Characteristics of the dietary intake of Korean elderly by chewing ability using data from the Korea National Health and Nutrition Examination Survey 2007-2010 / 한국영양학회지

The purpose of this study was to examine the characteristics of the dietary intake of Korean elderly according to chewing ability using data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted during 2007-2010. Among subjects aged 65 years and over, more than half, 54.3% of elderly people, were classified as the difficulty in chewing group (DC). The DC group had lower nutrients and food intakes than those of in the no difficulty in chewing group (NDC). Findings showed that subjects in the DC group consumed fewer foods, especially fruits and vegetables. In addition, the DC group had significantly lower intakes of pan-fried food, stir-fried food, braised food, and seasoned-cooked vegetables, which could not be easily cooked or chewed. On the other hand, the number of soups and stews included in the top 30 largely consumed dishes were higher in the DC group than in the NDC group. No difference in numbers of daily meal/snack intake was observed between the two groups, however, the DC group had lower numbers of side-dishes compared to the NDC group. Fewer side-dishes per meal could be related to lower intakes of nutrients in dietary quality. Findings of this study demonstrated that dietary intake was influenced by chewing ability of elderly Korean people. Therefore, study of factors affecting dietary intake such as convenient cooking methods to decrease cooking time and skills to extend preservation and storage time of foods will necessary. In addition, development of food products and new techniques of cooking considering health status, chewing, and swallowing ability is required for the elderly, followed by establishment of standards for senior-friendly food products.

A comparison of food and nutrient intake between instant noodle consumers and non-instant noodle consumers in Korean adults

Instant noodles are widely consumed in Asian countries. The Korean population consumed the largest quantity of instant noodles in the world in 2008. However, few studies have investigated the relationship between instant noodles and nutritional status in Koreans. The objective of this study was to examine the association between instant noodle consumption and food and nutrient intake in Korean adults. We used dietary data of 6,440 subjects aged 20 years and older who participated in the Korean National Health and Nutrition Examination Survey III. The average age of the instant noodle consumers (INC) was 36.2 and that of the non-instant noodle consumers (non-INC) was 44.9; men consumed more instant noodles than women (P < 0.001). With the exception of cereals and grain products, legumes, seaweeds, eggs, and milk and dairy products, INC consumed significantly fewer potatoes and starches, sugars, seeds and nuts, vegetables, mushrooms, fruits, seasonings, beverages, meats, fishes, and oils and fats compared with those in the non-INC group. The INC group showed significantly higher nutrient intake of energy, fat, sodium, thiamine, and riboflavin; however, the INC group showed a significantly lower intake of protein, calcium, phosphorus, iron, potassium, vitamin A, niacin, and vitamin C compared with those in the non-INC group. This study revealed that consuming instant noodles may lead to excessive intake of energy, fats, and sodium but may also cause increased intake of thiamine and riboflavin. Therefore, nutritional education helping adults to choose a balanced meal while consuming instant noodles should be implemented. Additionally, instant noodle manufacturers should consider nutritional aspects when developing new products.

Development of supplemental nutrition care program for women, infants and children in Korea: NutriPlus+

Onto the world-fastest ageing of society, the world-lowest fertility rate prompted a development of various policies and programs for a betterment of the population in Korea. Since the vulnerability of young children of low socio-economic class to malnutrition was clearly shown at the in-depth analysis of the 2001 Korea National Health and Nutrition Examination Survey data, an effort to devise supplemental nutrition care program for pregnant/breastfeeding women, infants and preschool children was initiated. The program was designed to offer nutrition education tailored to fit the needs of the participants and special supplementary foods, using USDA WIC program as a benchmark. Based on the dietary intake of those age groups, target nutrients were selected and their major food sources were searched through nutrient content of foods and dietary pattern analysis. As a result, we developed 6 kinds of food packages using combinations of 11 different food items. The amount of each item in a food package was determined to supplement the intake deficit in target nutrients. Nutrition education in NutriPlus + aims to improve the nutrition knowledge, attitude, and dietary behaviors of the participants, and is provided through group lessons, individual counseling sessions and home visits. Breastfeeding is promoted with top priority in education for the health of both mother and baby. The eligibility guidelines were set for residency, household income, age, pregnancy/breastfeeding and nutritional risk such as anemia, stunting, underweight, and/or inadequate nutrient intake. Income eligibility was defined as household income less than 200 percent of the Korean poverty guidelines. A pilot study to examine the feasibility of program implementation was run in 3 public health centers in 2005 and expanded to 15 and 20 in the following 2 years. The result of 3-year pilot study will be reported separately along with the ultimate nationwide implementation of the NutriPlus + in 2008.

