Nutritional status and related parental factors according to the breakfast frequency of elementary school students: based on the 2013 ~ 2015 Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study was conducted to identify the dietary life and nutritional status of Korean elementary school students according to breakfast frequency and to clarify the relationship between breakfast frequency of elementary school students and parental dietary and social environmental factors. METHODS: This study used data from the 2013 ~ 2015 Korea National Health and Nutrition Examination Survey (KNHANES VI). The subjects were 1,325 elementary school students aged 6 to 11 years old. Subjects were categorized into two groups: a skipping breakfast group (ate breakfast 0 ~ 4 times per week), eating breakfast group (ate breakfast 5 ~ 7 times per week) by sex and grade (lower grade: 1st ~ 3rd/upper grade: 4 th ~ 6 th). RESULTS: Among upper grade boys and girls, the skipping breakfast group had a higher rate of childhood obesity than the eating breakfast group. In lower grade boys, the mothers of the skipping breakfast group had higher rates of economic activity and eating breakfast alone without family members than the mothers of the eating breakfast group. For lower grade boys and girls and upper grade boys, the skipping breakfast group had a higher rate of parents who did not eat breakfast than the eating breakfast group. The energy intake of the breakfast consumed by all subjects was less than 25% of the Estimated Energy Requirements (EER). Moreover, for upper grade boys and girls, the skipping breakfast group had a higher rate of subjects whose daily intake was below the Estimated Average Requirement (EAR) for iron than the eating breakfast group. CONCLUSION: Breakfast frequency of elementary school students was related to childhood obesity. The frequency of eating breakfast among elementary school students was related to the dietary life factors of parents such as breakfast frequency and dietary condition. Intake for breakfast was less than 25% of the EER, while the skipping breakfast group had a higher rate of subjects whose daily intake was below the EAR for iron than the eating breakfast group. Therefore, it is necessary to consider diverse forms of policy support such as opening nutrition education programs for parents and practicing morning meals at school for elementary school students to provide regular and balanced breakfasts.

Is the association between unhealthy weight and academic performance influenced by children's physical activity level? / A associação entre peso não saudável e desempenho escolar é influenciada pelo nível de atividade física em crianças?

The purpose of this study was to verify the association between unhealthy weight and academic performance and the influence of physical activity level (PAL) in elementary school children. This study was conducted with 450 elementary school students (50% girls) enrolled in 1st to 4th grades. PAL was assessed by self-reported questionnaire of typical physical activity and daily food intake (DAFA). Academic achievement (Portuguese and Mathematics) was estimated based on the academic performance system of public schools from Recife/Brazil. Binary logistic regression was used to verify the association between unhealthy weight (underweight and overweight) and normal weight with academic performance. The results showed that 26.6% of the students presented overweight, 11.1% presented underweight, 49.1% and 50.9% were classified as high and low PAL, respectively. In addition, 56.9% had sufficient academic performance in Portuguese and 51.1% had sufficient academic performance in Mathematics. Students with overweight presented higher odds for insufficient performance in Portuguese when compared to normal weight counterparts, even when adjusted for reported PAL, gender and age (OR = 1.69; 95%CI: 1.08-2.64). The results corroborate with evidences that unhealthy weight is associated with poor academic performance in children.

O objetivo deste estudo foi verificar a associação entre peso não saudável e desempenho escolar e a influência do Nível de Atividade Física (NAF) em crianças do ensino fundamental. Este estudo foi realizado com 450 alunos do ensino fundamental (50% meninas) matriculados na 1ª a 4ª série. NAF foi avaliado indiretamente através de um questionário de auto relatado Dia Típico de Atividade Física e Alimentação (DAFA). Desempenho escolar (Português e Matemática) foi estimado com base no sistema de desempenho escolar das escolas públicas do Recife / Brasil. Regressão logística binária foi utilizada para verificar a associação entre o peso não saudável (baixo peso e sobrepeso) e peso normal, com o desempenho escolar. Os resultados mostraram que 26,6% dos estudantes apresentavam sobrepeso, 11,1% apresentavam baixo peso, 49,1% e 50,9% foram classificados como alto e baixo NAF, respectivamente. Em adição, 56,9% apresentavam desempenho suficiente em Português e 51,1% apresentavam desempenho suficiente em Matemática. Estudantes com sobrepeso apresentaram maior odds para desempenho insuficiente em português quando comparados aos seus pares com peso normal, mesmo quando ajustada por reportada NAF, gênero e idade (OR = 1.69; 95%IC: 1.08-2.64). Os resultados corroboram com evidências de que o peso não saudável é associado com pobre desempenho escolar em crianças.

