Korean Journal of Community Nutrition

[English]
Factors associated with malnutrition in demented and non-demented elderly residing in the community of Korea: a cross-sectional descriptive and analytical study: Jinhee Kwon, Jung Hee Kim, Hyeonjin Jeong, Jung Suk Lee; Korean J Community Nutr 2024;29(5):359-371. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00013

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This study aimed to investigate and compare factors associated with malnutrition according to the presence or absence of dementia in community-dwelling elderly people.
Methods
Needs assessment data from 311 long-term care insurance (LTCI) recipients (dementia group 203; non-dementia group 108) that participated in the second pilot program of the integrated care model in community care settings under the Korean LTCI system were used. Descriptive statistical analysis, independent t-test, and analysis of variance were conducted on the sociodemographic characteristics, health and functional status, and nutritional status of the dementia and non-dementia groups. Logistic regression analysis was conducted to identify factors associated with malnutrition in the dementia and non-dementia groups.
Results
Malnutrition occurred in 33.5% and 26.9% of participants in the dementia and non-dementia groups, respectively. In the dementia group, living with family rather than living alone (odds ratio [OR]: 3.81; 95% confidence interval [CI]: 1.50–9.66; P = 0.031), increase in Korean Activities of Daily Living (K-ADL) score (OR: 1.35; 95% CI: 1.17–1.55; P < 0.001), and increase in the Neuropsychiatric Inventory-Questionnaire score (OR: 1.02; 95% CI: 1.01–1.03; P = 0.005) were associated with a higher risk of malnutrition. In the non-dementia group, the risk of malnutrition increased as the K-ADL score increased (OR: 1.20; 95% CI: 1.04–1.39; P = 0.011) and in the depressed group (OR: 2.84; 95% CI: 1.04–7.74; P = 0.042).
Conclusions
The study results confirmed the necessity of nutritional management for community-dwelling LTCI recipients. When developing a nutritional management program, considering the differences in factors related to malnutrition between the dementia and non-dementia groups is important. This study proposes policies for improving the LTCI system in terms of nutritional management and the utilization of community resources.

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[Korean]
An educational needs analysis of sustainable dietary education for nutrition teachers: an application of the IPA, Borich needs assessment and The locus for focus model: Eunseo Yang, Borham Yoon; Korean J Community Nutr 2024;29(5):372-381. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00008

Abstract PDF PubReader ePub: Objectives
This study aimed to investigate the importance and performance levels of sustainable dietary education across the health, environment, and society domains as perceived by nutrition teachers and evaluate the needs and priorities for sustainable dietary education.
Methods
An online survey was conducted for 151 nutrition teachers in Jeollanam-do. The survey included 20 questions across the health, environment, and society domains. The data were analyzed using a paired-sample t-test, the importance-performance analysis (IPA), the Borich needs assessment model, and the locus for focus model.
Results
Overall, the average importance levels of the 20 items of sustainable dietary education were significantly higher than their average performance levels (4.44 vs. 3.68). The examination of each educational domain revealed that although the importance of education in the health domain was recognized and actively practiced by the nutrition teachers, the performance was comparatively lower in the environment and society domains. The Borich needs assessment and the locus for focus model identified education on biodiversity conservation, plant-based protein, and the use of local food as the top-priority group in the environment domain along with fair and ethical food, food security, regional food culture, food policy and trade, and family dining culture as the second-priority group in the society domain.
Conclusions
The results of this study underscore the need to support the nutrition teachers’ perception and practice of sustainable dietary education in the environment and society domains. We believe that the educational needs and priorities proposed in this study will be considered in the future development and modification of sustainable dietary education programs.

