Dietary evaluation of a low-iodine diet in Korean thyroid cancer patients preparing for radioactive iodine therapy in an iodine-rich region

BACKGROUND/OBJECTIVES: Despite the importance of a low-iodine diet (LID) for thyroid cancer patients preparing for radioactive iodine (RAI) therapy, few studies have evaluated dietary intake during LID. This study evaluated the amount of dietary iodine intake and its major food sources during a typical diet and during LID periods for thyroid cancer patients preparing for RAI therapy, and examined how the type of nutrition education of LID affects iodine intake. SUBJECTS/METHODS: A total of 92 differentiated thyroid cancer patients with total thyroidectomy were enrolled from Seoul National University Hospital. All subjects completed three days of dietary records during usual and low-iodine diets before 131I administration. RESULTS: The median iodine intake was 290 µg/day on the usual diet and 63.2 µg/day on the LID. The major food groups during the usual diet were seaweed, salted vegetables, fish, milk, and dairy products and the consumption of these foods decreased significantly during LID. The mean energy intake on the LID was 1,325 kcal, which was 446 kcal lower than on the usual diet (1,771 kcal). By avoiding iodine, the intake of most other nutrients, including sodium, was significantly reduced during LID (P < 0.005). Regarding nutritional education, intensive education was more effective than a simple education at reducing iodine intake. CONCLUSION: Iodine intake for thyroid cancer patients was significantly reduced during LID and was within the recommended amount. However, the intake of most other nutrients and calories was also reduced. Future studies are needed to develop a practical dietary protocol for a LID in Korean patients.

Dietary patterns based on carbohydrate nutrition are associated with the risk for diabetes and dyslipidemia

Several studies have been conducted on dietary patterns based on carbohydrate nutrition in Asian populations. We examined the cross-sectional associations in dietary patterns based on carbohydrate nutrition, including the glycemic index (GI) with dyslipidemia and diabetes among the Korean adult population. We analyzed 9,725 subjects (3,795 men and 5,930 women, > or = 20 years) from the Fourth Korea National Health and Nutrition Examination Survey. Dietary information was collected using single 24-hour recall. Reduced rank regression was used to derive dietary patterns from 22 food groups as predictor variables and four dietary factors related to the quantity and quality of carbohydrates as response variables. Two dietary patterns were identified: 1) the balanced pattern was characterized by high intake of various kinds of foods including white rice, and 2) the rice-oriented pattern was characterized by a high intake of white rice but low intake of vegetables, fruits, meat, and dairy products. Both patterns had considerable amounts of total carbohydrate, but GI values differed. The rice-oriented pattern was positively associated with hypertriglyceridemia in men and low high density lipoprotein-cholesterol in both men and women. The balanced pattern had no overall significant association with the prevalence of dyslipidemia or diabetes, however, men with energy intake above the median showed a reduced prevalence of diabetes across quintiles of balanced pattern scores. The results show that dietary patterns based on carbohydrate nutrition are associated with prevalence of dyslipidemia and diabetes in the Korean adult population.

Secular Trend in Dietary Patterns in a Korean Adult Population, Using the 1998, 2001, and 2005 Korean National Health and Nutrition Examination Survey

Koreans have undergone many changes in dietary patterns with economic growth. The purpose of this research was to examine changes in dietary patterns using data from the 1998, 2001, and 2005 Korean National Health and Nutrition Examination Survey. The study included 21,525 subjects (8,295 from 1998, 6,880 from 2001, and 6,350 from 2005) who were 20 years or older and who participated in a 24-h diet recall. The percentage energy intake from 22 food groups was calculated, and a cluster analysis was applied to identify dietary patterns. Two dietary patterns emerged; the first pattern was characterized by high intake of white rice, legumes, vegetables, kimchi, and seaweeds, the so-called "traditional" pattern (53%), whereas the other pattern was characterized by high intake of other grains, noodle dumplings, floured bread, pizza, hamburgers, cereals and snacks, potatoes, sugared sweets, nuts, fruits, meat.its products, eggs, fish, milk and dairy products, oils, beverages and seasoning, or the so-called "modified" pattern. The modified pattern comprised a higher proportion of younger aged, metropolitan residents with more education and higher incomes. However, the gender distribution was not significantly different. The modified pattern had a significantly higher intake of all nutrients except carbohydrates and had a higher proportion of energy from fat and protein. No association with a risk for metabolic syndrome was found for either dietary pattern. After age was standardized, the traditional pattern included 52% of the respondents in 1998, 54% in 2001, and 50% in 2005. However, the modified pattern was significantly more prevalent in the younger age group (20-29 yr), whereas the traditional pattern increased significantly in the older age group (> or = 65 yr). In conclusion, a secular trend was found for dietary pattern by age group, suggesting that it is necessary to monitor the changes in dietary pattern by age group and to develop appropriate dietary education and guidelines.

