Association between Glycemic Index, Glycemic Load, Dietary Carbohydrates and Diabetes from Korean National Health and Nutrition Examination Survey 2005

The purpose of this study was to establish an association between glycemic index (GI), glycemic load (GL), dietary carbohydrates and diabetes with the context of the current population dietary practice in Korea. The subjects of 3,389 adults (male 1,430, female 1,959) were divided into normal (serum fasting glucose 126 mg/dL) by serum fasting glucose. Anthropometric and hematologic factors, and nutrient intakes, dietary glycemic index (DGI), dietary glycemic load (DGL) were assessed. Multiple logistic regression model was used to determine the odds ratios (ORs) and 95% confidence intervals for relationship of DGI, DGL, carbohydrates intakes, and diabetes. DGI and DGL were not significantly correlated with impaired glucose tolerance and diabetes. However, the risk of impaired glucose tolerance and diabetes showed a tendency to increase as increase of DGI after multivariate adjustment (age, education, income, region area, diabetes family history, smoking, drinking, exercise, energy intake) in male. The risk of impaired glucose tolerance and diabetes showed a tendency to increase in the DGI 71.1-74.8 after multivariate adjustment in female. DGL was inversely related to impaired glucose tolerance and diabetes in male. In female, however, DGL was positively related to impaired glucose tolerance and diabetes. In particular, the risk of diabetes increased positively in level of DGL 260.5, and remained after multivariate adjustment (Q5 vs Q1:2.38, 0.87-6.48). When percent energy intakes from carbohydrates were more than 70%, the risk of impaired glucose tolerance and diabetes increased in both male and female. In particular, when percent energy intakes from carbohydrates were more than 69.9%, the risk of diabetes increased positively in male (Q4 vs Q1:2.34, 1.16-4.17). In conclusion, above 70% energy intakes from carbohydrates appeared to be a risk factor of diabetes. It seemed that the meal with high GI and GL value must be avoided it. And also, the macronutrients of the meal must be properly balanced. In particular, it may be said that it is a preventive way for treatment of the diabetes to avoid eating carbohydrates of much quantity.

A Study on Food and Nutrient Intakes of Weekday and Weekend Among High School Boys in Seoul

residing in Seoul using the 3-day food record. Frequency for breakfast skipping was the highest as compared with lunch and dinner skipping. Frequencies for breakfast and lunch skipping were significantly higher in weekend than weekday (p < 0.05). The daily average food, vegetable food and animal food intakes were 1,327.6 g, 800.5 g, and 425.8 g, respectively. Total food and vegetable food intakes of weekday were significantly higher than weekend (p < 0.05). The dietary variety score (DVS) was 20.5 in daily average, 23.3 in weekday and 15.1 in weekend, which showed significantly higher in weekday than weekend (p < 0.05). The daily averages of energy, protein, fat and carbohydrate intake were 2244.9 kcal, 89 g, 72.6 g, and 311.2 g, respectively. Fat intake was significantly lower and carbohydrate, fiber, phosphate, iron, sodium, potassium, vitamin A, niacin, folate, and vitamin C intakes were significantly higher in weekday than weekend (p < 0.05). The percentages of energy intake from carbohydrate, protein, and fat were 55.4%, 15.8%, 28.8% in daily average, 56.8%, 15.8%, 27.4% in weekday and 53.6%, 15.8%, 30.7% in weekend, respectively. The percentages of energy intake from carbohydrate in weekday and weekend were below 60%, and that from fat was above 27% in weekday and weekend. Carbohydrate intake was significantly higher and fat intake was significantly lower in weekday than weekend (p < 0.05). Energy intakes of daily average, weekday and weekend were above 83% as compared with estimated energy requirement (EER). Intakes of dietary fiber, calcium, potassium, vitamin C, riboflavin and folate were below 75% as compared with adequate intake (AI) or recommended intake (RI). Mean adequacy ratios (MAR), an index of overall dietary quality were 0.78 in daily average, 0.80 in weekday and 0.75 in weekend. MAR of weekend showed significantly lower than weekday (p < 0.05). This study revealed that the overall nutrient intake status was worse in weekend than weekday among high school boys.

