A Pilot Study for Development of a Gender Variable Model for Health Research in Korea

Background@#For gendered innovations to be streamlined in health research, researchers need tools to measure gender variables quantitatively. Because gender is a sociocultural concept which varies by culture, it is important to check feasibility of using tools developed in western countries before using them in Korea. The objective of this study is to conduct a pilot study for adapting a questionnaire measuring gender variables from the literature for the Korean population. @*Methods@#The research was conducted in two steps: 1) modification of questionnaire by an expert group, and 2) an on-line survey of 3,000 adults, in three age groups, balanced in sex. The questionnaire was composed of 7 gender variables with 2 to 6 items, constituting a total of 24 5-point Likert scale items. Gender variable scores were calculated as the average of Z-scores of items pertaining to each variable. @*Results@#Participants were 45.6% men, 43.9% women, and 10.5% other gender. Scores of five gender variables-caregiver tension, work tension, independence, emotional intelligence, and discrimination-were significantly different among sex and gender groups. Among gender variables, work strain, caregiver strain, and discrimination had notable influences on health status and health-related behaviors among survey participants. @*Conclusions@#Several gender variables were related to health status and health behaviors in Korean adults. This is the first attempt in Korea to quantify gender characteristics to be used for health research. Further studies are needed to verify the questionnaire and methods developed in this study for use with diagnosed disease outcomes.

Gender Perspectives on the Relationship between Red and Processed Meat Intake and Colorectal Cancer: A Systematic Review and Meta-Analysis

BACKGROUND@#Men and women choose different food items, and consume different amounts of food, due to biological, cultural, and social differences. However, when dietary assessment instruments are developed, gender differences in food selection and/or the portion sizes are often not considered.@*METHODS@#Prospective cohort studies with men and women that examined the association between red or processed meat intake and colorectal cancer and published up to July 2017, were identified using PubMed. Studies were categorized as gender-specific (GS) group if the Food Frequency Questionnaire was developed using gender-specific data, and as not gender-specific (NGS) group if not gender-specific data were used.@*RESULTS@#For cohort studies that reported combined intake estimates of men and women, a 100 g/day increment in red and processed meat intake was positively associated with a risk of colorectal or colon cancer in GS group (relative risk [RR], 1.23; 95% confidence interval [CI], 1.14–1.32) but not in NGS group (RR, 1.13; 95% CI, 0.90–1.35). For processed meat, the RR for 50 g/day increase was 1.28 (95% CI, 1.15–1.40) in GS group and 1.15 (95% CI, 1.03–1.27) in NGS group.@*CONCLUSIONS@#Gender differences need to be considered during development of dietary assessment tools because this may improve the quality of the findings of nutritional epidemiological studies.

Gender Analysis of Food Items Selection for Food Frequency Questionnaire Development

BACKGROUND@#The aims of this study were 1) to compare foods between men and women with high contributions to absolute intake and the variability in energy and nutrient intakes, which are common criteria of selecting foods for food frequency questionnaire (FFQ), 2) to analyze possible inaccuracies due to not taking gender into consideration.@*METHODS@#The study used 1-day 24 hour recall data of 7,952 participants (n=3,250 men, n=4,702 women) aged 19–64 years who participated in the 2013–2014 Korea National Health and Nutrition Examination Survey. Foods which have high possibility of being included in FFQ items, called candidate foods, were selected by analyzing their contribution to absolute intake and variability in the intakes of energy and 15 nutrients in total participants, men and women.@*RESULTS@#The number of candidate foods selected was 133 for total participants, 126 for men, and 153 for women. Intakes of candidate foods for total participants were significantly higher in energy and six nutrients out of selected 16 nutrients than those of candidate foods for men only. On the contrary, all nutrient intakes of candidate foods for total participants were significantly lower than those of candidate foods for women only.@*CONCLUSIONS@#Differences were revealed between men and women not only in the total numbers, but also in the selected food items from the candidate foods for FFQ. Thus, developing FFQs without considering gender may produce systematic errors in dietary assessment, possibly in different directions for men and women.

