Relationship between adhering to dietary guidelines and the risk of obesity in Korean children

BACKGROUND/OBJECTIVES: Dietary guidelines for Korean children were released in 2009. The goal of the present study was to examine diet quality in terms of adherence to these dietary guidelines as well as explore the association between guideline adherence and risk of obesity in Korean children. SUBJECTS/METHODS: Children aged 5-11 years (mean age = 8.9 years old, n = 191, 80.6% girls) were recruited from a university hospital in Seoul, Korea. Adherence to dietary guidelines for Korean children was calculated using the Likert scale (1-5), and children were then categorized into low, moderate, and high groups based on adherence scores. Obesity or being overweight was determined based on an age- and gender- specific percentile for body mass index (BMI) of the 2007 Korean National Growth Charts. Diet quality was evaluated from 3 days of dietary intake data. RESULTS: Children in the high adherence group were characterized by significantly lower BMI percentiles and paternal BMIs as well as higher percentages of fathers with a high level of education and higher household incomes compared to those in the low or moderate group. Children in the high adherence group consumed significantly higher amounts of milk and dairy products, were less likely to consume lower than the EAR of phosphorus and iron, and had higher NARs for calcium, phosphorus, iron, zinc, and MAR than those in low groups. The ORs for obesity (BMI > or = 95th percentile) or being overweight including obesity (BMI > or = 85th percentile) were significantly lower in the high adherence group compared to the low adherence group (OR: 0.33, 95% CI = 0.13-0.82, P for trend = 0.019; OR: 0.26, 95% CI: 0.11-0.61 P for trend = 0.002). CONCLUSIONS: Korean children who adhered to dietary guidelines displayed better diet quality and a reduced risk of obesity.

Developing a Questionnaire to Assess Exposure to Food-Borne Hazards

The aim of this study was to develop a reliable dietary questionnaire to assess human exposure to food-borne hazards. Eleven food-borne hazards were chosen as a priority control list through a literature review and advisory committees. The 11 food-borne hazards were phthalate, aflatoxin, bisphenol A, polycyclic aromatic hydrocarbons, dioxin, polychlorinated biphenyls, mercury, lead, cadmium, arsenic, and acrylamide. The characteristics, exposure level, and paths of these hazards were reviewed, and questionnaire items were identified to assess human exposure from the literature. A questionnaire was developed for each selected food based on its characteristics. Based on the items in the individual questionnaires, a comprehensive questionnaire, which contained demographic characteristics, job information, socioeconomic factors, health related lifestyles, and dietary behaviors, was developed. A 99-item food frequency questionnaire (FFQ) to assess food-borne hazard exposure was also developed. The FFQ included frequency of food intake during the previous year, container type for purchasing and storing food, and cooking method. The questionnaire developed in this study could be applied to assess dietary factors during an exposure assessment of food-borne hazards in a large population. A validation study for the questionnaire is needed before applying it to surveys.

Validation Study of a Dietary Questionnaire for Assessing Exposure to Food-Borne Hazards

Assessing human exposure to food-borne hazards requires standardized assessment tools. The objective of this study was to validate a newly developed dietary assessment questionnaire to assess human exposure to food-borne hazards, which include dietary behavior and food consumption patterns such as eating frequency, types of food containers and cooking methods. A total of 216 adults were recruited for two questionnaire surveys (questionnaire 1 and 2) about 1 week apart with a 3 day diet record. Reproducibility was evaluated by comparing responses from questionnaires 1 and 2, and validity was checked by comparing responses from questionnaire 2 and the 3 day diet record. Comparisons were based on the percent agreement and Spearman's rank correlation coefficient. The mean exact agreement of food containers at purchase between questionnaires 1 and 2 was 73.5%, for storing containers it was 71.9%, and for cooking methods it was 83.0%. The mean correlation coefficient for food intake frequency between questionnaires 1 and 2 was 0.71 (range, 0.50?0.83). The mean correlation coefficient of the food intake frequency between questionnaire 2 and the 3 day diet record was 0.21 (range, 0.04-0.48). The exact and adjacent agreement of food intake frequency quartile assessed by questionnaire 2 and the 3 day diet record was 65.4% (range, 51.0-82.1%). Although the correlation coefficient for food intake frequency between questionnaire 2 and the 3 day diet record was low, the exact and adjacent food intake frequency agreement was higher than 50% and reproducibility of the dietary behaviors exceeded 70%. Therefore, the questionnaire developed in this study could be applied to assess diets for the human exposure to food-borne hazards as a qualitative assessment in a large population.