Relationship between Food Intakes, Glycemic Index, Glycemic Load, and Body Weight among High School Boys in Seoul

This study was conducted to study the relationship between food intakes, glycemic index (GI), glycemic load (GL), and body weight with high school boys residing in Seoul. The subjects of 329 boys were divided into normal weight group (BMI or = 23 kg/m2, n = 117) by body mass index (BMI). The food intakes data obtained by the 3-day food record were analyzed by Can pro 3.0 software. Anthropometric measurements and physical activities were collected from each subject. Daily dietary glycemic index (DGI) and dietary glycemic load (DGL) were calculated from the 3-day food record. Body weights and BMI of normal weight group were 58.8 kg and 19.9 kg/m2 and those of overweight group were 79.2 kg and 26.8 kg/m2, which were significantly different between two groups (p or = 55%) in both groups. DGI and DGL were not significantly correlated with anthropometric data. Activity adjusted to energy intake was negatively correlated with percentage of body fat (r =-0.1308, p < 0.01) and that was positively correlated with height (r = 0.1227, p < 0.05) and lean body mass (r = 0.1351, p < 0.05).

A Study on the Fat and Fatty Acid Intake of College Women Evaluated through Internet Nutritional Assessment System

The purpose of this study was to investigate dietary fat and individual fatty acids intake pattern of 174 college women living in Seoul and Gyong-gi province through internet nutritional assessment system. Each of the subjects was required to input their own food intake for three days, which included two days during the week and one day of the weekend, on the web program directly and all of the data collected were used for statistical analysis. The mean daily caloric intake of the subjects was 1,500.9 kcal which was at 71.5% of Estimated Energy Requirement (EER ). Dietary fat contributed 27.6% of the total caloric intake which was slightly higher than the recommended limit of 25%. Daily cholesterol intake was 310.0 mg, which was also high to some degree. Mean daily N6 and N3 fatty acid intake was 6.1 g and 0.9 g, respectively, and calory % calculated from each were 3.63% and 0.53%. This result showed the intake of N3 fatty acid fell in Acceptable Macronutrient Distribution Ranges (AMDR )0.5 ~1.0% but that of N6 fatty acid was somewhat lower than the AMDR 4 ~8%. N6/N3 ratio 8.5/1, however, was within the desirable range 4 ~10/1. Considering overall dietary fatty acids intake, oleic acid was the most abundant, followed by linoleic and palmitic acid. And among polyunsaturated fatty acids intake, linoleic acid was exclusively high, accounting for 97.4% of total N6 fatty acid intake. On the contrary, three fatty acids, linolenic (67.3%), DHA (21.1%)and EPA (10.0%), together supplied 98.4% of total N3 fatty acid intake. Mean P/M/S was 0.9/1.1/1.0. The subjects' intake of fat, many fatty acids and cholesterol came from diverse food groups including meats, fats and oils, milk and milk products, eggs, fish, and soybean products. Nevertheless, the subjects tended to show unfavorable fat and fatty acids intake pattern in terms of quantity and quality. Based on these results, it is important to monitor dietary fat intake pattern of the general population continuously and an internet program such as the one used for this study would be valuable, especially for assessing dietary patterns in the younger generation.

Relation between Milk Consumption and Bone Mineral Density of Female College Students in Korea

The purpose of our study was to evaluate an association between milk consumption and bone mineral density (BMD) of female college students in Korea. The dietary data of 1,410 Korean college students living in the vicinity of Seoul area were collected through the Food Frequency Questionnaire. The mean age, height, weight and BMI of the subjects were 20.4 years, 162.1 cm, 52.7 kg, and 20.0 kg/m2 respectively. The mean intakes of energy, protein, and phosphorus were 2,398.7 kcal, 95.2 g, and 1,302.9 mg respectively, which were above their EER or Recommended Intake (RI), but the mean intake of calcium was 657.8 mg which was below its RI, and 44.0% of the subjects did not meet Estimated Average Requirement (EAR) of calcium. The daily milk consumption was 131.1 g, and the total consumption of milk and dairy product was 228.7 g. Forty five percent of the subjects consumed 50 ~200 g of milk or dairy products. After the analysis of their dietary intakes, the subjects were divided into quintiles of total consumption of milk and dairy product, which were considered as major source of dietary calcium. Ninety two subjects from the upper quintile (UQ) and 85 subjects from the lower quintile (LQ) were selected and their bone mineral densities (BMD) of lumbar spine (L1-L4) and the femur were examined by the dual energy X-ray absorptiometry. The BMD (g/cm2) of L1, L2, L3, and average of femur were 1.065, 1.150, 1.187, and 0.988 for the UQ subjects, which were significantly higher than those of the LQ subjects, 1.010, 1.090, 1.146, and 0.942 respectively. Moreover, the T-scores of the UQ were significantly higher than those of the LQ. The prevalence rates of osteopenia classified according to WHO's criterion were 12.0% in the UQ, and 20.0% in the LQ group which showed non significant. Blood levels of calcium, and phosphorus of UQ and LQ group were both within the normal range, and were not significantly different. Our results showed that UQ group presented the better status of bone mineral density and bone health. Therfore our results suggest that continuous consumption of more than one and a half cups of milk per day, which corresponds to the least amount of UQ group's consumption, would affect positively on the bone health of Korean adults.