Experiences with a graduate course on sex and gender medicine in Korea / 보건의료교육평가

No abstract available.

Gender Perspectives on the Relationship between Red and Processed Meat Intake and Colorectal Cancer: A Systematic Review and Meta-Analysis

BACKGROUND: Men and women choose different food items, and consume different amounts of food, due to biological, cultural, and social differences. However, when dietary assessment instruments are developed, gender differences in food selection and/or the portion sizes are often not considered. METHODS: Prospective cohort studies with men and women that examined the association between red or processed meat intake and colorectal cancer and published up to July 2017, were identified using PubMed. Studies were categorized as gender-specific (GS) group if the Food Frequency Questionnaire was developed using gender-specific data, and as not gender-specific (NGS) group if not gender-specific data were used. RESULTS: For cohort studies that reported combined intake estimates of men and women, a 100 g/day increment in red and processed meat intake was positively associated with a risk of colorectal or colon cancer in GS group (relative risk [RR], 1.23; 95% confidence interval [CI], 1.14–1.32) but not in NGS group (RR, 1.13; 95% CI, 0.90–1.35). For processed meat, the RR for 50 g/day increase was 1.28 (95% CI, 1.15–1.40) in GS group and 1.15 (95% CI, 1.03–1.27) in NGS group. CONCLUSIONS: Gender differences need to be considered during development of dietary assessment tools because this may improve the quality of the findings of nutritional epidemiological studies.

Gender Analysis of Food Items Selection for Food Frequency Questionnaire Development

BACKGROUND: The aims of this study were 1) to compare foods between men and women with high contributions to absolute intake and the variability in energy and nutrient intakes, which are common criteria of selecting foods for food frequency questionnaire (FFQ), 2) to analyze possible inaccuracies due to not taking gender into consideration. METHODS: The study used 1-day 24 hour recall data of 7,952 participants (n=3,250 men, n=4,702 women) aged 19–64 years who participated in the 2013–2014 Korea National Health and Nutrition Examination Survey. Foods which have high possibility of being included in FFQ items, called candidate foods, were selected by analyzing their contribution to absolute intake and variability in the intakes of energy and 15 nutrients in total participants, men and women. RESULTS: The number of candidate foods selected was 133 for total participants, 126 for men, and 153 for women. Intakes of candidate foods for total participants were significantly higher in energy and six nutrients out of selected 16 nutrients than those of candidate foods for men only. On the contrary, all nutrient intakes of candidate foods for total participants were significantly lower than those of candidate foods for women only. CONCLUSIONS: Differences were revealed between men and women not only in the total numbers, but also in the selected food items from the candidate foods for FFQ. Thus, developing FFQs without considering gender may produce systematic errors in dietary assessment, possibly in different directions for men and women.

Use of Dietary Supplements and Determinants of Taking Dietary Supplements by Gender in the Korean Population: Using the 4(th) Korean National Health and Nutrition Examination Survey (2007-2009) / 대한지역사회영양학회지

OBJECTIVES: Although dietary supplements use in Korea has been rapidly increasing and women are more likely to take dietary supplements more than men, only a few studies have been conducted to investigate factors contributing to gender differences in dietary supplement use in the Korean population. The aim of this study is to evaluate the prevalence of dietary supplement use and also identify gender-specific key factors that contribute to it using the data of the 4th KNHANES. METHODS: Subjects were divided into user and non-user groups according to the answer given to the question that asked whether they had used any dietary supplement for more than 2 weeks on a regular basis during the previous year. Factors related to dietary supplement use were examined by general characteristics, health behavior and eating behavior. RESULTS: Prevalence of dietary supplement use was 13.6% for men and 20.6% for women. Users were more likely to be middle-aged, have higher income and education, have a spouse, or reside in dong areas in both men and women. Regarding health behaviors, men with desirable lifestyle behavior were more likely to take dietary supplements, while men who smoked were less likely to take dietary supplements. Regarding disease history, both men and women with a current disease had higher odds of taking supplements. With regard to dietary behavior, frequent eating out and nutrition attitude were associated with higher odds of taking supplements in both men and in women. CONCLUSIONS: Health or dietary behavior related factors that were associated with taking supplements differed by gender. These findings can be useful for planning gender-specific dietary education and health programs.