Dietary patterns are associated with physical growth among school girls aged 9-11 years

The purpose of this study was to identify dietary patterns among Korean elementary school girls based on the change in body mass index (BMI), body fat, bone mineral density (BMD), and bone mineral content (BMC) during 22 months and to explore the characteristics of dietary patterns identified. Girls aged 9-11 years were recruited and 3-day dietary data were collected four times. Subjects with a diet record of 8 or more days and anthropometric data measured at baseline and 22 months later were included (n = 198). Reduced rank regression was utilized to derive dietary patterns using a change in BMI, body fat, and calcaneus BMD and BMC as response variables. Two dietary patterns were identified: the "Egg and Rice" dietary pattern and "Fruit, Nuts, Milk Beverage, Egg, Grain" (FNMBEG) dietary pattern. Subjects who had high score on the FNMBEG pattern consumed various food groups, including fruits, nuts and seeds, and dairy products, whereas subjects in the "Egg and Rice" dietary pattern group did not. Both dietary patterns showed a positive association with change in BMI and body fat. However, subjects who had a higher score on the "Egg and Rice" dietary pattern had less of a BMC increase, whereas subjects who had a higher score on the FMBEG dietary pattern had more increased BMC over 22 months after adjusting for age, body and bone mass, and Tanner stage at baseline. Our results provide evidence that a well-balanced diet contributes to lean body mass growth among young girls.

Nutritional Status of Korean Toddlers: From the Korean National Health and Nutrition Examination Survey 2007~2009 / 대한소아소화기영양학회지

PURPOSE: The aim of this study was to investigate the feeding patterns, use of dietary supplements, and nutrient intake of Korean toddlers. METHODS: We used data for 930 toddlers who participated in the 4th Korean National Health and Nutrition Examination Survey (KNHANES) from 2007 to 2009. Feeding patterns and use of dietary supplements were assessed using standardized questionnaires, and nutrition intake was assessed using the 24 hr recall method. RESULTS: In 2007~2009, 48.7% of toddlers used dietary supplements. Most parents (95.4%) initiated a regime of dietary supplements for their children following the advice of friends or relatives. Only 0.4% of parents followed the advice given by their doctors for dietary supplements use. In the survey of nutrient intake for toddlers, the prevalence of inadequate calcium intake was 53.9% for subjects aged 1 year, 55.2% for 2 years and 65.6% for subjects aged 3 years. The prevalence of inadequate iron intake was 52.0% for subjects aged 1 year, 48.7% for 2 years and 48.4% for subjects aged 3 years. In the survey performed on feeding patterns of toddlers during the infant period, mixed feeding accounted for 57.4%, breast feeding for 32.2%,and formula feeding for 10.4%. Sixty-five percent of toddlers began weaning between 4 and 6 months. CONCLUSIONS: This study indicated that a number of toddlers were at risk of inadequate calcium and iron intake. The role of professionals in counseling for qualified dietary intake and dietary supplement use is therefore necessary for Korean toddlers.

A Comparison of Cluster and Factor Analysis to Derive Dietary Patterns in Korean Adults Using Data from the 2005 Korea National Health and Nutrition Examination Survey / 대한지역사회영양학회지

The purpose of this study was to explore dietary patterns and compare dietary patterns using cluster and factor analysis in Korean adults. This study analyzed data of 4,182 adult populations who aged 30 and more and had all of socio-demographic, anthropometric, and dietary data from 2005 Korean Health and Nutrition Examination Survey. Socio-demographic data was assessed by questionnaire and dietary data from 24-hour recall method was used. For cluster analysis, the percent of energy intake from each food group was used and 4 patterns were identified: "traditional", "bread, fruit & vegetable, milk", "noodle & egg", and "meat, fish, alcohol". The "traditional" pattern group was more likely to be old, less educated, living in a rural area and had higher percentage of energy intake from carbohydrates than other pattern groups. "Meat, fish, alcohol" group was more likely to be male and higher percentage of energy intake from fat. For factor analysis, mean amount of each food group was used and also 4 patterns were identified; "traditional", "modified", "bread, fruit, milk", and "noodle, egg, mushroom". People who showed higher factor score of "traditional" pattern were more likely to be elderly, less educated, and living in a rural area and higher proportion of energy intake from carbohydrates. In conclusion, three dietary patterns defined by cluster and factor analysis separately were similar and all dietary patterns were affected by socio-demographic factors and nutrient profile.

