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Purpose@#Eating behaviors are influenced by food environments, such as availability and/or accessibility of healthy food options. In this study, we examined the relationship between healthy eating-out options and the intention to eat healthily in adults residing in Daqing, China, using an extended theory of planned behavior (TPB). @*Methods@#Data were collected via an online survey conducted from April to May 2021 using a previously validated questionnaire in Daqing. A total number of 308 subjects aged 18–64, either Daqing oilfield workers or their family members were eligible and finally included in the analysis. The relationships among the attributes and the quality of healthy eatingout options, the three major constructs of TPB, and the intentions of healthy eating were examined using multiple linear regression analyses. @*Results@#Subjective norms (p = 0.049) and perceived behavioral control (PBC) (p = 0.000) were significantly related to the healthy eating intention. The quality and attributes of the food served statistically significantly explained the intention to eat healthily. After controlling for age, sex, and body mass index, not the quality but the attributes of food served (p = 0.037), subjective norms (p = 0.016), and PBC (p = 0.000) had a significant relationship with the intention to eat healthily. The model explained 83.7% of the variance. @*Conclusion@#The healthy eating-out choices, along with subjective norms and PBC of TPB, may be a potential determinant of healthy eating intention among Chinese adults living in Daqing, China. Policy implications have highlighted that not only the personal intention to eat healthy foods, but also the available healthy food environment may be important for the choice of healthy options by the population of interest. Therefore, building an environment for healthy eating choices and campaigns aimed at increasing consumer awareness of healthy eating are equally important for a smart eating choice.
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Purpose@#This study was conducted to update the Nutrition Quotient for Adolescents (NQ-A), which is used to assess the overall dietary quality and food behavior among Korean adolescents. @*Methods@#The first 30 candidate items of the measurable eating behavior checklist were obtained based on a previous NQ-A checklist, the results of the seventh Korea National Health and Nutrition Examination Survey data, Korea Youth Risk Behavior Survey data, national nutrition policies and dietary guidelines, and literature reviews. A total of 100 middle and high school students residing in Seoul and Gyeonggi Province participated in a pilot study using the 25-item checklist. Factor analysis and frequency analysis were conducted to determine if the checklist items were organized properly and whether the responses to each item were distributed adequately, respectively. As a result, 22 checklist items were selected for the nationwide survey, which was applied to 1,000 adolescent subjects with stratified sampling from 6 metropolitan cities. The construct validity of the updated NQ-A 2021 was assessed using confirmatory factor analysis. @*Results@#Twenty checklist items were determined for the final NQ-A 2021. The items were composed of three factors: balance (8 items), moderation (9 items), and practice (3 items). The standardized path coefficients were used as the weights of items to determine the nutrition quotients. NQ-A 2021 and 3-factor scores were calculated according to the weights of questionnaire items. The weight for each of the 3 factors was determined as follows: balance, 0.15; moderation, 0.30; and practice, 0.55. @*Conclusion@#The updated NQ-A 2021 is a useful instrument for easily and quickly evaluating the dietary qualities and eating behaviors of Korean adolescents
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Purpose@#Food environmental factors related to food insecurity affect household food intake in several socio-ecological aspects. This study explores the relationship between food environment factors and food insecurity in households with married immigrant women. @*Methods@#From November 2018 to February 2020, a survey was conducted enrolling 249 married immigrant women residing in the metropolitan areas of South Korea. In the final analysis, 229 subjects were divided into 2 groups classified as food security (n = 154) and food insecurity (n = 75), as assessed by the score of food security. Three aspects of food environments were measured: built·natural, political·economic, and socio-cultural @*Results@#Food environments were significantly different between food security and food insecurity groups, as follows: the number of foods market and their distance from the home and food status for the last week at home in the built·natural domain; monthly cost of food purchase and experience for food assistance in the political·economic domain; total score of social support, parenting, and cooking skills in the socio-cultural domain. A stepwise multivariate linear regression model showed a negative association between the food insecurity score with social support from family and food inventory status in the last week. After adjusting for confounders, a positive association was obtained between the experience of a food support program. The final regression model explains about 30% of the relationship obtained in the three food environment domains and food insecurity (p < 0.001). @*Conclusion@#Not only economic factors, which are common determinants of household food insecurity, but socio-cultural factors such as social support also affect household food insecurity. Therefore, plans for implementing a food assistance program to improve food insecurity for households with immigrant women should consider financial support as well as other comprehensive aspects, including socio-cultural domain such as social support from family and community.