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.

An Iodine Database for Common Korean Foods and the Association between Iodine Intake and Thyroid Disease in Korean Adults

BACKGROUND AND OBJECTIVES: Iodine is essential for thyroid hormone production and the iodine intake of Koreans is high. Few studies have examined the association between iodine intake and thyroid disease in the Korean population due to the lack of an iodine database. Therefore, this study established an iodine database, evaluated iodine intake levels, and explored the association between iodine intake and thyroid disease. MATERIALS AND METHODS: We obtained data for 9998 subjects who had both biochemical and dietary data from the 2007-2009 Korea National Health and Nutrition Examination Survey. RESULTS: An iodine database was established for 667 food items. The median iodine intake in the population was 375.4 microg per day. The iodine contribution by food group was 65.6% from seaweed, 18.0% from salted vegetables, and 4.8% from fish. When subjects were divided into five groups across quintiles of iodine intake per 1000 kcal, excluding extreme subjects who consumed above the upper limit, age, sex, income, education, drinking, and smoking differed across the groups. While the energy and fat intakes decreased, other nutrients increased across the quintile groups. The consumption of seaweeds, fish, eggs, and salted vegetables increased across the quintile groups. After adjusting for all potential confounding variables, the odds ratio for thyroid disease in the highest quintile was 1.63 compared to that in the lowest quintile (p for trend=0.0352). CONCLUSION: The iodine intake of the Korean population is high, with high consumption of seaweeds, salted vegetables, and fish positively associated with thyroid disease.

The Impact of Low Adherence to the Low-iodine Diet on the Efficacy of the Radioactive Iodine Ablation Therapy

To improve the efficacy of radioactive iodine (RAI) therapy for differentiated thyroid cancer patients, a low-iodine diet (LID) prior to the therapy is recommended. In iodine-rich areas such as Korea, however, a strict LID is very difficult to maintain. We experienced the cases of three patients showing low adherence to the LID before initial RAI therapy, and analyzed the main food source supplying iodine during the LID, and examined the influence of the poorly maintained LID on the efficacy of RAI therapy. The dietary intake during the LID periods were assessed using three-day dietary records and remnant thyroid activity after the second RAI administration was also evaluated. All patients' mean daily iodine intake during two-week LID periods exceeded the 100 microg guideline set by the Korean Thyroid Association (median 110.9 microg, ranges 100.4-117.0 microg). Although the typical food sources of iodine intake are seaweeds in Korea, salted vegetables were the main contributor to the patients' iodine intake during the LID periods. Remnant thyroid activity was shown on a follow-up scan in all of 3 patients suggesting low efficacy of RAI therapy. In summary, the patients with low adherence to the LID guideline showed unsuccessful remnant ablation, and the main food source of iodine was salted vegetables. Further studies are necessary to examine the relationship between adherence of the LID and RAI efficacy according to dietary iodine intake levels, as well as food sources that cause low adherence to the LID. These data can then be used to develop more practical LID guidelines.

Effects of multiple herb formula SEC-22 supplementation on dietary intake, picky eating behaviors, and growth indices in thin preschool children

