Objectives This study was conducted to identify the awareness and practice of reducing sugar in school meals and the status of nutrition education regarding sugar reduction. Methods An online survey was conducted on 101 nutrition teachers (dietitians) working at elementary, middle, and high schools in Daegu. Results School nutrition teachers in Daegu recognized the need for efforts to reduce the sugar intake in the Korean diet, and it was found that elementary nutrition teachers were more aware of the implementation of the sugar reduction policy at the national level than middle and high school nutrition teachers (P = 0.002). Among the policies to reduce sugar intake at the national level, there was a high need for the promotion of self-control and limiting the sales of food with high sugar content in schools and their vicinity. The degree of practice for reducing sugar in school meals was found to be higher in the preparation, purchase, and cooking stage compared to the serving stage (P < 0.05). There was a high need for changing the preferences of the subjects for a sweet taste as a means of reducing the sugar in school meals. Thirty-six percent of nutrition teachers conducted sugar reduction education, and sending out school newsletters was the highest type of nutrition education at 80.6%. Conclusions To effectively promote reduced sugar intake in school meals, it is necessary to change the preference of the subjects for sweetness and to conduct continuous education that can improve the awareness of people for reducing their sugar intake. For this, it is necessary to set aside time for nutrition education and to prepare an institutional framework for providing this education.
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OBJECTIVES This study attempted to compare adolescents' dietary behaviors and perceptions by gender in order to recommend useful strategies for nutrition interventions. METHODS Subjects were 2,363 middle school (MS) and high school (HS) students. They completed a self-administered questionnaire on their interest in diet and health, dietary perceptions, nutrition knowledge, dietary practices, and dietary environment at home. Data were analyzed using t-test, χ2-test, and simple regression analysis by gender and by school groups. RESULTS Overall, girls obtained higher scores than boys did for "interest" (MS: p<0.001; HS: p<0.01), "dietary perceptions" (MS: p<0.001; HS: p<0.01), and "knowledge" (MS: p<0.01; HS: p<0.001). Regarding "dietary practices," no gender differences were observed among MS students, however, among HS students, boys obtained higher scores-reflecting good practices-than girls did (p<0.01). In all subjects, dietary environment at home was strongly associated with dietary practice than other variables (MS boys: β=0.435, p<0.001; MS girls: β=0.492, p<0.001, HS boys: β=0.271, p<0.001; HS girls: β=0.429, p<0.001). CONCLUSIONS We observed gender differences in some of the variables such as knowledge and perception among adolescent students. Educational programs and core strategies that consider these gender differences need to be developed. Specifically, for girls, educational programs should focus on facilitating dietary recommendation adherence, whereas for boys, the program could focus on improving dietary knowledge and perceptions.
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Yu Jin Oh, Young Mee Lee, Jung Hyun Kim, Hong Seok Ahn, Jeong Weon Kim, Hae Ryun Park, Jung Sook Seo, Kyung Won Kim, O Ran Kwon, Hye Kyoung Park, Eun Ju Lee, Huy Ni Sung
Korean J Community Nutr 2008;13(4):499-509. Published online August 31, 2008
This study investigated the experience and practice of elementary school students on nutrition education. The data were collected from 217 male and female students attending 5-6th grade elementary schools in Seoul and Kyunggi-Do from March to June 2007, interviewing face to face by a nutrition teacher and 3 interns of a nutrition teacher. The results were as follows: 86.5% of the subjects learned about 'Table etiquette', 'Reasons for eating fruits and vegetables'(78.7%), 'Food waste and environment'(72.3%), 'Healthy snacks'(55.7%), 'Food sanitation'(52.3%), 'Food culture of foreign countries'(48.1%). Nutrition education experience was significantly different by gender. A total of 43.5% boys responded that they never learned about 'basic food preperation'(p < 0.01). They had learned 'Nutrients for body'and 'Food waste and environment'in school, 'Healthy weight loss', 'Food culture of foreign countries', 'Food circulation'on television, Most content ('Table etiquette', 'Simple cooking', 'Food sanitation', 'Eating behaviors for health', 'Reasons for eating fruits and vegetables', 'Healthy snacks') was learned from parents. The practice after nutrition education was higher in 'Table etiquette'(2.14), 'Eating fruits and vegetables'(2.07) than others compared with education experience. The most reason of non-practice on nutrition information was 'Troublesome'. In 'Nutrients for body', a boy answered 'Difficult for practice'20.0%, a girl answered 'Difficult to understand'32.6%, showing a significant difference between the gender groups (p < 0.001). They remembered the 'Nutrients for body'(49.6%), 'Food sanitation'(44.5%) because of 'important content', 'Basic food preparation'(40.6%), 'Food culture of foreign countries'(36.3%) because of 'interesting content', 'Healthy weight loss'(52.0%), 'Eating behavior for health'(44.5%) and 'Healthy snacks'(33.7%) because of 'need for my health'.
