Korean Journal of Community Nutrition

[English]
Nutrient Composition and Content of Vitamin and Mineral Supplements and Their Appropriateness for Pregnant and Lactating Women in Korea: Young Hee Han, Jeong Hyeon Seo, Gu Rum Shin, Ju Young Shin, Ye Young Jo, Taisun Hyun; Korean J Community Nutr 2018;23(4):341-351. Published online August 31, 2018; DOI: https://doi.org/10.5720/kjcn.2018.23.4.341

OBJECTIVES
Use of dietary supplements containing vitamins and minerals is growing in Korean adults, especially in pregnant and lactating women. Vitamin and mineral supplements are available in different composition and in a wide range of contents. The purposes of the study were to examine nutrient composition and content of vitamin and mineral supplements for pregnant and lactating women and assess their appropriateness as dietary supplements.
METHODS
Information on the name, manufacturer, nutrient composition, and usage of vitamin and mineral supplements for pregnant and lactating women were obtained from the homepage of the Food Safety Information Portal managed by the Ministry of Food and Drug Safety, and Korean Index of Medical Specialties. A total of 264 products were identified.
RESULTS
Among 264 products, 26.1% were single nutrient products, and 73.9% were multinutrient products. The most commonly included nutrient was iron (70.1%), folic acid (66.3%), vitamin B12 (45.8%), vitamin C (38.6%), and vitamin B6 (38.6%). Although more than 50% of products contained nutrients less than 150% of Recommended Nutrient Intakes or Adequate Intakes for daily use, some products contained inappropriately high amounts of nutrients. When a maximum daily dose of supplements was taken as described on the label, iron in 73 products (39.5%), folic acid in 14 products (8.0%) were likely to be consumed in amounts greater than Tolerable Upper Intake Levels. Most products were assessed as inappropriate for pregnant women due to the possibility of excessive intake of vitamins or minerals when compared with Dietary Reference Intakes.
CONCLUSIONS
Pregnant and lactating women need to carefully select dietary supplements containing adequate amounts of vitamins and minerals. Nutritionists should provide guidelines regarding selection of appropriate vitamin and mineral supplements for pregnant and lactating women.

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Folate: 2020 Dietary reference intakes and nutritional status of Koreans
Young-Hee Han, Taisun Hyun
Journal of Nutrition and Health.2022; 55(3): 330. CrossRef
Analysis of A and E vitamer profiles in domestic raw and processed seafood consumed in Korea
Ye-Eun Park, Yu-Jeong Gwak, Jeong Kim, YuSen Guan, Won-Ho Hong, Su-Jin Park, Na-Young Yoon, Yeon-Kye Kim, Sang Kuk Han, Jiyeon Chun
Korean Journal of Food Preservation.2021; 28(7): 926. CrossRef

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[English]
Development of Education Materials as a Card News Format for Nutrition Management of Pregnant and Lactating Women: Young Hee Han, Jung Hyun Kim, Min Jun Lee, Taeksang Yoo, Taisun Hyun; Korean J Community Nutr 2017;22(3):248-258. Published online June 30, 2017; DOI: https://doi.org/10.5720/kjcn.2017.22.3.248

Abstract PDF PubReader

OBJECTIVES
The purpose of the study was to develop a series of education materials as a card news format to provide nutrition information for pregnant and lactating women.
METHODS
The materials were developed in seven steps. As a first step, the needs of pregnant and lactating women were assessed by reviewing scientific papers and existing education materials, and by interviewing a focus group. The second step was to construct main categories and the topics of information. In step 3, a draft of the contents in each topic was developed based on the scientific evidence. In step 4, a draft of card news was created by editors and designers by editing the text and embedding images in the card news. In step 5, the text, images and sequences were reviewed to improve readability by the members of the project team and nutrition experts. In step 6, parts of the text or images or the sequences of the card news were revised based on the reviews. In step 7, the card news were finalized and released online to the public.
RESULTS
A series of 26 card news for pregnant and lactating women were developed. The series covered five categories such as nutrition management, healthy food choices, food safety, favorites to avoid, nutrition management in special conditions for pregnant and lactating women. The satisfaction of 7 topics of the card news was evaluated by 140 pregnant women, and more than 70% of the women were satisfied with the materials.
CONCLUSIONS
The card news format materials developed in this study are innovative nutrition education tools, and can be downloaded on the homepage of the Ministry of Food and Drug Safety. Those materials can be easily shared in social media by nutrition educators or by pregnant and lactating women to use.