BACKGROUND/OBJECTIVES: Thin children may have insufficient intake of energy and nutrients, resulting in reduced immune function and growth. This study aimed to identify the effects of multiple herb formula SEC-22 supplementation on growth, dietary changes, and picky eating behaviors in thin children. SUBJECTS/METHODS: A double-blind, randomized clinical trial was conducted on 79 children aged 2-5 years with poor appetites, BMI percentile < 25, and without any illness. Subjects were given either SEC-22 (n = 35) or placebo (n = 44) for 2 months and followed for an additional 2 months. Three-day dietary records, questionnaires on picky eating behaviors, and anthropometric measures were collected. RESULTS: Energy, carbohydrate intake, and feeding difficulty improved in both groups during the intervention period. However, changes were maintained only in the SEC-22 group after 2 months of follow-up post-supplementation. 'Frequency of trying to feed' was improved in the SEC-22 group compared to the placebo group after the first month of follow-up (P < 0.05). Intakes of potassium and thiamine were improved in the SEC-22 group compared to the placebo group after the first month of intervention (P < 0.05). 'Frequency of food reward', eating amount, and intakes of carbohydrate, potassium, and vitamin C showed significant improvement compared to the placebo group after the second month of follow-up (P < 0.05). CONCLUSIONS: These results suggest that SEC-22 supplementation can improve parental feeding difficulty resulting from insufficient eating amount or picky eating as well as increase nutrient intake in thin children. Although these improvements were observable at least 2 months after supplementation, effects beyond this time frame need to be confirmed.

Low consumption of fruits and dairy foods is associated with metabolic syndrome in Korean adults from outpatient clinics in and near Seoul

BACKGROUND/OBJECTIVES: The aim of this study was to examine differences in nutrient intake and food consumption by the presence of metabolic syndrome in Korean adults. SUBJECTS/METHODS: Study subjects in this cross-sectional study were recruited from four outpatient clinics in and near the Seoul metropolitan area of South Korea between 2006 and 2012. A total of 668 subjects (413 men and 255 women) aged > or = 30 y were included in the final data analyses. For each subject, daily nutrient intake and food consumption were calculated using three days of dietary intake data obtained from a combination of 24-hour recalls and dietary records. To evaluate food consumption, mean number of servings consumed per day and percentages of recommended number of servings for six food groups were calculated. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. The general linear model was performed to examine differences in nutrient intake and food consumption by sex and the presence of metabolic syndrome after adjustment for potential confounding variables. RESULTS: Nutrient intake did not differ by the presence of metabolic syndrome in both men and women. Men with metabolic syndrome had lower consumption and percentage of the recommendation for fruits compared with those without metabolic syndrome (1.6 vs. 1.1 servings/day, P-value = 0.001; 63.5 vs. 49.5%, P-value = 0.013). Women with metabolic syndrome showed lower consumption and percentage of the recommendation for dairy foods than those without metabolic syndrome (0.8 vs. 0.5 servings/day, P-value = 0.001; 78.6 vs. 48.9%, P-value = 0.001). CONCLUSIONS: Low intakes of fruits and dairy foods might be associated with the risk of having metabolic syndrome among Korean adults. Dietary advice on increasing consumption of these foods is needed to prevent and attenuate the risk of metabolic syndrome.

Association between family structure and food group intake in children

BACKGROUNDS/OBJECTOVES: Family has an impact on dietary intake of children as a proximal food environment and family structures are changing and becoming more diverse. This study was performed to identify the association between family structure and food group intake of children aged 3-18 years in Korea. SUBJECTS/METHODS: A total of 3,217 children with complete data on variables for household information, dietary intake and sampling weights were obtained from 2010-2011 Korea National Health and Nutrition Examination Survey. Children's family structure was classified into 3 groups (Living with both parents, Living with one parent and Living without parents). To evaluate children's food group intake, scores of individual food groups ('Grains', 'Meat, Fish, Eggs and Beans', 'Vegetables', 'Fruits' and 'Milk and Dairy products') was calculated from percent adherence to the recommended servings of the Korean Food Guidance System (KFGS). 'Food group mean score' was obtained by calculating the average of five food group scores. RESULTS: After adjusting for age, sex, number of family members, and household income, children living with both parents had higher scores in 'Fruits' (P < 0.01), 'Milk and Dairy products' (P < 0.05), and mean score of individual food group score (P < 0.001) compared to children living with one parent. Individual food group scores and mean scores of individual food group scores were associated with different socio-demographic factors in study children. Family structure was associated with 'Fruits,' 'Milk and Dairy products' score and mean scores of food group scores. CONCLUSIONS: These results suggested that different approach might be required to solve nutrition problem in children depending on their family structure and other socio-demographic factors.