The purpose of this study was to investigate the awareness and practice on well-being life and well-being related behaviors, and the various factors affecting well-being related behaviors such as purchasing food materials, food habits, eating out and daily routine activities. A survey was conducted by questionnaire and on a 5-point Likert scale. The subjects of this study were composed of 221 students and their 102 parents who were over 40 years residing in the Ulsan area. The results of this study are summarized as follows: Almost half of the subjects (47.4%) responded that they have good health conditions; to keep a good health condition, 41.2% of the subjects were exercising regularly and 20.4% of them kept diet control. In regard to the meaning of well-being, 66.6% of the subjects thought it is the lifestyle for physical and mental richness (children: 70.6%, parents: 57.8%). 30.3% of the subjects answered that the most important part of well-being was food related. The importance order was mental richness, food related things, physical health for children, and for the parents, it was food related things, physical health, mental richness. Most of population (45.8%) answered that they have a willingness for the pursuit of a well-being life. Among the well-being related behaviors, 69.7% of subjects have purchased items (children: 61.5%, parents: 87.3%). 37.2% of the subjects have acquired information from TV. The average well-being practice score was 61.01+/-10.36. Children's scores were significantly lower than the parent's scores (p < 0.001). And the average practice score of 'purchasing food materials,' 'eating out,' 'food habits,' 'daily routine activities' were 15.3+/-3.3, 15.5+/-3.1, 16.8+/-3.3 and 13.4+/-3.5, respectively. Among five types of purchasing food materials, 'purchasing domestic agricultural food' was greatest (3.64+/-0.91) and 'purchasing of organic or low agricultural chemical food products' was lowest (3.15+/-0.91). In regard to food habits, 'eating rice and bread made of mixed grains' was greatest (3.46+/-1.12) and 'eating uncooked food or zen food' was lowest (2.46+/-0.99). The practice scores were significantly affected by gender (p < 0.05), monthly income (p < 0.01), educational level (p < 0.01), presence of disease (p < 0.05), subjective health condition (p < 0.05), well-being awareness (p < 0.001) and concern with well-being (p < 0.001). Well-being awareness scores and well-being practice scores are related positively. Therefore various programs in well-being education should be necessary in order to boost the authentic perceptions of well-being and well-being oriented behaviors in any socioeconomic situation, such as different generations; industrial companies producing well-being goods for consumer's needs and satisfaction; and government and local community create various conditions for well-being oriented behavior.