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Risk factors for inadequate and excessive gestational weight gain during pregnancy among women
Ju Sun Cho, Sook Jung Kang
Midwifery.2025; 144: 104345. CrossRef
A comparative study on nutritional knowledge and dietary behavior between Korean and Chinese postpartum women
Sohyun Kim, Heewon L Gray, Jia Li, Haeryun Park, Youngmi Lee, Kyunghee Song
Nutrition Research and Practice.2019; 13(6): 535. CrossRef

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[English]
Development of Nutrition Education Contents for Pregnant Women Based on Effective Communication Strategies: Taeksang Yoo, Young Hee Han, Jung Hyun Kim, Min Jun Lee, Taisun Hyun; Korean J Community Nutr 2017;22(2):115-126. Published online April 30, 2017; DOI: https://doi.org/10.5720/kjcn.2017.22.2.115

Abstract PDF PubReader

OBJECTIVES
The purpose of the study was to develop communication strategies for effective nutrition education targeting pregnant women and to create nutrition education contents.
METHODS
The format and the contents of online resources on nutrition information for pregnant women provided by reliable institutions were analyzed. Possible solutions to overcome barriers of nutrition education as well as communication strategies for effective nutrition education were identified by a brainstorming process. Based on the communication strategies, contents for nutrition education were created. Understandability, level of interest, applicability to daily life, harmony of text and illustration, and overall satisfaction of the contents were evaluated by dietitians and pregnant women.
RESULTS
The four communication strategies were developed; (1) to focus on a few important messages, (2) to provide evidence-based information, (3) to create illustrations or infographics with a minimum amount of text, and (4) to provide tips on how to improve the current diet options. Based on these strategies, the contents were focused on three important nutrients for pregnant women, folate, iron, and calcium. The percentages of the recommended nutrient intakes of the three nutrients on selected menu and its improved version by adding a dish or changing a dish into another dish were calculated and provided. Finally, the contents were delivered as illustrations with a minimum amount of text. Overall, dietitians and pregnant women were satisfied with the contents.
CONCLUSIONS
The contents developed in this study can be used in a pamphlet or a pregnancy diary, or can be shared in social networking services. Further contents on other nutrients and various menu are expected to be developed using these communication strategies.

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Development of Education Materials as a Card News Format for Nutrition Management of Pregnant and Lactating Women
Young-Hee Han, Jung Hyun Kim, Min Jun Lee, Taeksang Yoo, Taisun Hyun
Korean Journal of Community Nutrition.2017; 22(3): 248. CrossRef

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[English]
A study on Consumer's Needs for Development of Diet Guide Application for Pregnant Women: Sook Bae Kim, Jeong Weon Kim, Mi Hyun Kim, Young Sook Cho, Se Na Kim, Hee Sook Lim, Soon Kyung Kim; Korean J Community Nutr 2013;18(6):588-598. Published online December 31, 2013; DOI: https://doi.org/10.5720/kjcn.2013.18.6.588

Abstract PDF PubReader

This study was conducted to assess needs of educational mobile application (App) development for nutritional management and information on pregnant women. A total of 105 pregnant women were investigated on general characteristics, dietary habits, health behavior and needs for contents and composition of the application. The mean age of the subjects was 31.9 years and the mean gestation period was 25.4 weeks. The rate of skipping meal was 39.0% and the rate of irregular meal time was 46.6%. The consciousness of the meal as balanced nutrition and health was 19.9%. Eating out at least forth a week was 35.3%. Obtaining information about pregnancy and childbirth were internet (35.3%), hospital or health center (19.9%), books (17.1%), experience (15.2%), mobile (8.6%) and friends or acquaintances (4.8%). If the application is developed, subject replied 'frequently use' (51.4%), 'when needed' (47.6%) respectively. The favour topic in developing application were 'nutrition information of pregnant and fetal' (36.2%), 'weight management, feeding' (33.3%), 'food choice and cooking' (21.9%), 'shopping' (5.7%), 'example of menu' (1.9%), 'effect of smoking, drinking, exercising' (1.0%). The favorite content was 'include sufficient amount about information' (44.8%). Depending on the age and education level, the best age for pregnancy group have significantly higher ability for utilize and information gathering than old age pregnant group. Also the best age for pregnancy group have high demands of design, convenience and various contents in App development. Therefore, mobile application (App) for pregnant women could be widely used as an effective dietary guide.

