Gyu Jin Heo; So-Young Nam; Soo-Kyung Lee; Sang-Jin Chung; Ji hyun Yoon

doi:10.5720/kjcn.2012.17.2.226

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The Relationship between High Energy/Low Nutrient Food Consumption and Obesity among Korean Children and Adolescents: Gyu Jin Heo, So-Young Nam, Soo-Kyung Lee, Sang-Jin Chung, Ji hyun Yoon; Korean Journal of Community Nutrition 2012;17(2):226-242.
DOI: https://doi.org/10.5720/kjcn.2012.17.2.226
Published online: April 30, 2012

Department of Food and Nutrition, Inha University. Incheon, Korea.

¹Department of Food and Nutrition, Kookmin University. Seoul, Korea.

²Department of Food and Nutrition, Seoul National University. Seoul, Korea.

Corresponding author: Soo-Kyung Lee, Department of Food and Nutrition, Inha University, 253 YongHyun-dong, Nam-gu, Incheon 402-751, Republic of Korea. Tel: (032) 860-8121, Fax: (032) 862-8120, skleenutrition@inha.ac.kr

• Received: February 29, 2012 • Revised: April 6, 2012 • Accepted: April 11, 2012

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Abstract
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REFERENCES

Abstract

Consumption of foods with high energy and low nutrient values has been linked to various health issues including obesity and chronic diseases. This study investigated the high-energy/low-nutrient food consumption status and its relationship with obesity status and intake of energy and nutrients, using the Korea National Health and Nutrition Examination Survey (KNHANES) and the Korea Youth Risk Behavior Web-based Survey (KYRBWS). The prevalence of overweight and obesity among 2-18 year-olds was 8.4% and 10.8% in 2008 and 8.5% and 9.0% in 2009, respectively, in KNHANES. The prevalence of obesity among 12-18 year-olds was 13.9% in 2008 and 11.4% in 2009 in KNHANES, while it was 8.1% in 2008 and 8.2% in 2009 in KYRBWS. Consumption patterns of high-energy/low-nutrient foods were diverse depending on the particular food type. High-energy/low-nutrient foods such as cookies were most often consumed more frequently (2~3 times per week), but fast food type foods were generally consumed less frequently (once per week or less). No significant relationships between high-energy/low-nutrient food consumption and level of energy and nutrient intakes were found in either datasets. Adolescents who were not obese more frequently consumed ramen (p < 0.001), cookies (p < 0.001) and fast food (p < 0.001) than those who were obese in KYRBWS, however, such relationships were not found in KNHANES. This direction of the relationship could be probably attributed to the cross-sectional nature of the datasets. This study was limited by the cross-sectional nature of the data, therefore, further longitudinal research using various study techniques would be necessary to understand the effects of high-energy/low-nutrient foods on child obesity.
Keywords: high energy/low nutrient food; Korean children and adolescents; KNHANES; KYRBWS

NOTES

This research was supported by grants from Korea Food & Drug Administration.

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Table 1

Prevalence of overweight and obesity by gender and age (2 to 18 year old) in 2008

1) The estimated percent of population (standard error)

2) Korea National Health and Nutrition Examination Survey

3) 2007 Korean National Growth Charts. Underweight: < 5 percentile, Normal: 5 - 85 percentile, Overweight: 85 - 95 percentile, Obesity: ≥ 95 percentile or ≥ BMI 25

4) Criteria of weight status; underweight and normal → not obese; overweight and obese → obese

5) Korea Youth Risk Behavior Web-based Survey

^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001 (gender difference)

^#: p < 0.05, ^##: p < 0.01, ^###: p < 0.001 (age difference)

^{^}: p < 0.05 (year difference in 16 - 18y)

Table 2

Prevalence of overweight and obesity by gender and age (2 to 18 year old) in 2009

1) The estimated percent of population (standard error)

2) Korea National Health and Nutrition Examination Survey

3) 2007 Korean National Growth Charts. Underweight: < 5 percentile, Normal: 5 - 85 percentile, Overweight: 85 - 95 percentile, Obesity: ≥ 95 percentile or ≥ BMI 25