The purpose of this study was to evaluate the effectiveness of nutrition education with nutrition services provided by dietitians who were placed in child care facilities from the Korean Dietetic Association. For this, we investigated the levels of nutrition knowledge and dietary intakes of children who attended child-care centers as well as dietary practices of children assessed by their parents. The treatment for children consisted of nutrition education and food service activities that are provided by the dietitian who have 3 to 5 years experience. Nutrition education was implemented during 10 weeks, 20 times, and a total 400 min and it's effectiveness was evaluated by questionnaire. Data were obtained for 123 children aged 4 to 5 years old who attended four child-care centers, one for a control group and 3 for intervention groups. Dietary intakes were investigated by measuring one-serving size and plate waste a of child for one-day dietary records before and after nutrition education. The levels of nutrition knowledge of children improved showing 70.80 points before to 83.45 points after nutrition education (p < 0.001). Dietary intakes of the children after nutrition service increased significantly on cooked rice (133.66 g), Kimchi (19.41 g), side dish of meat/fish (48.40 g), and side dish of vegetables (24.88 g). Dietary practices of children after treatment also improved especially 'eat diverse meat, fish, egg, and bean' and 'never leave plate waste'. To summarize, this study pointed out that nutrition service and nutrition education provided by dietitians had influences on increases of the nutrition knowledge, dietary intake, and dietary practices. Therefore, placement of dietitians needs to extend to child care facilities from the 100 persons-over-capacity facility to the 50 persons-over-capacity facility, for providing professional service such as nutrition education and nutrition counseling.
Effective and systematic sanitation management programs are necessary to prevent foodborne disease outbreaks in school foodservice operations. The purpose of this study was to identify the elements to improve in order to ensure the safety of school food service by evaluating sanitation management practices implemented under HACCP-based programs. The survey was designed to assess the level of hygiene practices of school food service by using an inspection checklist of food hygiene and safety. Fifty-four school foodservice establishments considered as poor sanitation practice groups from two year inspections by Seoul Metropolitan Office of Education were surveyed from September to December in 2005. Inspection checklists consisted of seven categories with 50 checkpoints; facilities and equipment management, personal hygiene, ingredient control, process control, environmental sanitation management, HACCP system and safety management. Surveyed schools scored 68.0+/-12.42 points out of 100 on average. The average score (% of compliance) of each field was 10.7/20 (53.3%) for facilities and equipment management, 7.4/11 (67.2%) for personal hygiene, 7.4/11 (74.1%) for ingredient control, 22.4/32 (69.8%) for process control, 8.9/12 (73.8%) for environmental sanitation management, 4.2/7 (59.7%) for HACCP systems management, and 7.2/8 (89.7%) for safety management, respectively. The field to be improved first was the sanitation control of facilities and equipment. The elements to improve this category were unprofessional consultation for kitchen layout, improper compartment of the kitchen area, lacks of pest control, inadequate water supply, poor ventilation system, and insufficient hand-washing facilities. To elevate the overall performance level of sanitation management, prerequisite programs prior to HACCP plan implementation should be stressed on the school officials, specifically principals, for the integration of the system.
The purpose of this study was to determine the characteristics of infants' temperaments and eating behaviors, mothers' eating behaviors and feeding practices in poor eating infants. The participants were 80 infants of 12 - 24 months (27 poor eaters and 53 matched normal controls) from a hospital and a public health center. Mothers were questioned about their eating behaviors and feeding practices, and infants' temperaments, eating behaviors, and nutrient intakes by one day food recall. Subjects were divided by mean nutrient adequacy ratio (MAR, < 0.75; poor eater). Intakes of Ca, P, Fe, Zn, thiamin, riboflavin, niacin, vitamin C, E, folate were below 75% RDA in poor eaters, whereas protein, thiamin, riboflavin, vitamin B6, C, folate exceeded 125% RDA in good eaters. Rhythmicity of infants' temperaments and eating behaviors, restriction of mothers' eating behaviors and feeding practices were significantly lower, whereas activity levels of infants' temperaments were higher than good eaters. In multiple logistic regression model of poor eaters, activity of infants' temperaments (T, OR: 1.19, CI: 1.05 - 1.35) and attention spans of infants' eating behaviors (A, OR: 1.18, CI: 1.03 - 1.35) were significantly positive, whereas rhythmicity of infants' eating behaviors (R, OR: 0.79, CI: 0.67 - 0.94) was significantly negative [E (the logit) = -6.8644 + 0.1712 x T - 0.2337 x R + 0.1641 x A]. Our findings suggest that examination of eating behaviors, feeding practices, and temperaments will help target interventions to improve infants' food intakes, and these variables should be examined at the time of nutrition counseling.