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BACKGROUND/OBJECTIVES@#The Dietary Reference Intakes for Koreans (KDRIs) were revised in 2020. Due to the rapidly aging Korean population, special consideration was given to reclassify the KDRI age group categories of older adults. This article examines the evidence for modifying the current KDRI age group ranges of older adults (65–74 and ≥ 75 yrs). @*SUBJECTS/METHODS@#We first reviewed the domestic and international data on the elderly, following which we received expert opinions on age classification from the KDRI Advisory Committee. Finally, the 6th and 7th (2013–2017) Korea National Health and Nutrition Examination Survey (KNHANES) data were used to analyze the nutritional intake statuses by considering the age of older adults. @*RESULTS@#According to the review results of domestic and international data and the inputs received from the expert advisory committee, the minimum age considered for the elderly was maintained at 65 yrs. However, the KNHANES data was analyzed to review whether there was a need to subdivide the later periods. Examining the differences in nutrient intakes by age group through the interaction effect term of the piecewise linear regression model revealed the interaction effect was maximum in the groups divided by 65 yrs (50–64 and 65–80), as compared to the groups divided by 70 yrs (50–69 and 70–80) and 75 yrs (50–74 and 75–80). The mean adequacy ratio was calculated per 1 yr of age, and a 3-yr (age) moving average analysis was performed to examine the change in the trends of overall nutrient intake. However, it was challenging to secure a scientific basis for subdivision into age groups in older adults from the results obtained. @*CONCLUSIONS@#This study could not find any scientific evidence for modifying the KDRI age groups for older adults.
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BACKGROUND/OBJECTIVES@#The objective of this study was to describe the development process of the Korean Healthy Eating Index (KHEI) based on the Korea National Health and Nutrition Examination Survey (KNHANES). @*SUBJECTS/METHODS@#The components of KHEI were selected based on Dietary Guidelines for Koreans, domestic and overseas dietary quality indices, and results of the analysis of association with chronic diseases. The standards for scoring of KHEI were selected based on the 2015 Dietary Reference Intakes for Koreans (KDRI). The KHEI scores of Korean adults were calculated using a 1-day 24-h recall data in the 2013–2015 KNHANES. @*RESULTS@#The KHEI included eight adequacy components evaluating the proper intake of recommended foods such as fruit, vegetable, and milk and three moderation components evaluating the consumption of food that limit intake such as sodium and saturated fatty acid. In addition, three balance components assessing the balance of energy intake were included. The KHEI score was defined to range from the minimum of 0 point to the maximum of 100 points. Among Korean adults, the total KHEI score was 63.2 out of 100. Gender and age differences were found in the average of total KHEI scores. Women showed higher score than men (61.7 in men and 64.7 in women, respectively). By age group, 20s and 30s showed the lowest scores with 57.4 and 61.1 respectively, and the scores increased with age by peaking at 67.8 in ages 60–69 and slowed down again in ages 70 or over. @*CONCLUSIONS@#The KHEI can be useful for establishing and assessing national nutritional policies and in epidemiological studies to assess the relationship between overall dietary quality and chronic diseases. KHEI will need to be continuously updated to reflect changes in dietary guidelines and the KDRI.
