reference, revealed that 6.9% of the infants were malnourished and 1.8% of the infants were ovemourished. The weight-for-height Z-scores(WHZ) by the Korean standard were -2~5 for males and -2.5~5 for females. The NCHS reference WAZ scores were -1~4 and -1.5~4.5 for males and females, respectively. When the WHZ was compared with the Korean standard, 2.2% of infants were malnourished and 19.5% were overnourished. There were no malnourished subjects according to the NCHS reference and 19.1% of the infants were overnourished. When the three Z-scores are considered together, 92.0% of the infants should a normal growth status, there was no malnutrition, and 8.0% of the infants were overnourished. The growth performance was evaluated differently according to the type of standards. Thus, it is necessary to set proper growth standards for infants, according to which classification of feeding methods is chosen. A longterm and careful assessment of infants's growth performances to develop any group of standards.

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[English]
Cross-sectional Study of Growth of Korean Breast Fed Formula Fed Infants from 1 to 3 Postpartum Months: Kyungsuk Choi, Haymie Choi, Sang Jin Chung, Jaeok Koo, Hyeon Sook Lim; Korean J Community Nutr 1997;2(1):3-12. Published online February 28, 1997

Abstract PDF: One-to three -month-old infants(n=252) were compared their growth performance(weight, length, head circumference, chest circumference) by feeding methods in cross-sectional study. There were two groups : breast-fed(BF) and formula-fed groups(FF). The weights of infants at 1, 2, and 3 postpartum month were 4.50+/-.48kg, 5.76+/-0.62kg and 6.67+/-0.68kg, respectively. The weigh of male infants was higher than females. The length were 53.7+/-2.6cm, 57.4+/-3.3cm, 61.1+/-3.1cm at one to three postpartum months, respectively. The length of male infants was higher than females, too. Overall there were no significant differences between feeding methods in weight, length, head and chest circumferences, and monthly weight and length velocity. But 3-month-old formula-fed male infants showed bigger significantly in weight, monthly weight velocity and chest circumference than the breast-feds. By Korean standards, weight-for-height Z-score were distributed from 0 to +2. Not only was there a few malnourished infants but also overnourished were noticed, especially in formula-fed group.

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