A Comparison of Food and Nutrient Intakes between Instant Noodle Consumers and Non-Consumers among Korean Children and Adolescents

Instant noodle is one of the most popular foods in Korea. The objective of this study was to examine the association of instant noodle consumption and food and nutrient intake among children and teenagers in Korea. We used dietary data from 24-h recall of 1,748 subjects aged 7-19 years who participated in the 2005 Korea National Health and Nutrition Examination Survey. Those who consumed instant noodle once or more during the survey period were categorized as "instant noodle consumer (INC)" and were compared for food and nutrient intakes with the others (non-INC). The average age of the INC was 13.4 and that of the non-INC was 12.4; girls consumed more instant noodles than boys (p < 0.05). There was no significant difference in BMI between the two groups. With the exception of grains, as compared to the non-INC, the INC consumed significantly less amounts of potatoes, vegetables, mush-rooms, fruits, spices, seafood, and milk and dairy products. With respect to nutrient intakes, the INC-group showed significantly higher nutrient intakes of energy, fat, carbohydrate, sodium, thiamine, and riboflavin; however, as compared to the non-INC-group, the INC-group showed significantly less intakes of calcium, niacin, and vitamin C. The overall result suggests that consuming instant noodles may lead to excessive intake of fat and sodium, but it may cause an increased intake of thiamine and riboflavin. Therefore, nutrition education that helps children and teenagers choose a balanced meal while consuming instant noodle should be carried out. In addition, manufactures of instant noodles should consider nutritional aspects in product development processes.

Nutritional Labeling Practices for Processed Foods According to Food Category

The purpose of this study was to investigate the current nutritional labeling practices in the processed foods industry. Package labels provide consumers with reliable nutritional information, which has been considered a useful aid for food selection and a potent educational tool for nutrition in a daily life. To assess the nutritional composition labeling and nutritional claims on the food package labels in the Korean market, 2,691 processed foods were purchased from a wholesale market in August, 2004, under the food categories specified in the 2004 Food Code. Nutritional composition labels were found on 674 out of the 2,691 processed foods items. The study findings were as follows. Milk and dairy products showed the highest percentage(56.6%) of nutritional composition labeling among the food categories, while 86.2% of processed foods carried inappropriate types of nutrition labels. The title of nutritional composition labeling was ordered according to the nutritional composition presented on the top part of the box. The regulations method which it indicates was 77.8%. The expression unit of the nutritional composition labeling was per 100g(32.8%) or per OOg (29.4%). Of total processed foods, 83(3.1%) offered nutritional claims in their labels. These claims were divided into two ways: nutrient content claims and nutrient comparative claims. The most frequently used term in nutrient content claims was "contained"(67.2%). "More" or "Plus" were frequently used term in nutrient comparative claims(11.2%). Calcium was the most popular among nutrients claimed by processed foods(34.3%).

Nutritional Environment Influences Hypertension in the Middle-aged Korean Adults: based on 1998 & 2001 National Health and Nutrition Survey / 대한지역사회영양학회지