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Purpose@#This study was undertaken to update the Nutrition Quotient for Elderly (NQ-E), which reflects dietary quality and behavior among Korean older adults. @*Methods@#The first 29 items of the measurable food behavior checklist were obtained from a previous NQ-E checklist, recent literature reviews, and national nutrition policies and recommendations. One-hundred subjects (50 men and 50 women) aged ≥ 65 years living in the Seoul Metropolitan Area, including Gyeonggi Province, completed a pilot survey from March to April 2021. Based on the results of the pilot study, we conducted factor analysis and frequency analysis to determine whether the items of the survey were properly organized and whether the distribution of answers for each evaluation item was properly distributed. As a result, we reduced the number of items on the food behavior checklist and used 23 items for the national survey. Nationwide, 1,000 subjects (472 men and 528 women) aged > 65 years, completed the checklist survey, which was applied using a face-to-face survey method from May to August 2021. The construct validity of the NQ-E 2021 was assessed using confirmatory factor analysis, LISREL. @*Results@#Seventeen food behavior checklist items were selected for the final NQ-E 2021.Checklist items addressed three factors: balance (8 items), moderation (2 items), and practice (7 items). Standardized path coefficients were used as the weights of items to determine nutrition quotients. NQ-E and three-factor scores were calculated according to the weights of questionnaire items. @*Conclusion@#The updated NQ-E 2021 produced by structural equation modelling provides a suitable tool for assessing the dietary quality and behavior of Korean older adults.
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Purpose@#This study investigated the relationship between 3 major constructs of the theory of planned behavior (TPB), i.e., attitude, subjective norms and perceived behavioral control (PBC) and past experience of healthy eating and intentions of healthy eating in the short-term and long-term in adults living in Shanghai and parts of Anhui Province, China. @*Methods@#The online study questionnaire for this cross-sectional study was based on previously validated items. A total of 408 Chinese adults (aged 18–64 years) residing in Shanghai and parts of Anhui Province, China were included to examine relationships between 3 major constructs of TPB and past experience of healthy eating, and short-term and long-term intentions of healthy eating. Multiple linear regression model adjusted for age and body mass index (BMI) was employed to test relationships. @*Results@#Only PBC among 3 major constructs of TPB was significantly related to short-term (p < 0.001) and long-term (p = 0.002) intention of healthy eating after adjustment for age and BMI. Past experience of healthy eating was more significantly related to long-term intention (p < 0.001) compared to short-term (p = 0.020) intention of healthy eating. The short-term and long-term intention models explained 70.5% and 48.8% of the variance, respectively. @*Conclusion@#PBC is a potential determinant of both short-term and long-term behavioral intention of healthy eating regardless of past experience of healthy eating in adults residing in Shanghai and parts of Anhui Province, China. Our results indicate that programs promoting healthy eating to Chinese adults incorporate PCB to perform healthy eating under his or her control.
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The recommended meal composition allows the general people to organize meals using the number of intakes of foods from each of six food groups (grains, meat·fish·eggs·beans, vegetables, fruits, milk·dairy products and oils·sugars) to meet Dietary Reference Intakes for Koreans (KDRIs) without calculating complex nutritional values. Through an integrated analysis of data from the 6th to 7th Korean National Health and Nutrition Examination Surveys (2013–2018), representative foods for each food group were selected, and the amounts of representative foods per person were derived based on energy. Based on the EER by age and gender from the KDRIs, a total of 12 kinds of diets were suggested by differentiating meal compositions by age (aged 1–2, 3–5, 6–11, 12–18, 19–64, 65–74 and ≥ 75 years) and gender.The 2020 Food Balance Wheel included the 6th food group of oils and sugars to raise public awareness and avoid confusion in the practical utilization of the model by industries or individuals in reducing the consistent increasing intakes of oils and sugars. To promote the everyday use of the Food Balance Wheel and recommended meal compositions among the general public, the poster of the Food Balance Wheel was created in five languages (Korean, English, Japanese, Vietnamese and Chinese) along with card news. A survey was conducted to provide a basis for categorizing nutritional problems by life cycles and developing customized web-based messages to the public. Based on survey results two types of card news were produced for the general public and youth. Additionally, the educational program was developed through a series of processes, such as prioritization of educational topics, setting educational goals for each stage, creation of a detailed educational system chart and teachinglearning plans for the development of educational materials and media.