The purpose of this study was to determine the characteristics of infants' temperaments, maternal feeding behaviors and feeding practices in picky eaters. Participants were 83 infants (aged 12 - 24 months) from "A" hospital (Seoul) and "B" public health center (Kyunggido). Mothers completed questionnaires that assessed their own feeding behavior, feeding practices, infants' temperament and infants' feeding behavior. Picky eaters' demographics were not significantly different from non-picky eaters after adjusting sex and age. The average of thiamin, niacin and vitamin E intakes of picky eaters were below 75% Korean RDA, whereas vitamin A intakes exceed 120% RDA in both groups. Activity level of infants' temperament and disinhibition of maternal feeding behavior in picky eaters were significantly higher than those in non-picky eater. All constructs of infants feeding behavior were significantly associated with certain constructs of infants' temperament, maternal feeding practice and maternal feeding behavior. The pickiness of infants feeding behavior was positively correlated with activity level of infants' temperament, pickiness and disinhibition of maternal feeding behavior and negatively correlated with adaptability of infants' temperament. Findings suggest that maternal feeding behavior and feeding practices as well as infants' temperament should be addressed in nutrition education for picky eaters.
The purpose of the study was to investigate relationships among food safety training, knowledge, and practices of school food service employees. A questionnaire that identified employees' food safety training experience, knowledge, and practices was developed based on a review of literature. A total of 341 Korean school food service employees participated in the survey; the final usable responses were 293 (a response rate: 86%). Statistical analyses were conducted using SPSS for Windows (version 10). Most of the respondents (> 86%) took training sessions on 'proper hand washing' and 'proper food storage temperatures', whereas less than 60% had training on 'monitoring procedures and corrective actions at critical control points'. The mean score of their food safety knowledge was 8.02 out of 11. The majority of the employees knew correctly 'potentially hazardous foods (93.2%)' and 'diseases and symptoms with which they are excluded from working (87.0%)'; less than 50% chose a correct answer for 'sanitizing food contact surfaces.' A chi-square analysis revealed that the employees' actual knowledge did not differ significantly by whether they had food safety training (at the level of alpha = 0.01), except one topic "diseases and symptoms with which they are excluded from working." Their self-reported practice scores were rated as 2.98 - 3.39 based on a 5-point Likert-type scale (1-not at all, 5-always). Employees' food safety training should be conducted continuously and repetitively to improve the effectiveness of the training.
The relationship between dietary practices and juvenile delinquency was studied using a dietary survey. Subjects were selected from juvenile delinquents who were under the supervision of the Seoul Probation Office of the Ministry of Justice. The study group consisted of 52 male and 52 female delinquents. As a control group, 104 exemplary high school students were selected in Seoul. A questionnaire was designed to find out the subjects' general characteristics, dietary habits, lifestyle, eating behavior, food frequency, and nutrient intake using the 24-hour recall method. Compared to the exemplary students, the juvenile delinquents were significantly different in education level, family status, monthly allowance, residence status, breast fed, parents' education level, parents' concern. In dietary habits, fifty-eight percent of the juvenile delinquents ate 2 or fewer meals per day, preferred to eat with friends, and liked hot tasting foods. The juvenile delinquents consumed more ion drinks (OR=9.26 CI: 3.83-22.37), rameon (OR=7.67 CI: 3.21-18.33), cola (OR=6.75 CI: 2.91-15.69), soft drinks (OR=6.12 CI: 2.53-14.81), steamed korean sausage (OR=5.34 CI:2.31-12.32), hamburger (OR=5.15 CI: 1.91-13.87), kimbab (OR=3.63 CI: 1.76-7.46), ddokbokgi (OR=3.17 CI: 1.58-6.38), candy (OR=3.08 CI: 1.41-6.73), white rice (OR=2.59 CI: 1.19-5.64), hotdog (OR=2.52 CI: 1.31-4.86), and less rice mixed with grains (OR=0.02 CI: 0.01-0.05), tangerine (OR=0.06 CI: 0.02-0.20), milk (OR=0.29 CI: 0.14-0.60), roasted fish (OR=0.32 CI: 0.28-0.99, anchovy (OR=0.35 CI: 0.17-0.72), seaweed (OR=0.37 CI: 0.16-0.83), and tofu (OR=0.48 CI: 0.23-0.99) than the exemplary students. With respect to the juvenile delinquents, the nutrient intakes lower than 75% of the Korean RDA were for riboflavin (75.0%) and calcium (47.9%) among the boys, and calcium (46.9%) and iron (60.4%) among the girls. To prevent juvenile delinquency, nutritional education and well-balanced school food service meals should be emphasized so as to improve the management of dietary practices.