Developing and testing the reliability of a measurement tool for an urban area food environment in Korea: Focusing on food stores / 한국영양학회지

PURPOSE: The aim of this study was to develop a reliable measurement tool to assess the urban food environment, particularly focusing on food stores in Korea. METHODS: The items for the measurement tool were selected through systematic literature reviews and adjusted to the Korean food environment. A total of 25 food stores in an urban area were recruited for the pilot test to evaluate the time required for completion of the survey, ease of response, willingness to participate, difficulties in conducting the survey, and appropriateness, and 34 food stores were recruited for assessment of the reliability of the tool using percent agreement and kappa value. RESULTS: The measurement tool is composed of questions regarding food store characteristics, accessibility, and food availability. On average, 26 minutes was required to survey a single food store, and the subjects and interviewers answered that the process was not difficult for the survey. The percent agreement for the inter-rater and test-retest reliability ranged from 93.9~98.8% and 91.9~97.9, respectively. The kappa values ranged from 0.78 to 0.97, which was very high. Percent agreement and kappa value of food with healthy option were lower than those of the general food in the inter-rater reliability (p = 0.0027, p = 0.0095 respectively) as well as in the test-retest reliability (p = 0.0081, p = 0.0290, respectively), although they were still high enough (86.4~98.0% for percent agreement, 0.64~0.96 for kappa value). CONCLUSION: The newly developed measurement tool for assessment of food store environment appears to be feasible and reliable; therefore, it can be applied to research on the association between food environment and dietary behaviors as well as health outcomes.

Development and Evaluation of a Web-based Computer-Assisted Personal Interview System (CAPIS) for Open-ended Dietary Assessments among Koreans

The accuracy of dietary assessments has emerged as a major concern in nutritional epidemiology and new dietary assessment tools using computer technology to increase accuracy have been developed in many countries. The purpose of this study was to develop a web-based computer-assisted personal interview system (CAPIS) for conducting dietary assessment and to evaluate its practical utilization among Koreans. The client software was developed using Microsoft's ClickOnce technology, which allows communication with a database system via an http server to add or retrieve data. The system consists of a tracking system for the subject and researcher, a data-input system during the interview, a calculation system for estimating food and nutrient intake, a data-output system for presenting the results, and an evaluation system for assessing the adequacy of nutrient and food intake. Databases of the nutrient composition of common food (n = 3,642), recipes for common dishes (n = 1,886), and photos of serving sizes for food and dishes (n = 4,152) were constructed, and logical processes for data collection, calculation, and output were developed. The functionality, on-site applicability, and efficiency of CAPIS were evaluated in a convenience sample of 181 participants (61 males, 120 females; aged 24 to 85) by comparing with manual 24 hour recall method with paper questionnaire. The CAPIS was functioned adequately in the field survey in terms of completeness of function, security, and compliance of researcher and subjects. Regarding on-site applicability, 23.2%, 32.6%, 35.4%, and 43.7% of subjects reported that CAPIS was easier to recall their diet, to estimate the amount consumed, to communicate with the interviewer, and to concentrate on the interview than the manual method with paper questionnaire, respectively. Although CAPIS required more interview time (9 min 42 sec) compared to the manual method (7 min 30 sec), it saved time and cost for data coding and entry (15 min 35 sec) and gave high satisfaction from the prompt feedback after interview to the subjects, which increase efficiency to apply on the field survey. Our results suggest that the newly developed CAPIS is suitable for conducting personal interviews for dietary assessment in Korean population.