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Purpose@#This study was undertaken to revise and update the Nutrition Quotient (NQ) for Korean adults, a tool used to evaluate dietary quality and behavior. @*Methods@#The first 31 items of the measurable food behavior checklist were adopted based on considerations of the previous NQ checklist, recent literature reviews, national nutrition policies, and recommendations. A pilot survey was conducted on 100 adults aged 19 to 64 residing in Seoul and Gyeonggi Province from March to April 2021 using a provisional 26-item checklist. Pilot survey data were analyzed using factor analysis and frequency analysis to determine whether checklist items were well organized and responses to questions were well distributed, respectively. As a result, the number of items on the food behavior checklist was reduced to 23 for the nationwide survey, which was administered to 1,000 adults (470 men and 530 women) aged 19 to 64 from May to August 2021. The construct validity of the developed NQ (NQ-2021) was assessed using confirmatory factor analysis, linear structural relations. @*Results@#Eighteen items in 3 categories, that is, balance (8 items), moderation (6 items), and practice (4 items), were finally included in NQ-2021 food behavior checklist. ‘Balance’ items addressed the intake frequencies of essential foods, ‘moderation’ items the frequencies of unhealthy food intakes or behaviors, and ‘practice’ items addressed eating behaviors. Items and categories were weighted using standardized path coefficients to calculate NQ-2021 scores. @*Conclusion@#The updated NQ-2021 appears to be suitable for easily and quickly assessing the diet qualities and behaviors of Korean adults.
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Objectives@#Standardized guidelines and reference points for a food security policy are necessary to guarantee that basic social safety nets work properly. Therefore, this study aimed to explore the basic concepts and detailed dimensions of food security, including the potential relevant indicators, and sought to establish standardized well-being baselines. @*Methods@#A literature review and 14 expert roundtable discussions were carried out to analyze and extract the key concepts of food security. After determining these concepts and detailed dimensions of food security, a conceptual framework was modeled. Then, indicators for each local government that could be monitored and evaluated for each sub-area were suggested. @*Results@#The concept of food security was defined as follows: Individuals should be provided with sufficient, safe, and quality food, which should be accessible to the community and available for use to achieve health and well-being. In addition, food security should be ensured sustainably in a changing environment. Four dimensions were suggested while conceptualizing food security. First, sufficient food, which means sufficient food supply in quantity, quality, and safety. Second, equitable food which includes creating environments in which high-quality and safe food can be purchased at an appropriate price and can be provided regardless of the socioeconomic gap. Third, healthy food which should be provided to promote people’s health and happiness through the eco-friendly consumption of food.Fourth, sustainable food, which can be supplied in a sustainable manner and as part of an eco-friendly food system that considers the conservation of natural environments. @*Conclusions@#The basic concepts and detailed areas of food security including the potential indicators proposed in this study, may be useful for developing and implementing various policies and programs to support food and nutrition security in the future.