This study was performed to delineate the relationship between lifestyle and nutritional risk factors associated with hypertension in representative middle-aged Korean population. Hypertension in this study is defined as hypertensive (SBP> or = 140 mmHg or DBP> or = 90 mmHg) adults without recognition of a disease state before a health exam. With data from the 1998 and 2001 National Health and Nutritional Survey, nutrient intakes of 6,112 adults, 40-64 years of age were calculated using food composition database and matched with health examination records by individual ID. After excluding those with extreme intake values, the number of final subjects included in the analysis was 5,200 (male 2,458, female 2,742). Using logistic regression method, socio-demographic data, lifestyle factors, and nutrient intakes were analyzed. Risky factors for hypertension revealed in this study were age, sex, BMI over 23, waist circumference, alcohol intake of more than 16 g (male) or 8 g (female). Regarding nutrient intakes, the intakes of highest quartile for energy (> or = 2363.0 kcal) and protein (> or = 90.2 g) were significantly associated with higher risk of hypertension after adjusting for age, sex, and other socio-demographic factors (OR = 1.312 (1.046-1.711), OR = 1.488(1.194-1.854), respectively)). Although high intakes of sodium (> or = 6604.0 mg) and phosphorus seemed to be risk factors of hypertension also before energy adjustment (OR = 1.278(1.034-1.581), OR = 1.280(1.024 -1.600), respectively), only high intakes of energy and protein remained significant after adjustment. This study revealed that modifying risky lifestyles and dietary patterns, especially high energy intake, high protein intake, and high alcohol drinking, in middle-aged Korean adults could result in a prevalence decrease and/or prevention of hypertension.

Dietary Intake Pattern of the Korean Adult Population by Weight Status: 2001 National Health and Nutrition Survey / 대한지역사회영양학회지

To explore the relationship between weight status and food intake pattern, the Nutrition Survey results of the 2001 National Health and Nutrition Survey were analyzed. Dietary intake data of Korean adults aged 20 to 64, years who participated in the 2001 National Health and Nutrition Survey, was used along with their demographic data. Subjects were classified into 4 groups based on the BMI value of subjects: underweight, normal, overweight and obese. For male adults, obese subjects had significantly higher mean intake of energy, protein, carbohydrates, and fat than normal subjects. In addition, obese male adults consumed more animal foods, especially more meats, than normal subjects. However, females obese subjects did not show higher intake of energy or fat. Although obese male adults showed higher energy intake, calcium and iron intake per 1000 kcal was lower than normal adults. Average calcium intake in females was low; about 70% of RDA regardless of obesity level. In addition, riboflavin and Vitamin A intake was lower in overweight and obese female than in normal females. Percentage of subjects with low fruit and vegetable intake (<400 g per day) was also high in female subjects. These results showed that food and nutrient intake patterns of obese population were different between male and female adults. These dietary intake patterns need to be considered in developing and implementing nutrition policy and intervention programs to prevent and control obesity. Moreover, the National Survey and monitoring system should be developed for continuous and effective investigation on the relationship between obesity and dietary intake.

Application of a Practical Nutrition Education Program, KHIDIKIDS, for the Improvement of Dietary Attitudes and Habits of Elementary Students

The purpose of this study was to improve the dietary attitudes and habits of elementary students in lower classes through a 12-week practical nutrition education program called KHIDIKIDS, which was developed by Korea Health Industry Development Institute (KHIDI) in 2004 based on the 2003 Children's Dietary Guidelines of the Ministry of Health and Welfare of Korea. KHIDIKIDS has never been applied in the field, therefore, another purpose of this study was to evaluate the program in the school education and suggest the ideas for the improvement. KHIDIKIDS was applied to a class of 2nd-grade elementary students consisting of 28 children in Seoul during the fall semester of 2005, and the effect of the program was measured by using questionnaires for the students and their parents. The statistical analysis of the study was conducted by using SPSS WIN 11.5 program, and the results were as follows: The children's knowledge on nutrition was improved significantly by KHIDIKIDS education (p < .001), such that the average score on nutritional knowledge increased from 8.32 to 9.64 after education. This practical nutrition education program also improved the dietary attitudes and habits of children especially in healthy body weight, daily exercise, and having breakfast (p < .05). Parents also showed very positive responses for the nutrition education. During the application of KHIDIKIDS in the field, the followings were indicated for adjustment; First, some education content of the week was too much to be finished in a class hour and more hours need to be allocated. Second, some terminology need to be adjusted to help the students understand easily. Thirdl, the order of the '5 Basic Food Groups' needs to be matched with the order of each food group in the 'Food Tower' not to make children be confused. Above results showed that KHIDIKIDS was effective for the improvement of dietary attitudes and habits of lower elementary students. However, further educational effects would be achieved when the education was started from the 1st to higher grades along with the parents' participation.