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[English]
Outcome expectations, self-efficacy, eating environment, and eating behaviors by the stages of change in adequate sodium intake among university students: a cross-sectional study: Yeon Gyu Im, Kyung Won Kim; Korean J Community Nutr 2024;29(5):382-395. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00010

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This study investigated whether outcome expectations, self-efficacy, eating environment, and eating behaviors differed according to the stages of change in adequate sodium intake among university students. Methods: The participants were students recruited from nine universities in Seoul, Korea. An online survey was conducted, and data from 351 participants were analyzed. Participants were classified into pre-action and action stages based on adequate sodium intake. Data were analyzed using t-test, χ2-test, analysis of covariance, and correlation analysis. Results: Participants in the action stage (22.8%) felt fewer disadvantages of eating sodium adequately compared to those in the pre-action stage (77.2%, P < 0.001) and perceived more self-efficacy for healthy eating behaviors (P < 0.001) and controlling sodium intake (P < 0.01). The participants in the action stage also showed more desirable eating behaviors than those in the pre-action stage, including general eating behaviors, behaviors related to sodium intake, and sodium checks (P < 0.001). The physical environment in the action stage was more supportive of adequate sodium intake (P < 0.05). Eating behaviors, self-efficacy, and outcome expectations were significantly correlated with the stages of change; however, some differences were noticed in the correlation of the subscales of variables with the stages of change when examined by sex. Conclusion: We observed differences in factors according to the stages of change in adequate sodium intake. For the pre-action stage, nutrition education can be planned to modify negative expectations of eating adequate sodium, foster self-efficacy, and practice general eating behaviors and behaviors to gradually reduce sodium intake. It is also necessary to alter the physical environment to reduce sodium intake. In the action stage, support and reinforcement are needed to continually practice and maintain desirable eating behaviors. Nutrition education for women may be planned using multiple paths, whereas a simple strategy may be useful for men.

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[English]
Associations between the symptoms of gastroesophageal reflux disease and dietary and lifestyle behavior among young Korean adults: a preliminary cross-sectional study: Soheun Shim, Jeong-Hwa Choi, Young-Ran Heo; Korean J Community Nutr 2024;29(5):396-405. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00011

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Gastroesophageal reflux disease (GERD) is a clinical condition caused by esophageal tissue damage resulting from the reflux of stomach or duodenal contents. An increasing number of GERD cases have been reported recently; however, research on this population, especially young adults, is lacking. This study aimed to investigate the dietary and lifestyle factors associated with GERD symptoms in young Korean adults. Methods: A total of 202 individuals (19–34 years old) living in Gwangju were surveyed using a questionnaire to examine their general characteristics, lifestyle, and dietary behaviors. GERD symptoms were investigated using the gastroesophageal reflux disease questionnaire (GerdQ). The participants were grouped into normal (GerdQ score ≤ 4) and caution (GerdQ score ≥ 5), and their characteristics were analyzed according to the group. Results: The findings suggested 15 participants (7.4%) belonged to the GERD caution group. More non-office workers were in the caution group than in the normal group (P < 0.05). The participants’ smoking, physical activity, sleep duration, and pillow height were not significantly different between the GERD phenotypes; however, the caution group consumed alcohol more frequently than the normal group (P < 0.001). The analyses of the participants’ eating behaviors revealed that the frequency of overeating, late-night snacking and chocolate consumption was significantly higher in the caution group (P < 0.001). Conclusion: Lifestyle and dietary behaviors were associated with GERD symptoms in young Korean adults. Further studies with larger cohorts are required to confirm these findings.

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[Korean]
Food purchase patterns, food policy recognition, and food environment satisfaction among adults in Jeju, Korea, according to food security: a cross-sectional study: Sumin Kim, Youjeong Jang, Hyunji Ham, Hanbin Ko, Insuk Chai, Kyungho Ha; Korean J Community Nutr 2024;29(5):406-417. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00012

Abstract PDF Supplementary Material PubReader ePub: Objectives
Recently, food insecurity has been a major public health issue along with the food crisis caused by COVID-19, climate change, and the polarization of food supply due to socioeconomic disparities. Food insecurity is known to be related to the food choices and environment of the consumer. Therefore, this study aimed to evaluate the food security statuses of adults in Jeju and investigate their food purchase patterns, food policy recognition, and food environment satisfaction.
Methods
Based on data from the 2022 Jeju Food Survey, 346 adults aged ≥19 years in Jeju were classified into food security and insecurity groups (quantitatively and qualitatively) using the questionnaire. Food purchase patterns, including purchasing frequency, items, and reasons, were surveyed for local and eco-friendly foods. The recognition and necessity of several food policies and satisfaction with diet and food environment (availability, accessibility, affordability, accommodation, and acceptability) were measured using the Likert scale.
Results
Among the total participants, 47.4% were in the food insecurity group. The frequency of purchasing local and eco-friendly foods did not significantly differ by food security status. The insecurity group exhibited a higher recognition rate of basic rights to food (36.0%) than the security group (24.7%, P = 0.023). The recognition and necessity of specific food policies did not significantly differ by food security status, except for the policy of promoting food communities, for which the food security group exhibited higher recognition than the food insecurity group did (P = 0.004). The food insecurity group exhibited significantly lower scores regarding satisfaction toward diet and food environment factors (P < 0.05 for all).
Conclusions
Overall, the food security group reported higher satisfaction with their diet and food environment than the food insecurity group. Further in-depth studies to investigate the determinants of food insecurity and effective promotional strategies for food policies are needed.