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The discovery of the relationship between nutrients and deficiency diseases during the 100 years from the mid-1800s to the mid-1900s was a breakthrough that led to advances in the study of nutrition. The Recommended Dietary Allowances (RDA) were created as a quantitative standard for avoiding diseases caused by nutrient deficiency. In addition, a reductionism paradigm has become generally accepted among nutrition scholars in health and disease, which focused on the properties of individual nutrients, content in foods, cellular levels, and mechanisms of action. The reductionist paradigm worked very well for the prevention and treatment of malnutrition diseases. However, as the incidence of nutrient deficiencies decreased and that of chronic diseases increased, the nutrition goals have been changed to secure safe and adequate nutrient intake and to reduce chronic disease risks. Accordingly, Dietary Reference Intakes (DRIs), a set of nutrient-based reference values, were designed to replace the RDA. The revised Korean DRIs were published for 40 nutrients in 2020. However, there is still room for improvement in the reference intake levels targeted at reducing the risk of chronic disease. The reductionist approach can no longer be practical because chronic diseases are related to the interactions between multi-components in the foods and multi-targets in the body. Therefore, a second innovative leap is needed following the nutrition development breakthrough made over 100 years ago. To this end, the nutrition paradigm must evolve from reductionism to a holism approach. Cutting-edge scientific technologies, such as metabolomics, transcriptomics, microbiomics, and should also be acceptable in nutrition science based on the knowledge gained from basic nutrition studies. bioinformatics,
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Purpose@#The theory of planned behavior (TPB) was used to investigate how the psychological constructs of attitude, subjective norms, and perceived behavioral control (PBC) affect the individual intention of behaviors in adults. Social support is also important in enabling the stability of healthy eating. This study examined the relationship between three major constructs of TPB as well as social support and the intention of healthy dietary behaviors in adults residing in Beijing, China using the extended TPB. @*Methods@#The study questionnaire was based on previously validated items and an online survey was conducted from October to November 2020. Using a total of 244 Chinese adults in Beijing, multiple linear regression analysis was used to test the relationships between three major constructs of TPB as well as the social support and intention of healthy eating. @*Results@#Among the three major constructs of TPB, subjective norms (p = 0.044) and PBC (p = 0.000) were significantly related to the behavioral intention of healthy eating (p = 0.000), and the model explained 76.6% of the variance of the behavioral intention from the three constructs of TPB included in the multiple linear regression model. The additional inclusion of social support to the model did not increase the explanatory power of the model to describe the behavioral intention of healthy eating. The subjective norms (p = 0.040) and PBC (p = 0.000) were still significant where social support did not explain the variance of the behavioral intention adequately. @*Conclusion@#The subjective norms and PBC may be potential determinants of the behavioral intention of healthy eating in adults residing in Beijing, China. These study results can be used to promote healthy eating in Chinese adults living in urban areas. Large-scale intervention studies will be needed to determine if social norms and PBC predict the actual behaviors of healthy eating in Chinese adults
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Purpose@#This study was undertaken to develop a nutrition quotient for elementary school children (NQ-C) for evaluating the overall dietary quality and eating behaviors. @*Methods@#The NQ-C was developed by implementing 3 stages: item generation, item reduction, and validation. Candidate food behavior checklist (FBC) items of the NQ-C were derived from systematic literature reviews, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. For the pilot survey, 260 elementary school students (128 second graders and 132 fifth graders) completed self-administered questionnaires as well as 24-hour dietary intakes, with the help of their parents and survey team staff, if required. Based on the pilot survey results, expert reviews, and priorities of national nutrition policy and recommendations, checklist items were reduced from 41 to 24. A total of 20 items for NQ-C were finally selected from results generated from 1,144 nationwide samples surveyed. Construct validity of the NQ-C was assessed using the confirmatory factor analysis, LInear Structural RELations. @*Results@#Analyses of the exploratory factors of NQ-C identified that 5 dimensions of diet (balance, diversity, moderation, practice and environment) accounted for 46.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-C and 5-factor scores of the subjects were calculated using the obtained weights of the FBC items. @*Conclusion@#Our data indicates that NQ-C is a useful and suitable instrument for assessing nutrition adequacy, dietary quality, and eating behaviors of Korean elementary school children.
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Purpose@#This study was undertaken to develop a nutrition quotient for elementary school children (NQ-C) for evaluating the overall dietary quality and eating behaviors. @*Methods@#The NQ-C was developed by implementing 3 stages: item generation, item reduction, and validation. Candidate food behavior checklist (FBC) items of the NQ-C were derived from systematic literature reviews, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. For the pilot survey, 260 elementary school students (128 second graders and 132 fifth graders) completed self-administered questionnaires as well as 24-hour dietary intakes, with the help of their parents and survey team staff, if required. Based on the pilot survey results, expert reviews, and priorities of national nutrition policy and recommendations, checklist items were reduced from 41 to 24. A total of 20 items for NQ-C were finally selected from results generated from 1,144 nationwide samples surveyed. Construct validity of the NQ-C was assessed using the confirmatory factor analysis, LInear Structural RELations. @*Results@#Analyses of the exploratory factors of NQ-C identified that 5 dimensions of diet (balance, diversity, moderation, practice and environment) accounted for 46.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-C and 5-factor scores of the subjects were calculated using the obtained weights of the FBC items. @*Conclusion@#Our data indicates that NQ-C is a useful and suitable instrument for assessing nutrition adequacy, dietary quality, and eating behaviors of Korean elementary school children.