Although breastfeeding is recognized to be vital to the health and well-being of children and women, the rate of breastsfeeding among Korean women has continuously decreased. One barrier to breastfeeding has been identified to be associated with health care providers. Health care professionals do not give sufficient advice and encouragement, next do hospitals provide supportive environments for breastfeeding by separating infants from mothers or providing formula. The purpose of this study was to investigate prenatal breastfeeding education and infant feeding practices in public health centers and baby-friendly hospitals. A telephone survey was carried out on 57 public health centers located in the Seoul and Chungcheong areas and 13 baby-freindly hospitals from February to April in 2000. Among the public health centers, 43.8% offered periodic prenatal education for pregnant women who visited the centers. Most of them used leaflets or pamphlets developed by the Ministry of Health and Welfare or UNICEF. Twenty six percent of the public health centers developed their own educational materials. All of the 13 baby-friendly hospitals gave additional fluids to infants, did not allow mothers and infants to stay together 24 hours a day, and did not foster the establishment of breatfeeding support groups among the mothers. Most of the baby-friendly hospitals gave artificial teats, did not help mothers initiate breastfeeding within a half-hour of birth. Findings indicate that current practices even in the baby-friendly hospitals are not consistent with the '10 steps to success breastfeeding'. Therefore, deliberate efforts should be made to incorporate adequate breastfeeding education into prenatal program in both public health centers and hospitals, and create environments to support breastfeeding in hospitals, even in baby-friendly hospitals.
This study was conducted to investigate the weaning practice of 198 infants in Taejon city in October, 1998. Information on infant feeding and weaning practices were obtained by interviewing mothers in gynecologist and pediatric clinics located in Taejon. The results obtained were as follows : In the survey 37.4% of the infants were breast-feeding, while 31.3% of them were bottle-feeding and 29.3% of them were mixed-feeding. The reason for bottled-feeding was due either to the lack of breast-milk secretion or motner's job. The educational level of the mother and maternal job affected the feeding methods before weaning. Lower rates of breast-feeding were found among mothers witn a lover level of education. The breast-feeding rate was lower in full-time and part-time job worker groups than in housewife. There was no significant difference in the feeding methods according to family income. Among the subjects, 71.5% of infants began to be weaned within 7 months. The onset of weaning was delayed in the full-time worker group. There was no significant difference in the onset time of weaning according to feeding method, the educational level of the mother, and family income. 60.6% of infants received fruit juice and 29.6% of them received cereals for first-given-supplementary food. 'For baby's nutritional status' was the most common motivation for the onset of weaning. Commercially prepared foods were used more than home-made food for supplementary food.