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[English]
Health-related quality of life and nutrient intake of the elderly with type 2 diabetes according to comorbidity burden: a cross-sectional study: Yejung Choi, Kyong Park; Korean J Community Nutr 2024;29(5):418-430. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00014

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This study aimed to explore the cross-sectional association between health-related quality of life (HRQoL) according to the number of comorbidities in older adults with type 2 diabetes mellitus (T2DM) using the Euro Quality of Life-5 Dimensions (EQ-5D) index. Methods: This study included 3,553 participants aged ≥ 65 years from the 2008–2020 Korea National Health and Nutrition Examination Survey. Dietary data were collected through 24-hour recall interviews by trained researchers, and demographic and lifestyle information via self-administered questionnaires. HRQoL was measured using a modified EQ-5D scale. Multivariable linear regression analyzed the associations between EQ-5D scores, nutrients and comorbidity, controlling for sociodemographic and health variables. Results: Most participants reported ‘no problems’ in the EQ-5D scores, although approximately 17% to 47% of participants reported ‘some problems’ or ‘extreme problems,’ depending on the dimension. As comorbidities increased, significant declines were observed across all dimensions, particularly in mobility, usual activities, pain/discomfort, and anxiety/ depression. Nutrient intake analysis revealed that participants with three or more comorbidities consumed less carbohydrates, but more fat. Conclusion: Our findings demonstrate that among older adults with T2DM, a higher number of comorbidities is associated with decreased HRQoL. Additionally, there are differences in nutrient intake patterns among those with more comorbidities, specifically decreased carbohydrate intake and increased fat intake. These results emphasize the need for comprehensive and tailored management strategies that consider both diabetes and the co-occurring health conditions. By addressing the complex healthcare needs of individuals with multiple comorbidities, it is possible to enhance their HRQoL and overall well-being.

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[Korean]
The needs and prioritization of nutrition and dietary support for individuals with disabilities: an exploratory study: Jong Eun Park, Yu Jin Kim, So Young Kim, Jong Hyock Park; Korean J Community Nutr 2024;29(5):431-443. Published online October 31, 2024; DOI: https://doi.org/10.5720/kjcn.2024.00009

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Based on a survey of officers, social workers, and dietitians involved in managing nutrition and welfare policies or projects for vulnerable groups in local governments or private welfare institutions, this study aimed to assess the need for nutritional and dietary support policies and programs for persons with disabilities (PWD), as well as to identify appropriate support measures. Methods: An online survey was conducted from March 2 to 15, 2021. The survey included 20 questions exploring perspectives on the nutritional status of PWD, their need for nutritional and dietary support policies and programs, and the prioritization of appropriate support measures. A total of 132 responses were analyzed. Results: Approximately 68.9% of the respondents rated the nutritional status of PWD as “bad” or “very bad.” A substantial number identified “difficulty in purchasing ingredients, cooking, and preparing meals independently due to disability,” and “limited knowledge about nutrition and recipes necessary for maintaining a healthy and balanced diet” as the primary challenges in the dietary and nutritional management of this population. Additionally, 97.0% of the respondents deemed that the introduction of nutritional and dietary support policies and programs for PWD was “needed” or “very much needed.” Priority strategies to implement and strengthen these policies and systems included the “development of customized programs and services tailored to the needs and demands of the target population” and the “establishment of a dedicated department with specialized personnel.” Conclusion: Comprehensive nutritional and dietary support policies and programs should be actively implemented to ensure a healthy and stable diet for PWD, tailored to meet their actual needs and demands.

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