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This study examined the possible causes of nutritional inadequacy in Vietnamese immigrant women married to Korean husbands. Qualitative in-depth interviews were conducted with a sample of 34 Vietnamese marriage immigrant women and 17 Korean spouses participating in or having experienced Nutrition Plus from four Community Health Centers in Seoul, Korea. The study results showed that the nutritional staus of the Vietnamese marriage immigrant women was affected by the unfamiliar Korean food (cultural factor), low household income (economical factor), difficulty in purchasing Vietnamese food (environmental factor), and low accessibility to nutrition support systems (social factor). The Korean husbands' nutritional status was affected by the unfamiliar Vietnamese food (cultural factor), low household income (economic factor), and irregular working conditions (social factors). Nutritional interventions as a public service to the community needs to be developed and applied. Suggestions are presented regarding the future efforts to better understand and meet the nutrition needs of intermarried couples to respond to their heterogeneous needs and deliver adequate nutrition service to ever increasing intermarried families.
Subject(s)
Female , Humans , Asian People , Community Health Centers , Emigrants and Immigrants , Family Characteristics , Korea , Marriage , Nutritional Status , Qualitative Research , Seoul , SpousesABSTRACT
OBJECTIVES: This study was conducted to investigate the current difficulties surrounding children's obesity management and evaluate the application of a mobile phone as a tool to overcome such difficulties of obesity management from the perspective of main caregivers of elementary school students. METHODS: The qualitative data were collected through 3 focus group interviews including 6 full-time housewives, 7 mothers with overweight children, and 4 working mothers. Data were analyzed using a thematic approach. RESULTS: The limitations of current children's obesity management included difficulty in diet management and exercise as well as challenges of setting goals and lack of support at the household and school levels. Mobile technology may be useful to overcome the current problems by providing real-time knowledge on diet management and physical activity, online compensation scheme according to goal setting, and interactive environmental supports at both household and school levels for promoting overall health. CONCLUSIONS: The mobile-based multiple support program may assist in overcoming the current limitations of child obesity management by providing tailored information and by creating a more supportive environment.
Subject(s)
Child , Humans , Caregivers , Cell Phone , Compensation and Redress , Diet , Family Characteristics , Focus Groups , Mothers , Motor Activity , Obesity , Overweight , Parents , Pediatric ObesityABSTRACT
OBJECTIVES: This study was conducted to investigate the current difficulties surrounding children's obesity management and evaluate the application of a mobile phone as a tool to overcome such difficulties of obesity management from the perspective of main caregivers of elementary school students. METHODS: The qualitative data were collected through 3 focus group interviews including 6 full-time housewives, 7 mothers with overweight children, and 4 working mothers. Data were analyzed using a thematic approach. RESULTS: The limitations of current children's obesity management included difficulty in diet management and exercise as well as challenges of setting goals and lack of support at the household and school levels. Mobile technology may be useful to overcome the current problems by providing real-time knowledge on diet management and physical activity, online compensation scheme according to goal setting, and interactive environmental supports at both household and school levels for promoting overall health. CONCLUSIONS: The mobile-based multiple support program may assist in overcoming the current limitations of child obesity management by providing tailored information and by creating a more supportive environment.
