Development of a Food Frequency Questionnaire for the Korea National Health and Nutrition Examination Survey: Data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV)

The objective of this study was to develop a semi-quantitative food frequency questionnaire (FFQ) for an adult population for use in the Korea National Health and Nutrition Examination Survey (KNHANES). The 24-hour recall data for 2,939 subjects aged 19 years and over from the fourth KNHANES first year (2007) were used to extract the items included in the questionnaire. The FFQ items were developed by selection of major dishes based on the cumulative contribution rate, between-person variability based on the cumulative R2 of energy and 14 nutrients (carbohydrate, protein, fat, crude fiber, calcium, phosphorous, iron, sodium, potassium, vitamin A, thiamin, riboflavin, niacin, and vitamin C) and the number of consumers of each dish. In addition, the FFQ items were revised with analysis of 24-hour recall data of the fourth KNHANES second and third year (2008, 2009). Finally, 112 items were included in the FFQ and grouped as follows: rice (5 items), noodles and dumplings (6), breads and rice cakes (8), soups and stews (12), soybeans, eggs, meat and fish (23), vegetables, seaweed and potatoes (27), milk and dairy products (4), fruits (13), beverages (5), snacks (6) and alcoholic beverages (3). The food items of FFQ accounted for an average of 87.0% of energy and 14 nutrient intakes and also accounted for 81.7% of the between-person variability. The frequency range of the FFQ items was classified into nine categories (never or seldom, once per month, 2-3 times per month, once per week, 2-4 times per week, 5-6 times per week, once per day, twice per day and three times per day) and the portion size was divided into three categories (small, medium and large). We expect that this developed dish-based FFQ could be used in assessment of long-term dietary intakes of Korean adults.

Body Fat Percentile Curves for Korean Children and Adolescents: A Data from the Korea National Health and Nutrition Examination Survey 2009-2010

A valid assessment of obesity in children and adolescents is important due to significant change in body composition during growth. This study aimed to develop percentile curves of body fat and fat free mass using the Lambda, Mu, and Sigma method, and to examine the relationship among body mass index (BMI), fat mass and fat free mass in Korean children and adolescents, using the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010. The study subjects were 834 for boys and 745 for girls aged between 10 and 18 yr. Fat mass and fat free mass were measured by dual-energy x-ray absorptiometry. The patterns of development in body fat percentage, fat mass and fat free mass differed for boys and girls, showing a decreased fat mass with an increased fat free mass in boys but gradual increases with age in girls. The considerable proportion of boys and girls with relatively normal fat mass appeared to be misclassified to be at risk of overweight based on the BMI criteria. Therefore, the information on the percentiles of body fat and fat free mass with their patterns would be helpful to complement assessment of overweight and obesity based on BMI for Korean children and adolescents.

The effect of a healthy school tuck shop program on the access of students to healthy foods

The objective of this study was to evaluate the effect of a healthy school tuck shop program, developed as a way of creating a healthy and nutritional school environment, on students' access to healthy foods. Five middle schools and four high schools (775 students) participated in the healthy school tuck shop program, and nine schools (1,282 students) were selected as the control group. The intervention program included restriction of unhealthy foods sold in tuck shops, provision of various fruits, and indirect nutritional education with promotion of healthy food products. The program evaluation involved the examination of students' purchase and intake patterns of healthy foods, satisfaction with the available foodstuffs, and utilization of and satisfaction with nutritional educational resources. Our results indicated that among of the students who utilized the tuck shop, about 40% purchased fruit products, showing that availability of healthy foods in the tuck shop increased the accessibility of healthy foods for students. Overall food purchase and intake patterns did not significantly change during the intervention period. However, students from the intervention schools reported higher satisfaction with the healthy food products sold in the tuck shop than did those from the control schools (all P < 0.001), and they were highly satisfied with the educational resources provided to them. In conclusion, the healthy school tuck shop program had a positive effect on the accessibility of healthy food. The findings suggest that a healthy school tuck shop may be an effective environmental strategy for promoting students' access to healthy foods.

The Effect of Seasoning on the Distribution of Nutrient Intakes by a Food-Frequency Questionnaire in a Rural Area

The development of food frequency questionnaire (FFQ) is based on food use and/or dish use. Regardless of potential effect of oils and seasonings on chronic diseases, most of food-based FFQs do not include oils and seasonings in calculation of nutrient intake. This study examined the effect of added (seasoning) oils and seasonings on the distribution of subjects by relative nutrient intake using a dish-based FFQ. The subjects were 1,303 persons (men 478, women 825) aged over 20 years old, who completed FFQ composed of 121 items. Three types of daily nutrient intake were calculated; 1) total nutrient intake with oils and seasonings, 2) nutrient intake without oils, and 3) nutrient intake without oils and seasonings. The correlation and agreement of classification of subjects by relative nutrient intake were examined. All analyses were performed using absolute nutrient intakes and total energy-adjusted nutrient intakes by residual method. Comparing total nutrient intake with the nutrient intake without oils, energy, vegetable fat and vitamin E intake were significantly decreased and kappa values were 0.95 (kappa w = 0.98), 0.64 (kappa w = 0.81), and 0.59 (kappa w = 0.79), respectively. Comparing total nutrient intake with the nutrient intake without oils and seasonings, most of nutrients intake except animal fat, animal protein, retinol and cholesterol were significantly decreased, and kappa values of vegetable fat (kappa = 0.64, kappa w = 0.81), vitamin E (kappa = 0.59, kappa w = 0.79) and sodium (kappa = 0.61, kappa w = 0.80) were under 0.80. After total energy was adjusted, agreement was lower than before total energy adjustment. Excluding oils and seasonings to assess nutrient intake underestimated vegetable fat, vitamin E and sodium intake and affected the distribution of subjects by their relative nutrient intake. Therefore, we suggest that research focused on these nutrients need to be cautious about the interpretation of the results.

Sensory Evaluation of Chungkukjangs with Herbal Extracts and Clinical Evaluation in Atopy Dermatitis Patients

The purpose of this study was to develop the antiallergic and hypoallergic fermented soybean foods without side effect. We manufactured Chungkukjang with addition of herbal (aloe, cinamon, licorice root) extract. Sensory evaluation was performed to evaluate the acceptability by the consumer. Clinical evaluation was performed with 10 atopic dermatitis (AD) patients who showed positive reaction with specific IgE and skin prick test. Cross-over study between normal Chungkukjang and Chungkukjang with aloe extract was performed. In sensory evaluation, Chungkukjang with aloe extract obtained best score overall. In clinical evaluation, 7 out of 10 AD patients showed positive reaction to soybean and 4 out of 10 AD patients showed positive reaction to normal Chungkukjang. 2 out of 10 AD patients showed positive reaction to Chungkukjang with aloe extract. In conclusion, Chungkukjang could be recommended as functional food with hypoallergic effect. As adding aloe extract to Chungkukjang, hypoallergic effect was increased.