4) Criteria of weight status; underweight and normal → not obese; overweight and obese → obese

5) Korea Youth Risk Behavior Web-based Survey

^#: p < 0.05, ^##: p < 0.01, ^###: p < 0.001 (age difference)

^{^}: p < 0.05 (Year difference)

Table 3

Prevalence of overweight and obesity by gender and age (12 to 18 year old) in 2008

1) The estimated percent of population (standard error)

2) 2007 Korean National Growth Charts. Underweight: < 5 percentile, Normal: 5 - 85 percentile, Overweight: 85 - 95 percentile, Obesity: ≥ 95 percentile or ≥ BMI 25

3) Korea National Health and Nutrition Examination Survey

4) Korea Youth Risk Behavior Web-based Survey

5) Gender or age difference of KNHANES

6) Gender or age difference of KYRBWS

7) Year difference of KNHANES 16 - 18y

8) Criteria of weight status; underweight and normal → not obese; overweight and obese → obese

Table 4

Prevalence of overweight and obesity by gender and age (12 to 18 year old) in 2009

1) The estimated percent of population (standard error)

2) 2007 Korean National Growth Charts. Underweight: < 5 percentile, Normal: 5 - 85 percentile, Overweight: 85 - 95 percentile, Obesity: ≥ 95 percentile or ≥ BMI 25

3) Korea National Health and Nutrition Examination Survey

4) Korea Youth Risk Behavior Web-based Survey

5) Gender or age difference of KNHANES

6) Gender or age difference of KYRBWS

7) Year difference of KNHANES 16-18y

8) Criteria of weight status; underweight and normal → not obese; overweight, and obese → obese

Table 5

Consumption frequency of High energy/Low nutrient food types ( 12 - 18 ages) in 2008

1) Korea National Health and Nutrition Examination Survey

2) Korea Youth Risk Behavior Web-based Survey

3) The estimated percent of population (standard error)

^*: p < 0.05, ^***: p < 0.001

Table 6

Consumption frequency of High energy/Low nutrient food types (12 - 18 ages) in 2009

1) Korea National Health and Nutrition Examination Survey

2) Korea Youth Risk Behavior Web-based Survey

3) The estimated percent of population (standard error)

^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001

Table 7

Consumption frequency of high energy/low nutrient food types between not obese and obese group (12 - 18 ages) in 2008⁾

1) Korea National Health and Nutrition Examination Survey

2) Korea Youth Risk Behavior Web-based Survey

3) 2007 Korean National Growth Charts. Not obese: < 85 percentile, Obese: ≥ 85 percentile or ≥ BMI 25

4) The estimated percent of population (standard error)

^***: p < 0.001

Table 8

Consumption frequency of high energy/low nutrient food types between obese and non-obese group (12 - 18 ages) in 2009

1) Korea National Health and Nutrition Examination Survey

2) Korea Youth Risk Behavior Web-based Survey

3) 2007 Korean National Growth Charts. Not obese: < 85 percentile, Obese: ≥ 85 percentile or ≥ BMI 25

4) The estimated percent of population (standard error)

^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001

Table 9

Energy and nutrients intake by high energy/low nutrient food consumption¹⁾ (KNHANES)

Values are Mean ± SE

1) High energy/low nutrient foods were determined by the High energy/low nutrient food list from Korea Food & Drug Administration.

2) Percentage energy from carbohydrate compared to total energy intake per day

3) Percentage energy from protein compared to the total energy intake per day

4) Percentage energy from fat compared to the total energy intake per day

^**: p < 0.01, ^***: p < 0.001 intake group difference 2008

^{^^}: p < 0.01, ^{^^^}: p < 0.001 intake group difference 2009

^#: p < 0.05 year difference in total

Table 10

Relationship between high energy/low nutrient food consumption and energy and nutrient intake adequacy¹⁾

1) Covariates: Gender, age, weight, quartile of income

2) OR: Odd Ratio Reference: Sufficiency Criteria of energy, carbohydrate, protein, fat and sodium