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A Keyword Analysis Study on Postpartum Obesity Using Big Data
Hyung-ui Baik, Bo-Kyung Seo, Gyu-Ri Kim, Jung-Eun Ku
International Journal of Environmental Research and Public Health.2021; 18(16): 8807. CrossRef
A comparative study on nutritional knowledge and dietary behavior between Korean and Chinese postpartum women
Sohyun Kim, Heewon L Gray, Jia Li, Haeryun Park, Youngmi Lee, Kyunghee Song
Nutrition Research and Practice.2019; 13(6): 535. CrossRef
Development of Education Materials as a Card News Format for Nutrition Management of Pregnant and Lactating Women
Young-Hee Han, Jung Hyun Kim, Min Jun Lee, Taeksang Yoo, Taisun Hyun
Korean Journal of Community Nutrition.2017; 22(3): 248. CrossRef
Development of Nutrition Education Contents for Pregnant Women Based on Effective Communication Strategies
Taeksang Yoo, Young-Hee Han, Jung Hyun Kim, Min Jun Lee, Taisun Hyun
Korean Journal of Community Nutrition.2017; 22(2): 115. CrossRef
Comparison on the Use of Smartphone Application between International and Korean Pregnant Women
Hyeon Jihye, Syed Nitas Iftekhar
International Journal of Information and Education Technology.2016; 6(5): 404. CrossRef
Comparing Nutrition Knowledge, Eating Habits, and Neonatal Health Status of Primipara for Pregnant Women of Advanced Maternal Age Compared to Those of Younger Ages
Sun-Ok Lee, Kyung-Yeon Park, Mi-Jung Han
Korean Journal of Women Health Nursing.2015; 21(4): 253. CrossRef

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[English]
The Use of Iron Supplements of Pregnant Women and Pregnancy Outcome: Ji Hyun Cho, Hong Seok Ahn, Hyun Sook Bae; Korean J Community Nutr 2009;14(3):327-339. Published online June 30, 2009

Abstract PDF: It is known that Korean pregnant women take iron supplements at a higher than the recommended level. This study was designed to provide data on current iron intake levels both from food sources and supplement to better guide iron supplement use during pregnancy. We also explored associations of iron supplement intake levels with varioussociocultural factors and pregnancy outcomes. Dietary intakes of 510 pregnant women were assessed by a validated 102- item food frequency questionnaire, and information on types and amounts of nutritional supplement intakes were also attained. While dietary intake levels of most nutrients exceeded the KDRIs (Korea Dietary Reference Intakes: EAR: Estimated Average Requirements), folate fell short of the KDRIs. A total of 428 women (83.9%) reported to take iron supplement. The pregnant women were divided into the three groups (group I: Fe supplement intake < or = EAR, group II: EAR< Fe supplement intake < or = 3 times of EAR, group III: 3 times of EAR< Fe supplement intake). The mean dietary intake of iron was 24% of the total iron intake for pregnant women. Iron intake from food was not significantly different among I, II, and III. In case of iron intake from supplements, the most frequent dose (34.1%) was 90-100 mg/day, and the mean iron supplement intake was 362% of the EAR. The study findings showed that those with higher levels of iron supplements had better meal quality measured by NAR (Nutrient Adequacy Ratio) and INQ (Index of Nutrient Quality). In addition iron supplement intake levels were significantly related to age (20s: 66.5 +/- 38.6 mg/day, 30s: 77.3 +/- 47.8 mg/ day, p< 0.0116) and experience of childbirth (1st pregnancy: 70.9 +/- 41.2 mg/day, 2nd pregnancy: 64.5 +/- 39.5 mg/day, > or = 3rd pregnancy: 94.4 +/- 63.8 mg/day, p< 0.005). However, no significant difference was found between iron supplement intake levels and various pregnancy outcomes including birth weight, birth height, gestational age, weight gain during pregnancy, and jaundice. It is worrisome that iron intake by supplement use greatly exceeded the EAR, suggesting the need of appropriate guidelines for iron supplement intake during pregnancy. Thus iron overdose from supplements in pregnancy should be considered as a serious condition.