The Physical Development and Dietary Intake for Korean Children and Adolescents: Food and Nutrient Intake

The aim of this study was to evaluate the food and nutrient intakes in 5th to 8th grade school boys and girls. A total of 1,333 students were recruited from 1 elementary and 1 middle school, both located in Seoul. The data on food and nutrients intake were collected by 3-day food record. The food intake was calculated as the percentage of total energy intake according to 21 food subgroups. The consumption of noodles, and meat's products (including ham and sausage) groups were higher in 7th and 8th grade than 5th and 6th grade. On the other hand consumption of vegetables and milk and its products groups were lower in 7th and 8th grade. As results, calcium, riboflavin, and vitamin C intakes were lower in 7th and 8th grade students. Dietary patterns by cluster analysis resulted in 77% of subjects with traditional pattern based rice and kimchi, and 23% with modified pattern. All students regardless of grades showed high fat intake, above 20 percent energy intake from fat, and high cholesterol intakes. In conclusion, there was significant difference between 5th and 6th grade primary school students and 7th and 8th junior school students regarding food and nutrient intakes. It should be necessary to provide proper nutrient education and monitoring in order to establish good dietary profile.

The Physical Development and Dietary Intake for Korean Children and Adolescents Body Composition and Obesity Prevalence

The aim of this study was to evaluate the body composition difference and obesity prevalence in grade 5 to 8 by gender. A total of 1,333 students, 707 boys and 631 girls, were recruited from one elementary and one middle school in Seoul, Korea. Anthropometric measurements including height, weight, lean body mass, and body fat were assessed. Height and weight were increased by grade, but Body Mass Index (BMI) by grade showed no significant difference among boys. Lean body mass had growth spurt between 7 and 8 grade among boys compared to gradual increase among girls. Overweight and obesity prevalence were higher among elementary schoolers than middle schoolers. Overweight (BMI for age >85 th percentile) prevalence was about 44% among 5 th grade boys compared 29% among same grade girls. These results provided that there were prominent difference regarding body growth and obesity prevalence in gender and grade. Further studies for children and adolescents should be considered their body composition change.

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.

Socioeconomic, Nutrient, and Health Risk Factors Associated with Dietary Patterns in Adult Populations from 2001 Korean National Health and Nutrition Survey

The objective of the study was to define dietary patterns in the representative Korean adult population and to explore their associations with other factors. The Korean National Health and Nutrition Survey was conducted on a stratified random sample (n = 9,968) of the Korean population in 2001. This study analyzed data of 5,721 adult population aged 30 and over. Demographic and lifestyle factors were assessed by questionnaires and food consumption by a 24-h recall method. Cluster analysis identified two dietary patterns with 22 food groups: the larger group that included 85% of total subjects was named as the "traditional" pattern due to greater intakes of white rice, kimchi, and vegetables, and the smaller group was named as the "modified" pattern which had greater intakes of noodles, bread, snack, and fast foods. The modified pattern had significantly higher proportion in younger age, higher educational level, residing in metropolitan area, and higher household income. The modified group showed significantly higher intake of all nutrients except carbohydrate. Percent of energy from fat intake, 22% was significantly higher in the modified group than 14% in the traditional group. There were no differences in prevalence of metabolic syndrome and its 5 components among patterns. In conclusion, there were two distinctive patterns that were associated with socio-demographic, nutrient intake, and health risk factors in Korea. It should be considered when designing nutrition policy and intervention program.