Factors Affecting Bone Mineral Density by Dietary Pattern Group for some Korean College Women

To investigate the effects of dietary patterns on bone mineral density and its biochemical markers among Korean healthy college women for 2 years, 34 female college students were recruited through convenience sampling. Bone mineral density was measured using Dual Energy X-ray Absorptiometry (DEXA) twice at baseline and two years later. Osteocalcin and parathyroid hormone were measured in fasting serum and N-teleopeptides of type collagen (NTx) in urine. Dietary intake was assessed by 24-hour recall method 8 times with average 4-month interval. Dietary patterns with percent energy of each food group using cluster analysis were classified into two groups. The first cluster (n = 16) was characterized with high consumption of bread, snack, fast foods, beverage and considerable of rice so it was determined as "Modified dietary pattern group". The second cluster was characterized with high consumption of rice and kimchi so determined as "Traditional dietary pattern group". There were no significant difference of age, menarcheal age, body mass index but percent of body fat by pattern groups. The traditional group showed higher value of bone mineral density among lumber spine and all femur sites at baseline and 2 years later but it was not significant after adjusted for percent of body fat. Serum osteocalcin and urine NTx was higher among the traditional group at baseline than the modified group. There were similar proportions of carbohydrate:fat:protein between groups but significantly higher intake of protein, iron, vitamin A among the traditional group. In conclusion, there were two distinctive dietary patterns among Korean college women. There was difference of bone mineral density and its biochemical markers between two patterns. Further research would be necessary to explore the relationship between dietary patterns and health risks for larger-sized and various populations.

The Effect of Milk Consumption on Blood Lipid Levels of the Korean College Women

This research was conducted to study the effect of milk consumption on blood lipid levels of Korean college women. According to milk intake from food frequency questionnaire (FFQ), top 20% of subjects were classified as high group(HG) and bottom 20% as low group (LG). Body weight, height and blood pressure were measured and BMI was calculated from the anthropometric data, but there was no significant difference between the groups. Blood samples were collected and analyzed for total cholesterol (TC), triglycerides (TG) and lipoprotein fractions. There was no significant difference in the blood level of albumin, total protein and hemoglobin between two groups, and all blood parameters were in the normal range. Blood lipid levels of two groups were not significantly different, but HDLcholesterol level were higher in HG (p < 0.05). Therefore, according to the result of the research, it is considered that drinking a pack of milk (200 ml) everyday, the average intake of dairy products of HG, is advisable to promote good health without increasing of cardiovascular disease (CVD) risk.

Elementary, Middle and High School Teachers' Opinions of School Foodservice Programs

This study investigated elementary, middle, and high school teachers' satisfaction, nutrition education, workload changes, and demands in school foodservice programs (SFPs). The subjects were 630 teachers at 12 elementary, 9 middle, and 9 high school within the nation. Ninety five percent of the teachers felt that there was a necessity for SFPs. Middle school teachers (MTs) and high school teachers (HTs) thought that it was necessary in order to reduce the students'burden of carrying lunch boxes. The teachers were relatively satisfied with their school's foodservice management types, food distribution types, meal quality, and sanitation. Elementary teachers (ETs) and HTs had a higher satisfaction than MTs. Teachers thought that SFPs had positive effects on their students' nutrition and health, enhancing desirable eating habits, and socialization. ETs had more positive opinions than MTs or HTs. ETs and MTs thought that their workload had been increased by SFPs more than HTs, but they had relatively positive opinions on the workload change. ETs taught nutrition and health through SFPs more frequently than MTs or HTs. Many teachers thought that there was a lack of appropriate teaching materials. Some teachers thought that the problems in the present SFPs were: a lack of cafeteria facilities, poor quality of meals, and management of leftovers. Their demands for SFPs were a improvement of meal quality and the establishment of cafeterias. In conclusion, MTs had more negative opinions than ETs or HTs. ETs perceived that SFPs had a function as an important educational activity as well as the supply of nutritional meals. MTs or HTs tended to consider only a meal. It is suggested that teachers, especially MTs and HTs, should modify their attitudes and recognize the educational functions of SFPs. Training programs should be developed under government auspices.