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[English]
Serum Iron Concentration of Maternal and Umbilical Cord Blood during Pregnancy: Hey Mi Jang, Hong Seok Ahn; Korean J Community Nutr 2005;10(6):860-868. Published online December 31, 2005

Abstract PDF: Anemia diagnosed early in pregnancy is associated with increased risks of low birth weight and preterm delivery. The purposes of this study were to assess the maternal iron status during pregnancy and to evaluate the relationships between the iron indices of maternal-umbilical cord serum iron and ferritin levels and pregnancy outcomes. Dietary intakes of the pregnant women were estimated by 24 hour-recall (3 times). Serum iron and ferritin levels in maternal blood and umbilical cord were measured at 1st-, 2nd-, 3rd- trimester and delivery, respectively. The mean of maternal serum iron levels of the trimester and delivery were 124.27microgram/dl, 97.03microgram/dl, 94.32microgram/dl, and 145.53microgram/dl. Those maternal levels were significantly lower than that of umbilical cord blood (222.59microgram/dl). Serum ferritin levels of maternal trimester and delivery were 22.68microgram/l, 11.09microgram/l, 14.18microgram/l and 24.54microgram/l, which were significantly lower than those of umbilical cord blood (184.35microgram/l)(p<0.0001). This prevalence of anemia of total subjects was 30.3% by WHO criteria (Hb<11.0 g/dl, Hct<33%). Iron levels of 2nd-trimester was significantly higher in the normal group than in the anemia group. And ferritin levels of 3rd-trimester and delivery was significantly higher in the normal group than in the anemia group. Therefore, we suggest for successful pregnancy outcome and delivery differential iron supplementation programs will be carried out with individual pregnant women on the basis of pre-pregnancy nutrition.

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[English]
A Change of Serum Folate and Vitamin B12 Concentrations of Maternal and Umbilical Cord Blood during Pregnancy: Geum Ju Lee, Hey Mi Jang, Hong Seok Ahn; Korean J Community Nutr 2005;10(5):615-622. Published online October 31, 2005

Abstract PDF: Folate and Vitamin B12 are essential nutrients important during pregnancy. This study was conducted to evaluate the folate and vitamin B12 nutritional status of Korean pregnant women and to investigate the relationship between maternal-umbilical cord serum folate and vitamin B12 levels and pregnancy outcomes. Dietary intakes of the pregnant women were estimated by 24 hour-recall (3 times). Serum folate and vitamin B12 levels in maternal blood and umbilical cord of 27 pregnant women at 1'st-, 2'nd-, 3'rd- trimester and delivery were measured by RIA (radioimmuno assay), respectively. Means of folate and vitamin B12 intake were 283.53 +/- 58.01 microgram/day and 2.99 +/- 1.32 mg/day, respectively. Maternal mean serum folate levels of the trimester and delivery were 9.75 +/- 3.60 ng/ml, 10.46 +/- 4.63 ng/ml, 10.71 +/- 4.14 ng/ml and 15.05 +/- 7.04 ng/ml. Those maternal levels were significantly lower than that of umbilical cord blood (23.99 +/- 9.42 ng/ml). Serum vitamin B12 levels of maternal trimester and delivery were 479.07 +/- 137.56 pg/ml, 310.96 +/- 137.56 pg/ml, 308.22 +/- 74.65 pg/ml, and 295.67 +/- 93.36 pg/ml, which were significantly lower than those of umbilical cord blood (500.13 +/- 185.60 ng/ml). This finding indicates that the uptake of folate and vitamin B12 in the fetus may be due to an active placental transport mechanism. Maternal serum level correlated positively with those of umbilical cord blood, showing that folate and vitamin B12 concentration of umbilical cord blood might be affected by maternal status. There was no significant correlation between the serum folate levels in maternal-umbilical cord blood and the pregnancy outcomes. However, maternal vitamin B12 level at 1'st trimester was significant positive correlation between the gestational age except for birth weight and weight gain.