Food and Nutrient Consumption Patterns of the Korean Adult Population by Income Level - 2001 National Health and Nutrition Survey / 대한지역사회영양학회지

To explore the relationship between economic status and food and nutrient intake patterns, the 2001 National Health and Nutrition Survey result was analyzed. Dietary intake data of 6,978 Korean adults of 20 years and older who participated in the 2001 National Health and Nutrition Survey were used along with their demographic data. Economic status of the subjects was classified into the following 4 groups based on the self-reported average monthly income of household with reference to the minimum monthly living expenses (MLE) in 2001: low<100% MLE < or = middle<200% MLE < or = high<300% MLE < or = higher. Individuals in the higher income class had significantly higher mean intake for most of the nutrients including energy, protein, carbohydrate, fat, calcium, thiamin, riboflavin, niacin and vitamin C, and a higher percentage of energy intake from fat. In addition, they consumed more animal foods including meats, eggs, fish/shellfish, milk/dairy products and fats. On the other hand, the mean intakes of individuals in the lower economic class for calcium, vitamin A, and riboflavin were lower than 75% of RDAs. And, there was a predominant difference in contribution of fat to total energy intake among the groups of different economic status. These results showed that household income is an important factor influencing the food and nutrient intake patterns of the Korean adult population. Although individuals at different age classes may respond differently to a change in economic status, developing and implementing nutrition policy and intervention programs for those nutritionally vulnerable groups should consider the economic status as an important factor to customize and differentiate the content of the program.

Satisfaction Measurement and Needs Analysis of the Beneficiaries of the Elderly Meal Service Program

In the process of devising an efficient meal service system for the elderly, 478 elderly were interviewed at 6 different social centers with the elderly meal service program in Seoul area to monitor degree of satisfaction and/or needs of the beneficiaries regarding the program. The survey was conducted during the month of December 2002 by well-trained interviewers using self-developed questionnaire. Results were analyzed statistically using SAS package program. Most of the beneficiaries were low economic class and 76% of them had doctor diagnosed disease(s). Among the beneficiaries of congregate meal service, mean score of 12 aspects of satisfaction was 3.72 out of 5. For most of the questions, female elderly and healthy elderly responded with higher score than male elderly and unhealthy elderly, respectively (p<0.05, p<0.01). On the other hand, beneficiaries of the home-delivered meal service were little bit less satisfied with the service (3.54 out of 5). Compared to the beneficiaries of congregate meal service, larger portion of beneficiaries of home-delivered meal service wanted more meats (28.5 % vs. 17.1 %) and vegetables (23.2 % vs. 12.3 %) as side dishes. On the other hand, the most preferred type of cooking and/or seasoning was stewing for both cases. Based on these findings, it is suggested that more fresh foods should be used than processed foods in the preparation of meals for the elderly and, more fish-, meat- and vegetable- dishes should be served to come up to the needs of the elderly. Onto this, mainly Korean style meals with some intermittent Western, Japanese or Chinese style meals served at the right temperature would suffice most of the elderly needs.

Satisfaction Measurement and Needs Analysis of the Beneficiaries of the Elderly Meal Service Program

In the process of devising an efficient meal service system for the elderly, 478 elderly were interviewed at 6 different social centers with the elderly meal service program in Seoul area to monitor degree of satisfaction and/or needs of the beneficiaries regarding the program. The survey was conducted during the month of December 2002 by well-trained interviewers using self-developed questionnaire. Results were analyzed statistically using SAS package program. Most of the beneficiaries were low economic class and 76% of them had doctor diagnosed disease(s). Among the beneficiaries of congregate meal service, mean score of 12 aspects of satisfaction was 3.72 out of 5. For most of the questions, female elderly and healthy elderly responded with higher score than male elderly and unhealthy elderly, respectively (p<0.05, p<0.01). On the other hand, beneficiaries of the home-delivered meal service were little bit less satisfied with the service (3.54 out of 5). Compared to the beneficiaries of congregate meal service, larger portion of beneficiaries of home-delivered meal service wanted more meats (28.5 % vs. 17.1 %) and vegetables (23.2 % vs. 12.3 %) as side dishes. On the other hand, the most preferred type of cooking and/or seasoning was stewing for both cases. Based on these findings, it is suggested that more fresh foods should be used than processed foods in the preparation of meals for the elderly and, more fish-, meat- and vegetable- dishes should be served to come up to the needs of the elderly. Onto this, mainly Korean style meals with some intermittent Western, Japanese or Chinese style meals served at the right temperature would suffice most of the elderly needs.