Customer perception and expert assessment in restaurant food environment by region: Focused on restaurants in Suwon, Hwaseong city / 한국영양학회지

PURPOSE: The aim of this study was to assess the food environment, particularly focusing on restaurants in three areas (Suwon city, Hwaseong Byeongieom-dong, and Bibong-myun). METHODS: A total of 662 persons were surveyed on customers' perceptions of the food environment in restaurants. A structured questionnaire composed of 30 questions on 7 factors, sanitation (4 items), displaying information (5), food quality (12), information on nutritional and healthy food choice (6), restaurant's accessibility (1), availability (1), and affordability (1) was used. In addition, an expert assessment of restaurant sanitation, and information on nutritional.healthy food choice was conducted through visiting 126 restaurants. RESULTS: Scores (range of score : 1~7) for each factors assessing the restaurant food environment were 5.06 for sanitation factors, 5.05 for displaying information factors, 5.13 for taste.appearance factors, and 4.35 for healthy menu factors. Informations on nutritional.healthy food choice showed a low rate: only 16.24% of the subjects answered that there is a message encouraging choice of healthy foods and 27.4% answered that menus contain nutritional information. Significant differences in food environment were observed by region (city, town, rural). The restaurants food environment in the rural area turned out to be poorer than that of the other two areas. In comparison of customer perception and expert assessment, significant differences were observed for 'Employee appearances and uniforms are clean and tidy' (p < .05), and 'There is a message encouraging the choice of healthy foods' (p < .05). CONCLUSION: This study provided evidence for differences of restaurant food environment by regions. In the rural area, there is a problem in restaurant's accessibility, availability, and affordability because of a lack of variety in menu items and restaurants. This results suggest that there is a need for more healthy food restaurants in the rural area.

The relationship between intake of nutrients and food groups and insulin resistance in Korean adults: Using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV, 2007-2009)

The aim of this study was to examine the relationship between dietary variables and the prevalence of insulin resistance (IR) in middle-aged Korean adults using data from the 2007-2009 Korea National Health and Nutrition Examination Survey. Because IR is closely linked with metabolic syndrome, subjects were divided into three groups according to symptoms of metabolic syndrome: the 'Normal group' without any symptoms, the 'Risk group' with one or two symptoms, and the 'Metabolic syndrome (MetS) group' with three or more symptoms. Subjects between the ages of 30 and 65 years with no prior diagnosis or treatment for diabetes, hypertension, or dyslipidemia were selected. The number of subjects per group was as follows: 2,085 adults in the Normal group, 3,699 adults in the Risk group, and 1,160 adults in the MetS group. Metabolic syndrome was defined according to Adult Treatment Panel III criteria with modified waist circumference cutoff values (men > or = 90 cm, women > or = 85 cm). Subjects with HOMA-IR > 2.0 were classified as IR. Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) was calculated using the following formula: (fasting plasma glucose x fasting plasma insulin)/22.5. Nutrients and food groups intake were obtained from a single 24-hour recall. Subjects with IR in the Normal group were more obese and less physically active than non-IR subjects. In the MetS group, subjects with IR were more obese and had a lower prevalence of smoking and drinking, compared with non-IR subjects. Men with IR in the Normal group had a tendency to consume more oils and sugars than non-IR men, while women with IR in the same group had higher intake of carbohydrate, dietary glycemic index, and dietary glycemic load than non-IR women. Women with IR in the Risk group had lower energy intake but higher intake of oils and sugars than non-IR women. In the MetS group, consumption of fruits was higher in subjects with IR than in non-IR subjects. In conclusion, findings of this study suggest that dietary carbohydrate intake, including glycemic index, may be associated with IR in healthy women. Further research in prospective cohort studies in order to examine the effects of dietary carbohydrate on IR incidence will be necessary.

Association between picky eating behaviors and growth in preschool children / 한국영양학회지