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[English]
Mineral Intakes and Serum Mineral Concentrations of the Pregnant and Lactating Women: Woon Ju Kim, Hong Seok Ahn, Eun Jung Chung; Korean J Community Nutr 2005;10(1):59-69. Published online February 28, 2005

Abstract PDF: The purpose of this study was to estimate the mineral intakes and serum mineral levels of pregnant and lactating women. The subjects consisted of 34 non-pregnant, 56 pregnant and 20 lactating women. Nutrients intakes were investigated by the 24-hr recall method, and serum major and trace minerals were analyzed by the ICP-spectrometry. Calcium (Ca) and zinc (Zn) intakes were observed lower than RDA especially for both pregnant and lactating women. Iron (Fe) intake of pregnant women was 85 - 139% RDA through Fe supplementation, and that of lactating women was lower than RDA. Compared with non-pregnant women, the pregnant women had similar Ca intake and higher magnesium (Mg) intake. Comparing with the non-pregnant women, serum Ca level in pregnancy was lower, and that of lactating women was not significantly different. Serum phosphorus and Mg levels were not significantly different among the groups. Serum Fe level of pregnant and lactating women was lower than that of the non-pregnant women. Serum Zn level of pregnant women was lower than those in the lactating and non-pregnant women. Serum copper level decreased as the pregnancy progressed. Serum sodium (Na) level was higher in 2nd- and 3rd trimester and potassium (K) level was higher in 3rd trimester and lactating period than other groups. Na/K ratio was not significantly different among the groups. During all periods, there was no correlation between dietary intakes and serum levels in each minerals. Serum Ca level positively corrleated with serum Mg level, especially in 3rd trimester and lactating women. In general, serum mineral levels in pregnancy were changed compared to the levels in non-pregnancy and restored in lactation to the levels for non-pregnancy.

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[English]
The Dietary Intake of Pregnant Women in Daegu Area: Hyo Jee Joung, Bong Soon Choi, Joung Ja Shin, Sung Do Yoon, Hwak Yoon; Korean J Community Nutr 2003;8(4):538-546. Published online August 31, 2003

Abstract PDF: This study was carried out to figure out the dietary intake of pregnant women in Daegu area. A total of 467 pregnant women was recruited at two hospitals in this area to collect the information on dietary intakes, general characteristics, and anthropometric measurements using an interview. Forty-seven women (10.1%) were in the first trimester, 101 women (21.6%) in the second trimester, and 319 women (68.3%) in the third trimester. The mean age, prepregnant weight and height of subjects were not significantly different among the trimester groups. The mean daily nutrient intakes of energy, fat, protein, carbohydrates, phosphate, sodium, vitamin B1, vitamin B2, and vitamin C were significantly different among the trimester groups, but the other nutrients were not different. For the calcium and iron, the percentage of subjects consumed less than 75% of the Korean RDA was over 80%, and for other nutrients such as energy, vitamin B1, and vitamin B2 over 50% of subjects consumed less than 75% of the Korean RDA in the first trimester. The correlations between nutrient intakes and weight gain during pregnancy showed different patterns among the trimester groups. The mean adequacy ratio and dietary variety scores were not significantly different among the trimester groups. The amount of food intake from cereals and cereal products were higher during the second and the third trimester compared to the first trimester, but those of the other food groups were not significantly different. In conclusion, nutrient intakes of the pregnant women for iron, calcium and some vitamins were inadequate and nutritional management programs for these nutrients are necessary.