3) Meeting 75% - 125% of the Estimated Energy Requirement (EER) reference for gender and age in the Dietary Reference Intake for Koreans

4) High energy/low nutrient foods were determined by the High energy/low nutrient food list from Korea Food & Drug Administration

5) Meeting 75% - 125% of the individually calculated Estimated Energy Requirement (EER) using the formulas in the Dietary Reference Intake for Koreans

6) Intake adequacy was determined by meeting the Acceptable Macronutrient Distribution Ranges (AMDR) for age. Carbohydrate 55 - 70%, Protein 7 - 20%, Fat 2y: 20 - 35%, 3 - 18 y: 15 - 30%

7) Intake adequacy was determined by consuming less than the Standard of Target nutrient intake

Table 11

Energy and nutrient intake from high energy/low nutrient food¹⁾ between obese and non-obese group (KNHANES)

Values are Mean ± SE

1) High energy/low nutrient foods were determined by the High energy/low nutrient food list from Korea Food & Drug Administration

2) 2007 Korean National Growth Charts. Not obese: < 85 percentile, Obese: ≥ 85 percentile or ≥ BMI 25

3) Energy intake from high energy/low nutrient food as percentage of the total energy consumed per day

4) Protein intake from high energy/low nutrient food as percentage of the total protein consumed per day

5) Fat intake from high energy/low nutrient food as percentage of the total fat consumed per day

6) Carbohydrate intake from high energy/low nutrient food as a percentage of the total carbohydrate consumed per day

7) Sodium intake from high energy/low nutrient food as a percentage of the total carbohydrate consumed per day

8) Amount of intake from high energy/low nutrient food as a percentage of the total amount of food consumed per day

^*: p < 0.05 (year difference in the obese group)

Figure & Data

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The Relationship between High Energy/Low Nutrient Food Consumption and Obesity among Korean Children and Adolescents

Korean J Community Nutr. 2012;17(2):226-242. Published online April 30, 2012

DOI: https://doi.org/10.5720/kjcn.2012.17.2.226

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The Relationship between High Energy/Low Nutrient Food Consumption and Obesity among Korean Children and Adolescents

Table 1

Prevalence of overweight and obesity by gender and age (2 to 18 year old) in 2008

1) The estimated percent of population (standard error)

2) Korea National Health and Nutrition Examination Survey

3) 2007 Korean National Growth Charts. Underweight: < 5 percentile, Normal: 5 - 85 percentile, Overweight: 85 - 95 percentile, Obesity: ≥ 95 percentile or ≥ BMI 25

4) Criteria of weight status; underweight and normal → not obese; overweight and obese → obese

5) Korea Youth Risk Behavior Web-based Survey

^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001 (gender difference)

^#: p < 0.05, ^##: p < 0.01, ^###: p < 0.001 (age difference)

^{^}: p < 0.05 (year difference in 16 - 18y)

Table 2

Prevalence of overweight and obesity by gender and age (2 to 18 year old) in 2009

1) The estimated percent of population (standard error)

2) Korea National Health and Nutrition Examination Survey

3) 2007 Korean National Growth Charts. Underweight: < 5 percentile, Normal: 5 - 85 percentile, Overweight: 85 - 95 percentile, Obesity: ≥ 95 percentile or ≥ BMI 25

4) Criteria of weight status; underweight and normal → not obese; overweight and obese → obese

5) Korea Youth Risk Behavior Web-based Survey

^#: p < 0.05, ^##: p < 0.01, ^###: p < 0.001 (age difference)

^{^}: p < 0.05 (Year difference)

Table 3

Prevalence of overweight and obesity by gender and age (12 to 18 year old) in 2008

1) The estimated percent of population (standard error)

2) 2007 Korean National Growth Charts. Underweight: < 5 percentile, Normal: 5 - 85 percentile, Overweight: 85 - 95 percentile, Obesity: ≥ 95 percentile or ≥ BMI 25