Dietary Assessment Using Dietary Pattern Analysis of Middle School Students in Seoul

The objectives of this study were to identify dietary patterns of Korean middle school students and to investigate the characteristics of dietary intake of subjects with different dietary pattern. Three-day diet records were obtained from 163 male and 155 female 7th graders in Seoul, Korea. Food items from the diet records were aggregated into 22 food groups before subjected to factor analysis. Four dietary patterns emerged from factor analysis with different factor score. Cluster analysis using factor score classified subjects into three groups named 'Traditional' (n = 42), 'Westernized' (n = 135), and 'Intermediate' (n = 145). Major nutrient intake and dietary quality assessed by NAR (Nutrients Adequacy Ratio), MAR (Mean Adequacy Ratio), DDS (Dietary Diversity Score), and DVS (Dietary Variety Score) of the three groups were compared. Mean energy intakes of three groups were 1783, 1916, 1578 kcal in Traditional, Westernized, and Intermediate diet group respectively. Differences in nutrient intake of the groups were significant in all nutrients except vitamin B1. Percent energy from fat was significantly higher in Westernized and Intermediate diet group, and cholesterol intake of Westernized diet group was higher than 300 mg. NARs of most nutrients were higher in Traditional and Westernized than Intermediate diet group except vitamin E. Traditional and Westernized diet groups had the highest MAR of fourteen nutrients. DDS was the highest in Westernized and DVS was the highest in Traditional and Westernized diet group. Traditional diet groups had 22% of energy consumption from breakfast, significantly higher than other diet groups. In conclusion, these results suggest that Korean teenagers with Traditional diet pattern have lower diet in % energy from fat, diversity of food and regularity of meals. Future studies need to focus on the relationship between dietary patterns and health status of Korean teenagers.

Effect of Dietary, Biochemical and Other Factors on Bone Mineral Density Change for 2 Years in Korean College Women

This study was conducted to examine whether bone mineral density changes in 55 young Korean college women aged 19 to 26 years over 2 years and nutritional and biochemical factors are related. Bone mineral density (BMD) was measured in the spine (LS), femoral neck (FN), ward's triangle (WT), and femoral trochanter (FT) by dual energy X-ray absorptiometry three times at one-year intervals. Serum osteocalcin (OC), parathyroid hormone (PTH), and urinary cross-linked N-teleopeptides of type collagen (NTx) were measured. Dietary intake was assessed 8 times with 24-hour recall method. Physical activity (PA) was obtained by questionnaire and body fat content was measured by bioelectrical impedance analysis at baseline and after 2 years. Analyses were performed on 34 subjects with all three BMD measurements. The BMDs at the lumbar spine gradually increased over 2 years, while the BMDs of three sites at the femur were sustained or increased. The mean OC, PTH had a similar pattern with the change of BMD at the femur. The mean NTx decreased over 2 years but was still higher than those in other studies. BMI, body fat, vitamin A and zinc intake had a significant correlation with LS-BMD. Femur, PTH, body fat, vitamin A, vitamin B2 and calcium intake had a significant correlation with WT-BMD and was mostly influenced by diet. By multiple regression analysis, it was shown that the significant factors affecting the LS-BMD were BMI and vitamin A intake and those affecting FN and WT were age, BMI, PTH and calcium intake. These results indicate that some Korean women still experience increases in BMD and that this was associated with PTH and vitamin A and calcium intake. Therefore, proper diet and diet management is needed to increase changes in BMD among college women.

Assessment of Customer Satisfaction of Service Quality in University Foodservices / 대한지역사회영양학회지

The purpose of the study was to assess customer satisfaction concerning service quality characteristics of university foodservice by using a developed DINESERV model. In particular, it was intended to develop a tool to assess the difference between customer judgements on importance and customers perceptions with actual service delivery by university foodservices. Quenstionnaires were distributed to 1,000 university students. A total at 820 university students responded with a usable response rate of 77.7%. A statistical data analysis was completed using SAS programs for descriptive analysis; a t-test, chi-square test and Dunan's multiple range test. The results of the study are as follows; 1) The mean number of students visiting university foodservices per week for males was larger than that of females. The students' first choice depended on distance when they selected foodservices. They answered their preference as the first factor when they order a particular menu items in foodservices. The first complaint factor concerning university foodservices was the price of the food. 2) Customers was not satisfied with the quality of the service of university foodservices. The important mean score of the service quality was 3.63 out of 5, but the perception mean score of the service quality was 2.87. Therefore, there was a gap(0.76) between the importance score and perception score. 3) Customers' satisfaction with the service quality by dimensions wee int he follow order: assurance>reliability>responsiveness>tangibles>empathy. Customers were more satisfied with the service quality of contracted management than that of self-operated facilities.