This study was conducted in order to investigate the association between picky eating behaviors of preschool children and growth outcomes. In this study, picky eating behaviors were defined as containing four constructs of 'eating a small amount (ES),' 'neophoic behavior (NB),' 'refusal of specific food groups (RF),' and 'preference for specific food-preparation methods (PP).' A 7-point scale was used for the multi-item questionnaire, which consisted of 21 items (three items for ES, two items for NB, nine items for RF, and seven items for PP), in order to evaluate picky eating behaviors of children. Subjects were recruited among visitors at a medical clinic in Seoul. A total of 150 self-administered survey responses from parents of preschool children were analyzed in order to investigate the association between picky eating behaviors of preschool children and growth outcomes. Height for age (HFA) and weight for height (WFH) z-scores were used for assessment of preschool children's growth. The prevalence of ES, NB, RF, and PP was 44%, 57%, 73%, and 53%, respectively. Children with ES had lower HFA (p < 0.05) and WFH (p < 0.0001) than those without ES, while children with NB, RF, or PP had HFA and WFH were similar to their counterparts. The mean HFA z-score of children with ES was less than 0 (p < 0.05) and the mean WFH z-scores of children with ES, NB, RF, or PP were less than 0 (p < 0.05). According to the study results, related growth outcome differed depending on constructs of picky eating behaviors. In particular, picky eating of ES showed a risk of faltering height growth in preschool children. Further comprehensive studies on the reason for ES and intervention approach is warranted.

Development and Feasibility of a Web-based Program 'Diet Evaluation System (DES)' in Urban and Community Nutrition Survey in Korea

BACKGROUND: Repeated 24 hour recall has been considered as a preferred method for obtaining accurate dietary information while time and cost for coding and data processing have been a major barrier for their use in large studies. This burden can be resolved by automating the interview and data processing. However, there has been no report about a computerized interview system for dietary survey in a free-living population in Korea. METHODS: This study attempts to test the feasibility of a newly-developed web-based dietary assessment program, Diet Evaluation System (DES) for subjects in a mixed region of urban and rural areas via wireless internet. We conducted total of 134 interviews, twice for each of 67 subjects of various age. As another aspect of feasibility, the group discussion among interviewers was done. RESULTS: Success rate of total attempted interviews was about 70%. Major reasons for problem with DES were instability of wireless internet and consequent inefficient booting of laptops in some areas. It took 14 minute 56 seconds on average to complete an interview and data processing conducted automatically. Subjects' age and internet environment influenced the DES interview time. The group discussion revealed that one-stop system with DES is fast and convenient assuming good wireless internet environment. CONCLUSIONS: Web-based dietary assessment was feasible in this community nutrition survey. To confirm the feasibility in large scale, studies with more comprehensive area and subjects are needed with various wireless condition.

Establishing a Table of Glycemic Index Values for Common Korean Foods and an Evaluation of the Dietary Glycemic Index among the Korean Adult Population

Recent studies have reported that the glycemic index (GI) has an effect on developing the risk for metabolic abnormalities such as diabetes, dyslipidemia, and obesity. As there are no reliable GI values for common Korean foods, only a few studies have been carried out using the dietary GI for Korean adults. The aim of this study was to establish a table of GI values for common Korean foods and evaluate dietary glycemic index (DGI) and dietary glycemic load (DGL) among the Korean adult population. International tables of GI values and other published values were used to tabulate GI values for common Korean foods. Among 653 food items, 149 (22.8%) were adapted from published data, 60 (9.2%) were imputed from similar foods, and 444 (68.0%) were assigned a zero. Data from 7,940 subjects aged 20 years and older in the 2007-2008 Korea National Health and Nutrition Examination Survey were obtained, and DGI and DGL were calculated. The average DGI was 60.0 and the average DGL was 182.5 when the reference food GI value was glucose. After adjusting for potential confounding variables, DGI and DGL increased significantly according to age group (p for trend < 0.001). The food group that contributed most to DGL was grain and its products supplying 85.3% of total DGL, whereas the mean GI value in grain and its products was 72.6. Fruits and potatoes also contributed to DGL (5.8 and 2.9%, respectively), and their GIs were high (67.7 for potatoes and 45.8 for fruits). For individual food items, white rice supplied 66.7% of total GI followed by glutinous rice (2.3%) and steamed white rice cakes (2.0%). In conclusion, a table of GI values for 653 common food items was established in which white rice was the most contributing item to DGL. Our results will be useful to examine the relationships between DGI, DGL, and metabolic abnormalities in the Korean population.