Food allergy knowledge, perception of food allergy labeling, and level of dietary practice: A comparison between children with and without food allergy experience

BACKGROUND/OBJECTIVES: The prevalence of food allergies in Korean children aged 6 to 12 years increased from 10.9% in 1995 to 12.6% in 2012 according to nationwide population studies. Treatment for food allergies is avoidance of allergenic-related foods and epinephrine auto-injector (EPI) for accidental allergic reactions. This study compared knowledge and perception of food allergy labeling and dietary practices of students. SUBJECTS/METHODS: The study was conducted with the fourth to sixth grade students from an elementary school in Yongin. A total of 437 response rate (95%) questionnaires were collected and statistically analyzed. RESULTS: The prevalence of food allergy among respondents was 19.7%, and the most common food allergy-related symptoms were urticaria, followed by itching, vomiting and nausea. Food allergens, other than 12 statutory food allergens, included cheese, cucumber, kiwi, melon, clam, green tea, walnut, grape, apricot and pineapple. Children with and without food allergy experience had a similar level of knowledge on food allergies. Children with food allergy experience thought that food allergy-related labeling on school menus was not clear or informative. CONCLUSION: To understand food allergies and prevent allergic reactions to school foodservice among children, schools must provide more concrete and customized food allergy education.

Relationship between Food Behavior and Level of Attention Deficit Hyperactivity Disorder in Elementary School Students in Suwon-si, Korea

The purpose of this study was to investigate the correlation between food behavior and Attention Deficit Hyperactivity Disorder (ADHD) score in elementary students in Suwon-si, Gyeonggi-do. Two hundreds and thirty two students (113 male and 119 female) in grades 4~6 participated. We assessed food behavior by using Nutrition Quotient (NQ). NQ was examined by an NQ questionnaire, which consisted of 19 food behavior checklist items. Their items were grouped into five categories: balance, diversity, moderation, regularity, and practice. All data were statistically analyzed by SPSS 18.0. Among the five factors, NQ for food behavior and balance factor showed the lowest score, whereas that of diversity factor showed the highest score. The final Nutrition Quotient (NQ) score weighted on such five factors was 62.59 points. The average level of ADHD by Conners-Wells Adolescent Self-Report Scale (Short Form) [CASS(S)] was 17.02 points out of a total of 81 points. Six students (2.2%) who scored more than 41 points were classified as ADHD risk. By gender, male students (19.76 points) showed a higher CASS(S) score than female students (14.41 points) did. There was a significant negative correlation between NQ and CASS(S) score (r=-0.445, P<0.001). Multiple regression determined the effects of moderation (Exp(beta)=-0.193, P<0.01) and practice (Exp(beta)=-0.345, P<0.001) on CASS(S) score. In conclusion, distinctive nutritional education is needed for students with a high level of ADHD to help their understanding considering their different levels of attention.

Avaliação multi-informe do traço de neuroticismo em escolares / Multi-source assessment of neuroticism trait in school children

A presente investigação avalia o traço de neuroticismo em escolares por meio de metodologia multi-informe que inclui autorrelato, heterorrelato, entrevista semiestruturada e observação comportamental. Especificamente, objetiva identificar o grau de concordância na avaliação de neuroticismo entre as várias fontes de informação utilizadas. A amostra [N=368] constitui parte do "Estudo Longitudinal de Avaliação das Competências Psicológicas das Crianças do Centro Pedagógico/Universidade Federal de Minas Gerais". Na seleção de crianças com alto e baixo neuroticismo, utilizaram-se os resultados em duas escalas de autorrelato - Big Five Questionnaire for Children e o Eysenck Personality Questionnaire - Junior. Logo, uma subamostra de 68 crianças foi submetida à avaliação multi-informe. Os resultados mostraram correlação moderada entre as escalas neuroticismo dos instrumentos de autorrelato. Não houve associação significativa entre o relato de pais e o de professores quando avaliaram neuroticismo, mas sim associações positivas entre o autorrelato e as avaliações multi-informes. As observações comportamentais não se mostraram úteis na mensuração dos traços e as razões para tais resultados são discutidas. Conclui-se que o presente estudo trouxe importantes contribuições para a literatura da área no que se refere à avaliação multi-informe do neuroticismo em crianças brasileiras.