3) Korea National Health and Nutrition Examination Survey

4) Korea Youth Risk Behavior Web-based Survey

5) Gender or age difference of KNHANES

6) Gender or age difference of KYRBWS

7) Year difference of KNHANES 16 - 18y

8) Criteria of weight status; underweight and normal → not obese; overweight and obese → obese

Table 4

Prevalence of overweight and obesity by gender and age (12 to 18 year old) in 2009

1) The estimated percent of population (standard error)

2) 2007 Korean National Growth Charts. Underweight: < 5 percentile, Normal: 5 - 85 percentile, Overweight: 85 - 95 percentile, Obesity: ≥ 95 percentile or ≥ BMI 25

3) Korea National Health and Nutrition Examination Survey

4) Korea Youth Risk Behavior Web-based Survey

5) Gender or age difference of KNHANES

6) Gender or age difference of KYRBWS

7) Year difference of KNHANES 16-18y

8) Criteria of weight status; underweight and normal → not obese; overweight, and obese → obese

Table 5

Consumption frequency of High energy/Low nutrient food types ( 12 - 18 ages) in 2008

1) Korea National Health and Nutrition Examination Survey

2) Korea Youth Risk Behavior Web-based Survey

3) The estimated percent of population (standard error)

^*: p < 0.05, ^***: p < 0.001

Table 6

Consumption frequency of High energy/Low nutrient food types (12 - 18 ages) in 2009

1) Korea National Health and Nutrition Examination Survey

2) Korea Youth Risk Behavior Web-based Survey

3) The estimated percent of population (standard error)

^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001

Table 7

Consumption frequency of high energy/low nutrient food types between not obese and obese group (12 - 18 ages) in 2008⁾

1) Korea National Health and Nutrition Examination Survey

2) Korea Youth Risk Behavior Web-based Survey

3) 2007 Korean National Growth Charts. Not obese: < 85 percentile, Obese: ≥ 85 percentile or ≥ BMI 25

4) The estimated percent of population (standard error)

^***: p < 0.001

Table 8

Consumption frequency of high energy/low nutrient food types between obese and non-obese group (12 - 18 ages) in 2009

1) Korea National Health and Nutrition Examination Survey

2) Korea Youth Risk Behavior Web-based Survey

3) 2007 Korean National Growth Charts. Not obese: < 85 percentile, Obese: ≥ 85 percentile or ≥ BMI 25

4) The estimated percent of population (standard error)

^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001

Table 9

Energy and nutrients intake by high energy/low nutrient food consumption¹⁾ (KNHANES)

Values are Mean ± SE

1) High energy/low nutrient foods were determined by the High energy/low nutrient food list from Korea Food & Drug Administration.

2) Percentage energy from carbohydrate compared to total energy intake per day

3) Percentage energy from protein compared to the total energy intake per day

4) Percentage energy from fat compared to the total energy intake per day

^**: p < 0.01, ^***: p < 0.001 intake group difference 2008

^{^^}: p < 0.01, ^{^^^}: p < 0.001 intake group difference 2009

^#: p < 0.05 year difference in total

Table 10

Relationship between high energy/low nutrient food consumption and energy and nutrient intake adequacy¹⁾

1) Covariates: Gender, age, weight, quartile of income

2) OR: Odd Ratio Reference: Sufficiency Criteria of energy, carbohydrate, protein, fat and sodium

3) Meeting 75% - 125% of the Estimated Energy Requirement (EER) reference for gender and age in the Dietary Reference Intake for Koreans

4) High energy/low nutrient foods were determined by the High energy/low nutrient food list from Korea Food & Drug Administration

5) Meeting 75% - 125% of the individually calculated Estimated Energy Requirement (EER) using the formulas in the Dietary Reference Intake for Koreans

6) Intake adequacy was determined by meeting the Acceptable Macronutrient Distribution Ranges (AMDR) for age. Carbohydrate 55 - 70%, Protein 7 - 20%, Fat 2y: 20 - 35%, 3 - 18 y: 15 - 30%

7) Intake adequacy was determined by consuming less than the Standard of Target nutrient intake

Table 11