A Study on the Nutritional Status according to Body Mass Index in Korean College Women

This study was performed to investigate dietary habits and nutritional intake according to body mass index (BMI) of female college students. The subjects were 1361 students with a mean age of 20.4 years residing in Seoul and Kyonggui area. BMI (kg/m2) between > or = 18.5 to 23 as overweight. The subjects had a mean BMI of 20.0 kg/m2 and 25% of them were classified as underweight group, 67% as normal group and 8% as overweight group. Dietary intake was assessed by food frequency method and consumption of foods and nutrients was analyzed. Frequency of meal skipping was higher in the overweight group, 16.1% of the overweight group skipped dinner. Also, the frequency of snack intake was lowest in the overweight group. The overweight group consumed less meat and fish than the normal and underweight groups. The total number of foods consumed in a day was also significantly lower than that of the underweight and normal group. The overweight group consumed less energy, protein, fat, phosphorus and niacin than the underweight and normal groups. The overweight group took iron and sodium intake lower than the normal group. Mean intakes of nutrients except clacium and iron in all three groups were over Korea RDA. The NAR (nutrient adequacy ratio) value of all nutrients, except calcium, was lower in the overweight group when compared to the normal and underweight groups, and the MAR (mean adequacy ratio) of the overweight group was 0.89, which was lower than 0.92 of the underweight and 0.93 of the normal group. The above results indicated that the deficiency of major nutrients such as calcium and iron could be inducde by less kinds of consumed foods and frequent meal skipping including dinner in the overweighted group. Therefore, balanced nutrient intake is required to maintain skeletal health and prevent anemia in overweighted female college students aged twenties.

A Suggestion to Develop a Nutrition Policy on Food and Nutrition Labeling and Education Systems for Fast Food and Carbonated Soft Drinks in Korea

The objective of this study is to develop a nutrition policy on food and nutrition labeling and education systems for fast food and carbonated soft drinks in Korea by identifying the fast food and soft drink use and by examining nutrition policies and labeling in Korea and other countries. Fast food is defined as food dispensed quickly at a restaurant generally offering a limited menu of inexpensive items, which may be mostly not nutritious. It is a growing component of the Korean diet, especially on children and adolescent population. Low nutrient dense beverages such as carbonated drinks are also increasing in the children and adolescent's diet in Korea and concern has been raised that these beverages may replace more nutritious beverage and provide empty calories. According to 2001 Korean national health and nutrition survey, fast food and carbonated soft drinks were most popular among 13 - 19 years old adolescents. Thirty six and 72 percent of adolescents consumed hamburger and carbonated beverage equal to or more than once a week, respectively. In United States, all processed food including soft drinks should disclose full nutrition information by nutrition labeling requirement. Restaurant foods are not required to provide nutrition information currently, but legislation on mandatory nutrition labeling of fast foods with other restaurant foods has been proposed currently in US. The sales of foods of minimal nutritional value, such as soft drinks, in the nation's schools is regulated by the United States Department of Agriculture. Nutrition information about fast food in US has been provided by fast food companies, non-profit organizations, hospitals and government through internet, booklet and brochure, etc, but the information is available from only a few resources in Korea. This study suggests a nutrition policy on fast food and soft drink use which includes establishing mandatory nutrition labeling and developing nutrition education materials and programs by web-site, booklet and government and school programs in Korea.

Nutritional Factors Related to Bone Mineral Density in the Different Age Groups of Korean Men