The present research evaluates the dimension of Neuroticism in school children using a multi-source design that includes self-report, parents' and teachers' reports, semi-structured interview and behavior observation. Specifically, the study intended to verify the agreement level in evaluation of Neuroticism from different sources of information. The sample [N= 368] "Estudo Longitudinal de Avaliação das Competências Psicológicas das Crianças do Centro Pedagógico/Universidade Federal de Minas Gerais". Two self-report scales were used to select children with hight and low Neuroticism - Big Five Questionnaire for Children and Eysenck Personality Questionnaire - Junior. A sub sample of 68 children was submitted to a multi-source assessment. The results demonstrated moderate correlations between both Neuroticism scales used. There was not any significant association among parents' and teachers' reports when they evaluated Neuroticism, but were found positive associations between self-report and multi-source assessment. Behavioral observations were not useful in the measurement of traits. The reasons of these results are discussed. To sum-up, this research brought up important contributions to the personality literature, regarding the Neuroticism multi-source assessment in Brazilian children.

Health Status and Nutrient Intakes of 5th Grade Elementary Students in Seoul and Gyeonggi Province / 대한지역사회영양학회지

This study was conducted to investigate health status and nutrient intakes among 5th grade elementary students at Korea Centers for Disease Control and Prevention 2010. This study was cross-sectional study on 1,384 children (687 boys, 697 girls) from nine elementary schools located in Seoul and Gyeonggi province. The average height, weight and BMI were 145 cm, 40.6 kg 19.2 kg/m2 for boys and 145.4 cm, 38.2 kg, 18.0 kg/m2 for girls. The prevalence of overweight and obesity were 11.3%, 5.2%, respectively. Serum AST, ALT, glucose, HDL-Cholesterol and RBC levels were significantly higher, while TG levels was significantly lower for boys than for girls. The average energy intake was 1772.4 kcal, which was 98.7% of Estimated Energy Requirement (EER). The boys consumed more energy intake (1800.4 kcal) than the girls (1744.7 kcal). Also, they took insufficient calcium and folate (69.1% and 83.3% of Recommended Intake (RI)) and excess sodium (297.6% of Adequate Intake (AI)) and 85.1% of the subjects had breakfast everyday. In general, the proportion of the children who consumed fruits and vegetables at least once or more a day was low. There was a higher proportion of children in boys who had ramyun and milk with sufficient physical activity than those in girls. As a result of this study, we can find risk factors on obesity and metabolic disorders, and the results can be used for an evidence of nutrition education program and the intervention program.

Snack Consumption Behaviors and Nutrition Knowledge among Elementary School Students in Siheung-si / 대한지역사회영양학회지

Good snack consumption behaviors are important among elementary students because snack provides additional energy and nutrients and because good dietary behaviors should be formed during early stages of life. This study investigated, among elementary school students, 1) snack consumption behaviors, 2) snack-related nutrition knowledge level, and 3) relationships between snack behaviors and snack-related nutrition knowledge. A convenience sample (N = 372), drawn from 5th and 6th graders of an elementary schools in Siheung-si, Gyeonggi-do, completed a pre-tested questionnaire. More than 85% of the participants snacked more than once per week. Most (77%) had their snacks at home. Fruit and fruit juice were the most frequently consumed and the most liked snack items. Taste was the most important in choosing a snack item closely followed by health/nutrition. Snack-related knowledge level was relatively high and the participants obtained their nutrition knowledge through mass media (30.4%) and family/friends (29.0%). Snack-related nutrition knowledge level and snack consumption behaviors showed positive relationships in various areas such as choosing more nutritious snack items and checking nutrition labels. Although this study was limited by its cross-sectional study design, these positive relationships suggest that better nutrition knowledge could result in better behaviors. Results of this study indicated that factual nutritional knowledge has been well transmitted to students. Therefore, future nutrition education on snacking could focus more on providing problem-solving and operational knowledge.