Subject(s)
Child , Humans , Caregivers , Cell Phone , Compensation and Redress , Diet , Family Characteristics , Focus Groups , Mothers , Motor Activity , Obesity , Overweight , Parents , Pediatric ObesityABSTRACT
OBJECTIVES: This study was conducted to investigate the current status and to suggest future directions for health management of teenagers who use healthy school tuck shops to improve teenagers' eating habits while reducing and preventing obesity. METHODS: A total of 29 students (16 middle school students and 13 high school students) took part in the interview for this study, and the interview was conducted for each school's focus group by using qualitative research methodology. RESULTS: The current status of using healthy school tuck shops and suggested future directions were divided into two categories. Personal barriers such as discrepancies between personal perceptions and behaviors and lack of food choice suitable to individual tastes can be solved by rebuilding the operating system to provide intuitive promotion of behavior and customized products through improvements in existing products and new product development. A lack of consistent management from low utilization convenience and difficulty in maintaining a constant purchase price can be handled by establishing a solution to restricted physical access for products, as well as seeking profit by improving distribution costs via continuous cooperation between the school and community. CONCLUSIONS: Continuous funding and a system that reflects the needs and preferences of healthy school tuck shop users should be applied for sustainable operation of healthy school tuck shops to improve teenagers' eating habits.
Subject(s)
Adolescent , Humans , Eating , Financial Management , Focus Groups , Obesity , Qualitative ResearchABSTRACT
OBJECTIVES: This study was conducted to investigate the current status and to suggest future directions for health management of teenagers who use healthy school tuck shops to improve teenagers' eating habits while reducing and preventing obesity. METHODS: A total of 29 students (16 middle school students and 13 high school students) took part in the interview for this study, and the interview was conducted for each school's focus group by using qualitative research methodology. RESULTS: The current status of using healthy school tuck shops and suggested future directions were divided into two categories. Personal barriers such as discrepancies between personal perceptions and behaviors and lack of food choice suitable to individual tastes can be solved by rebuilding the operating system to provide intuitive promotion of behavior and customized products through improvements in existing products and new product development. A lack of consistent management from low utilization convenience and difficulty in maintaining a constant purchase price can be handled by establishing a solution to restricted physical access for products, as well as seeking profit by improving distribution costs via continuous cooperation between the school and community. CONCLUSIONS: Continuous funding and a system that reflects the needs and preferences of healthy school tuck shop users should be applied for sustainable operation of healthy school tuck shops to improve teenagers' eating habits.
Subject(s)
Adolescent , Humans , Eating , Financial Management , Focus Groups , Obesity , Qualitative ResearchABSTRACT
BACKGROUND/OBJECTIVES: Although a lot of effort has been put into increasing fruit and vegetable intakes in preschool children, vegetable intake in this group is still low. This study investigated whether nutrition education focusing on fruit and vegetable intakes can affect preschoolers' fruit and vegetable intakes as well as their behavioral outcomes. SUBJECTS/METHODS: Thirty-five preschoolers (54.3% boys, n = 19) aged 4–6 years residing in Seoul underwent weekly nutrition education intervention (8 sessions) between May and July 2016. Intakes of fruits and vegetables were measured during pre and post-intervention. At snack time, fresh fruit (150 g) and vegetable (120 g) snacks were distributed to each child by teachers. The remaining portions of the snacks were weighed and recorded for each child. Behavioral outcomes were measured by applying Child behavior checklist 1.5–5 and the Diagnostic and statistical manual of mental disorders. RESULTS: During post intervention, vegetable intake increased from 36.15 ± 30.64 g to 48.01 ± 31.23 g (P = 0.010). Among the emotional and behavioral problems measured by parents, levels of total problems (P = 0.001), internalizing (P = 0.004), externalizing (P = 0.003), anxiety and depression (P = 0.001), and aggressive behavior (P = 0.005) decreased. Anxiety (P = 0.026) score, as measured by teachers, also decreased. CONCLUSIONS: Nutrition education of preschoolers regarding the intakes of fruits and vegetables had a positive effect on preschoolers' vegetable intake as well as on their emotional and behavioral outcomes. A long-term, large-scale study with a broader study design is warranted to further investigate the role of fruit and vegetable intake in cognitive development and behavior of preschoolers.