Nutritional factors affecting bone mineral density (BMD) in the different age groups of Korean men were investigated to obtain baseline data for maintaining bone health. Information on diet and anthropometry was collected in 80 elementary school children, 83 high school students, 87 adults aged 25 to 35 years and 98 elderly people over 60 years of age. Data for food and nutrient intake were obtained by 24-hour recall method. BMDs of lumbar spine (L(2) - L(4)) and femoral neck were measured by dual energy x-ray absorptiometry. The relationship between BMD and nutritional factors were analyzed. In the femoral neck, 5.7% of adults was classified as osteopenia and 47.9% and 37.8% of the elderly were classified as osteopenia and osteoporosis. It was shown that plant protein, Ca, P, Fe, thiamin, riboflavin and vitamin C intakes were related with BMD in all age groups. As for the mean adequacy ratio (MAR) of nutrients, the lowest quartile group of BMD showed significantly lower MAR among children. The RDA percent of nutrients was a strong influential factor on BMD. Subjects who consumed below 75% of Korean RDA in energy, vitamin A, thiamin, and vitamin C showed lower BMD. Stepwise multiple regression analysis revealed that MAR in children, vegetable Ca in adolescents, and vitamin C in adults and elderly people were the highest influential factor on BMD. Therefore, the above results demonstrated that not only calcium but also other nutrients such as protein, iron, vitamin A, riboflavin, and vitamin C were necessary in order to keep the healthy bone status. In addition, although there were various dietary factors that influenced bone density, MAR was identified as the major factor that affected bone density. Thus, a balanced diet that includes all nutrients is necessary for a healthy bone density.

A Survey of Food and Nutrient Intakes of Korean Men by Age Groups

A dietary survey was conducted using 24-hour recall method in 80 male elementary school children, 83 high school students, 87 adults and 98 elderly people over 65 years of age to discuss food and nutrient intakes among different age groups. In observing food intake by age groups, the percentage of plant foods to total food intake was significantly higher in the elderly than other groups and that of animal foods was the highest in the children. The children consumed significantly higher amounts of milk and dairy products. Carbohydrate energy percent in the elderly people was 68.0%, significantly higher than other age groups. All age groups consumed Ca below Korean RDA and especially, 65.1% of the adolescents and 68.4% of the elderly consumed below 75% of RDA. Nutrient adequacy ratio (NAR) of most nutrients was lowest in the elderly. Mean adequacy ratio (MAR), an index of overall dietary quality, was 0.94 for the children, 0.84 for the adolescents, 0.84 for the adults, and 0.73 for the elderly. The above results suggest that food and nutrient intakes have been differently affected with advancing age, and overall dietary quality of the elderly people is lower than that of other age groups.

Comparisons of Student Satisfaction with the School Food Service Programs in Middle and High Schools by Food Service Management Types

This study on satisfaction with school food service (FS) programs was conducted with 485 middle school students and 515 high school students based on FS management type. There were four types of FS management: independent-conventional (IC), independent-commissary (ICM), contract-conventional (CC), and contract-delivery (CD). About seventy percent of the students expressed satisfaction with the food quantity of the school lunches. But one third of the students, who felt the quantity was insufficient, cited the small size of the rice serving. Many high school students cited the small size of the side dishes as well as the rice serving. It is suggested that the meal quantity should be determined in consideration of the students' physical development. The satisfaction with FS sanitation was lower than that with the meal quality, eating environment, and environment of dining room with respect to all four types of FS management, and was lowest in the CD. It is suggested that FS sanitation should be managed more thoroughly for the students' safety, and that the school FS Committee should carefully monitor the sanitary management of the contract FS companies by means of a well-designed and monitored management system. Most of middle and high school students expected good taste and a diversity of foods in their school lunches. Food taste should be improved, and various food materials and cooking methods should be used for balanced nutrition and greater student satisfaction, particularly in contract FS types (CC and CD).

A Survey of Food and Nutrient Intakes of Korean Women by Age Groups

To study the level of change in food and nutrient intake among different age groups, a dietary survey using the 24-hour recall method was conducted among 80 female elementary school children, 84 high school students, 100 adults from 25 to 35 years old and 120 elderly people over 60 years of age. The results of the study showed that plant food and total food intake were higher in adults and animal food intake was significantly higher in children. The percentage of plant food to total food intake was highest in the elderly and that of animal food to total food intake was highest in the children. The elderly consumed significantly less meat and poultry and more fish than the other groups. However, the children consumed significantly higher amounts of milk and dairy products. The elderly had the lowest Ca intake. Carbohydrate energy intake in the elderly was 70.3%, significantly higher than that for the other age groups. All of the age groups consumed a quantity of Ca below the Korean RDA and 77.5% of the elderly consumed an amount below 75% of the RDA. Nutrient adequacy ratio (NAR) of most nutrients was lowest in the elderly. Mean adequacy ratio (MAR), an index of overall dietary quality, was 0.88 for the children, 0.84 for the adolescents, 0.80 for the adults, and 0.70 for the elderly. Therefore, the results show that food and nutrient intake changes with advancing age, and the overall quality of the diet of elderly people is lower than that for the other age groups.