Change of Perception after Weight Management Education among some Elementary, Middle and High School Students in Seoul

To investigate the change of perception after weight management education in elementary, middle and high school students, a survey was conducted. Same questionnaire was administered twice, before and after weight management education, to 426 students at 9 schools in Seoul area. The mean height, weight and body mass index were 145.5+/-8.0cm, 40.0+/-8.3kg, 18.6+/-3.0 for elementary school students, 160.1+/-5.2cm, 50.2+/-7.3kg, 19.5+/-2.4 for middle school students, and 162.2+/-5.0cm, 52.2+/-6.4kg, 19.8+/-2.3 for high school students, respectively. Before education, their preferred weight and perceived healthy weight was 35.4kg and 37.0kg among elementary school students, 44.8kg and 46.5kg among middle school students, and 47.3kg and 48.9kg among high school students, respectively. Differences between their present body weight and their preferred weight and/or perceived healthy weight appeared to be 4.5kg and 2.9kg in elementary school students, 5.6kg and 4.0kg in middle school students, and 5.1kg and 3.3kg in high school students, respectively. After administering education, the differences decreased to 2.5kg and -0.2kg in elementary school students, 4.2kg and 2.7kg in middle school students, and 4.3kg and 2.0kg in high school students, respectively (p<0.01). And their perception on own body shape was investigated using 5 point scale ('too lean' to 'too fat', 1 to 5) before and after education. The mean values changed from 3.1 to 2.8 in elementary school students, from 3.3 to 3.0 in middle school students, and from 3.4 to 3.2 in high school students (p<0.01). Their satisfaction with own body weight was monitored using 5 point scale ('very satisfied' to 'very unsatisfied', 1 to 5), also. The mean values changed from 3.0 to 2.7 in elementary school students, from 3.6 to 3.2, in middle school students, and from 3.8 to 3.4 in high school students (p<0.01). In the evaluation of their nutrition knowledge about weight control using 10 item quiz, before and after education, the mean quiz score was changed from 6.3 to 7.0 in elementary school students, from 7.0 to 7.9 in middle school students, and from 7.5 to 8.1 in high school students (p<0.01). In summary, nutrition education on weight management improved the subject's perception on perceived healthy weight and own body shape, and satisfaction with present body weight. This result suggests that nutrition education program should incorporate strategies to change incorrect beliefs and knowledge regarding weight control. Onto this, weight control education for students should start from their early age, be repeated periodically and consistently, and focus on the harmful effects of excessive weight loss and information on the practical and scientific ways of weight management.

A Study on the Current Nutrition Labelling Practices for Processed Foods / 대한지역사회영양학회지

This study examined the status of current nutrition labelling and claims for the processed foods that were purchased in the supermarket. They were assessed in the aspects of frequency and content of nutrition labelling and claims. The results are summarized as follows; The percentage of products contain the nutrition labelling or claims of processed foods of investigation were 18.7% and 18.8% respectively. In the nutrition labelling method, the format separated by expression contents with 'only liability indication nutrient' or 'liability indication nutrients plus discretion indication nutrients' were 44.7% and 43.4% respectively. In the case of type and title, 'table' and 'nutrition composition' were used most frequently, 83.9% and 83.2% respectively. And in the case of expression unit, 'per 100 g or 100 ml' was higher (56.8%) than others. Nutrition claims were divided into 'nutrition content claim' and 'comparative claim', in the former the most claim was 'containing' and in the other 'more or plus' used most frequently. 'Nutrient function claim' was 13.4% and 'Implied nutrient claim' was 7.3% of all the claims. Results of the evaluation of current nutrition labeling system, nutrition labelling was less advanced and variable in content and format and also the information was not easy for consumers to understand and use them. To support achievement of the nutrition label, there must be program and initiatives for better understanding and communication and guidances on food labelling and nutrition for food manufactures.