This cross-sectional study was conducted to describe the changes of plasma cardiovascular disease(CVD) risk factors in Korea. Overnight fasting plasma levels of total cholesterol, high density lipoprotein(HDL)-cholesterol, triacylglycerol and glucose were analyzed. Blood pressure and anthropometric data were also measured. Health practice factors such as smoking status, alcohol consumption and frequency fo exercise were evaluated by a self-administered questionnaire. Questions regarding dietary habits and food preferences were also asked. Seventy eight percent of the subjects had more than one CVD risk factor. Plasma total cholesterol, triacylglycerol, and fasting blood glucose were significantly increased according to the subjects body mass index(kg/m2, BMI), whereas HDL-cholesterol, low density lipoprotein(LDL)-cholesterol and blood pressure showed no significant differences with BMI. Current smokers had significantly high plasma total cholesterol, LDL-cholesterol and triacylglycerol levels. Alcohol consumption significantly increased plasma total cholesterol and fasting blood sugar, but regular exercise had no effects on the plasma CVD risk factors. Overeating and frequency of fast food consumption were positively correlated with the CVD risk score, whereas intake of grains, meats and vegetables were negatively correlated with that score. A stepwise multiple regression analysis was performed to examine the effects of specific dietary factors on plasma lipid levels. For plasma total cholesterol level, the frequency of fast food intake explained 8% of the variance, followed by habitual overeating, frequency of grain intake and high cholesterol food intake(Model R2=22.4%). For plasma triacylglycerol level, preference of oily foods accounted for 7.5% of the variance, followed by eating breakfast, preference of fruit and frequency of grain intake(Model R2=22.0%). The findings suggest that intervention programs to reduce the risk of CVD should focus on health practice through reducing BMI, smoking cessation and moderate or no alcohol drinking. Moreover, desirable dietary habits such as eating breakfast, not overeating and reduced intake of fast food may improve CVD risk.
Although many people initially enroll in health education programs, there are many instances of erratic participation and dropouts. Inconsistent participation in intervention programs minimizes their impact on health promotion. Therefore, a theoretical understanding of factors influencing participation in these programs can potentially enhance the effectiveness of its educational strategy. This study used the Pender's Health Promotion Model to examine specific factors influencing incentives to participate in an elderly nutrition education program. The Elderly Nutrition Counseling and Education Program was conducted with 147 volunteers (76 males, 71 females), aged 60 to 87, at 5 separate community elderly centers, by public health dietitians from February to April 1997. Some participants dropped out during the program. Overall, 61 people(18 males, 43 females) finished all 7 steps over 2 months. Pre-intervention data were collected by trained dietitians. This data included individual cognitive-perceptual factors(perceived benefits of nutrition improvement, importance of health, perceived control over health by multidimensional health locus of control, self esteem, perceived health status, concern about health, depression scale and social health scale), which were known to influence the likelihood of health behavior, and modifying factors(socioeconomic variables, biological characteristics, behavioral factors, such as smoking, alcohol drinking and exercise). Male finalists had a significantly lower chance for health locus of control, and better social health status with their children and grandchildren, compared to males who dropped out. Female finalists had a significantly higher locus of control regarding food behavior, higher self-esteem, better recognized nutritional status, worse self-recognized health status and lower concern about health than those who dropped out. There was no significant difference between the attendees and dropouts in age, BMI( kg/m2), Nutritional Risk Index, depression scale and daily nutrient intake. These results suggest that elderly nutrition intervention plans should focus on the individual cognitive and perceptual factors, with interpersonal influences, to increase participation in nutrition in nutrition improvement programs.
The purpose of this study was to evaluate the nutritional status and growth of Korean infants, who were atending peripheral community clinics in low income areas, by anthropometric measurements and estimating dietary intakes. Dietary intakes and growth were compared among different feeding patterns of 143 infants until age 9 months. The overall mean nutrient intakes of infants in this study were below the recommended allowances except the calcium intake from significant difference in each groups; however, calcium, zinc and iron intake of the formula fed infant(FF) was higher than the breast fed infant(BF) or the mixed fed infant(MF). Form ages 4-6 months, the nutrient intakes were shown to be higher in groups that were given supplementary foods than groups that were not. From ages 7-9 months, all nutrient intakes were higher in or the formula and supplementary foods fed(ESF) infants than in the breast and supplementary food(BSF) or the formula and supplementary food(FSF) groups, All subjets in this study showed a large Z-score. The growth of infants up to 6 months of age showed no significant difference in the feeding pattern, however, after 7 months of age the BSF group had significantly lower weight than the FSF or the ESF groups, There were significant positive relationships between infants weight gain at age 7-9 months from birth and the current protein or zinc intakes. As a result the average status of nutrient intakes of infants in this area was loser than the RDA, however, the growth pattern was fairly good. Although the breast milk is beneficial for infants, mothers should be educated for the importance of supplemental food and its practice to support good nutrition.