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[English]
A Screening Tool for Identifying High-Risk Pregnant Women of Fe Deficiency Anemia : Process II: Jung A Park, Jin Sook Yoon; Korean J Community Nutr 2003;8(2):160-170. Published online April 30, 2003

Abstract PDF: Pregnant women in South Korea are a highly risk group for iron deficiency anemia. Previous studies indicated that the 24-hour recall method was insensitive in distinguishing iron deficiency anemic women from normal women. This method is also impractical to when used at community health centers where no public health dietitians are employed. The objective of this study was to develop a convenient tool to evaluate the usual iron (Fe) intake of pregnant women. The study participants were 115 pregnant women (age 23 to 37 years) at gestational stage of 13 to 24 weeks. Anemic subjects were classified on the basis of their serum ferritin < 12.0 microgram/L and hemoglobin < 12.0microgram/dL levels. Food frequency questionnaires with 46, 29, and 15 commonly consumed food items were used to measure the usual intake of iron of the subjects. Hemoglobin and serum ferritin were measured from fasting blood samples. Nutrients intake was assessed on three consecutive days using the 24-hour recall method and the food record method. The iron index score calculated using the food frequency method showed a significantly positive correlation with iron intake for the three days dietary intake. The iron index showed a significantly difference (p < 0.05) between the normal and anemic groups. However, there was no significant difference in the iron intake between the anemic and the normal women as measured by the 24-hour recall and food record method. Our study indicated that the 29-food items questionnaire could be used as a screening tool to identify poor dietary intake of iron.

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[English]
A Screening Tool for Identifying High-Risk Pregnant Women of Fe Deficiency Anemia : Process I: Jung A Park, Jin Sook Yoon; Korean J Community Nutr 2001;6(5):734-743. Published online December 31, 2001

Abstract PDF: Iron deficiency anemia is a worldwide public health problem relevant to unsound nutritional practice. While the prevalence of iron deficiency anemia is very common among pregnant women, appropriate nutritional service programs to improve the iron status are lacking in Korea. In an attempt to develop a nutritional screening tool to separate the high-risk subjects of iron deficiency, we carried out a nutritional survey for 115 Korean pregnant women whose gestational age ranged from 13 to 24 weeks. Each subject was interviewed with questionnaires for general characteristics and dietary habits. Food intake was measured by 24-hour recap method and 2 day record. Fasting blood was drawn for measuring hemoglobin and serum ferritin. It appeared that half of the pregnant women belonged to the anemia group and had insufficient dietary habits to provide adequate amounts of dietary iron. The first gravida and the working women had better hematological iron indicators than the second or more gravida and the housewives. It also appeared that women who had bigger family size and lower BMI in pre-pregnancy had poorer iron status. Among the food consumption habits, fruit dependent dietary habit was related to poor iron status. Sufficiently consumed green leafy vegetable and appropriate amount of food before morning sickness were positive factors of iron stares. Our results indicated that parity, BMI, current job, family size, food habits including consumption of fruits, green & yellow vegetables, and food habits before the onset of morning sickness are significant factors to contribute the Fe deficiency anemia during pregnancy.

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[English]
Assessment of the Intake and Availability of Dietary Iron and Nutrition Knowledge in Pregnant Women: Eunkyung Kim, Kyuhee Lee; Korean J Community Nutr 1998;3(1):53-61. Published online February 28, 1998

Abstract PDF: This study was designed to estimate mean daily iron intake and its bioavailability and to assess nutrition knowledge for 144 pregnant women in the last trimester. Serum ferritin concentration was analyzed to estimate their iron stores. Dietary intakes of iron(heme iron and nonheme iron), the amounts of MPF(meat, poultry and fish) and ascorbic acid were assessed by modified 24-hr recall method. The food frequency questionnaire was used to assess subjects usual food consumption patterns. The mean value of serum ferritin was 21.3+/-15.3ng/ml and 26.4% of the pregnant women had a serum ferritin level<12ng/ml(i.e. depleted iron stores). The mean daily intake of total orin in the pregnant women was 56.5%(17.0 mg) of RDA and heme iron intake was 0.94 mg which was 5.5% of total iron intake. Total absorbable iron calculated by the method of Monsen was 2.41 mg and bioavailability of dietary iron was 2.41%. Food frequency test score of meats group was positively correlated(r=0.443) with the bioaavailability of dietary iron. The mean score on the nutrition knowledge test of subjects was 12.76(out of a possible 20 points). These results indicate that the nutritional iron status may be improved by increasing either the amount of iron in the diet or its availability.

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