The Relationship between Beverage Consumption, Nutrient Intake and Body Mass Index in Elementary School Students in Gyeongnam Area

This study was performed to assess the effects of beverage consumption on nutrient intake and anthropometric measurements. Beverage intake and dietary intake were measured by a beverage frequency and quantity questionnaire and three 24-hour dietary recalls in 160 elementary school students in the Gyeongnam area. The number of drinking moments per month was 93.5 and drinking amount of all beverages was 626.6 mL per day. The amount of milk intake was 253.8 ml per day, which was the highest in all types of beverage consumption, followed by juice (133.6 mL), and carbonated beverage (77.7 mL). The amount of sweetened beverage which was defined as all beverages except milk and soy milk was 359.7 ml per day. Energy intakes from all kinds of beverages and sweetened beverages accounted for 20.3% and for 10.5% of the daily energy intake, respectively. The contributions of sweetened beverage intake to the daily energy intake in girls accounted for 13.5% , whereas in boys it was 7.7% and significantly lower. The number of drinking moments and the contribution of sweetened beverage intake to daily energy intake were negatively correlated with protein, vitamin A and niacin intake, respectively. The consumption of milk and soybean milk combined showed a significant negative correlation with the body fat ratio (%) and it also negatively correlated with waist-hip girth ratio (WHR). However, the sweetened beverage intake was not related any of the anthropometric measurement. In conclusion, consumption of the sweetened beverage dropped the nutritional quality of diet. However it was not related with anthropometric measurements in elementary students.

Effects of Nutrition Education Using Food Exchange System: Changes in Elementary Students' Nutrition Knowledge, Dietary Attitude and Nutrients Intake / 대한지역사회영양학회지

The purpose of this study was to investigate the effects of nutrition education using Food Exchange System on elementary students' nutrition knowledge, dietary attitude and nutrients intake. Nutrition education lessons (40 min /lesson, 4 times), '5 major nutrients and functions', '6 food groups and sources of 6 food groups', 'good choice of snacks and eating out' as class lesson, 'daily needed energy and food exchange units' as individual lesson, were provided to 70 elementary students (4th grade 33 students, 5th grade 37 students) in Jeonbuk Province. We assessed the changes in nutrition knowledge, dietary attitude, food habit using a questionnaire and nutrient intake using 24 hr recall method by nutrition education. In nutrition knowledge, there were significant increases in scores of 'functions of carbohydrate', 'functions of protein', 'functions of lipid', 'foods of carbohydrate', and 'foods of lipid'. In dietary attitude, there were significant increases in scores of 'taking a meal with joy', 'taking a meal at ease', 'taking a meal with sufficient protein intake' and 'taking a meal without spicy foods' by nutrition education. There were significant changes in the type of breakfast and in the frequency of snacks. After education, in type of breakfast, it showed higher number of students ate rice oriented meal than they did before education. and in frequency of snacks, it showed lower number of students ate snacks 'over 3 times' than they did before education. In Carbohydrate : Protein : Fat (CPF) ratio (%), it was significantly changed from 55.8 : 17.7 : 26.6 to 63.6 : 15.3 : 21.1. In evaluation of nutrient intake by Dietary Reference Intakes for Koreans (KDRIs), vitamin A, thiamin, niacin, vitamin B6, calcium, phosphate, iron and zinc showed positive changes in distribution of number of children by intake level. That is, there were significant improvements in intakes of vitamin A, thiamin, niacin, vitamin B6, calcium, phosphate, iron and zinc. These results showed that nutrition education using Food Exchange System for elementary students improved nutrition knowledge, dietary attitude and nutrients intake. It suggest that nutrition education using Food Exchange System may improve dietary behaviors and reduce an incidence of obesity in elementary students.

Improvement of Dietary Attitudes of Elementary Students by Nutrition Labeling Education / 대한지역사회영양학회지

The purpose of this study was to improve the dietary attitudes of elementary students through nutrition labeling education. A class of fifth-grade elementary students was selected and educated for basic nutrition and reading of nutrition labeling for 8 weeks by using education materials from the KFDA. After the education, the children were subjected for the practice of reading nutrition labeling during winter vacation, and the changes in their dietary attitudes and practice were measured by using questionnaires for children and their parents along with measuring physical changes. The results were as follows: The level of nutritional knowledge was improved significantly after the education (p < 0.05). Nutrition labeling education increased the children's frequency of reading nutrition labeling from 34.2% to 57.9% while purchasing processed foods (p < 0.05), and 92.1% of the children answered that their dietary attitudes improved by nutrition labeling education. However, no improvement in physical measurements was observed after education. This result suggested that 8-week of education were not enough to show the improvement in physical measurements, and long-term and repeated education is necessary. After the education, most children answered that they recognized the benefit of reading nutrition labeling and they would read the nutrition labeling when purchasing processed foods. Parents also recognized the necessity of nutrition labeling education in school and suggested the need of nutrition labeling be easy to read. The above results suggested that nutrition labeling education is an effective way for improving dietary attitudes of children.

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.

Relation among Dietary Habits, Nutrient Intakes and Bone Mineral Density in Korean Normal and Obese Elementary Students / 대한지역사회영양학회지

The purpose of this study was to investigate the relation between bone mineral density and nutrient intake among normal and obese elementary students. Each subject was assigned to one of such as normal (n = 69) and obese groups (n = 94) according to their obesity indices. And they were asked for general characteristics, dietary habits and nutrient intakes using questionnaires and 24-hr recall method. They measured the sound of speed (SOS) of calcaneus using quantitative ultrasound. The averages age of the subjects were 10.6 years in normal and 10.7 years in obese group. The averages weight (p < 0.001) and obesity index (p < 0.001) of the normal group were significantly lower than those of the obese group. In dietary habits, the obese group in boys was the higher skipped breakfast than normal group (p < 0.01). The plant calcium intake of obesity in girls was lower than those of normal group (p < 0.05). The SOS in the calcaneus was 1697.6 m/s in the obese group and 1763.7 m/s in the normal group (p < 0.01). The SOS in the calcaneus was negatively correlated to weight (p < 0.01), obesity index (p < 0.001) and percent of body fat (p < 0.01). Also the SOS in the calcaneus was positively correlated plant calcium intake (p < 0.05). In conclusion, the excessive increase of weight and percent of body fat in elementary students appeared to have negative impact to bone health. And based on these results, further studies on the effects on bone mineral density of obese and nutrient intakes in needed for proper bone health.

Satisfaction of Elementary Students Eating School Lunch; Association with Level of Involvement in School Lunch Service / 대한지역사회영양학회지

The purpose of this study was to determine the relationship between the students' levels of involvement in school lunch service and their satisfaction levels with the service. A survey was conducted with 5th and 6th grade elementary students eating school lunches. Out of 1,680 questionnaires distributed to the students from 14 schools, 1,254 complete questionnaires (74.6%) were analyzed. The questionnaire included two 5-point multi-item scales for measuring levels of involvement in and satisfaction with school lunch service, respectively. A factor analysis grouped 20 items measuring school lunch satisfaction into three factors: 'food satisfaction', 'nutrition & sanitation satisfaction', and 'service & environment satisfaction'. As a result of multiple regression analyses controlling the influence of such variables as students' grades, gender, school location, years and places of eating school lunches, students' levels of involvement in school lunch service was proven to be positively associated with levels of school lunch satisfaction overall, as well as satisfaction levels in regard to 'food', 'nutrition & sanitation', and 'service & environment', respectively. It was suggested that efforts such as nutrition education to increase students' levels of involvement in school lunches could be a useful strategy to improve students' satisfaction with school lunch service.

Compare the Knowledge, Attitude and Behavior about Smoking in the Elementary Students according to Anti-smoking Education / 아동간호학회지

PURPOSE: To investigate and compare the knowledge and attitude about smoking of the elementary students according to anti-smoking education. METHOD: A descriptive comparative study design was used. A total 2,000 of the 4th, 5th and 6th grade of elementary students classified into education and non-education groups according to their anti-smoking education. Knowledge and attitude about smoking were measured by the constructed questionnaire. RESULTS: 1) Students' knowledge about smoking were 11.50point on average with highest score being 20. The knowledge of the education group was significantly higher than those of non-education group. No significant differences were observed according to grade or sex. 2) Students' attitude toward smoking were negative with the mean score 31.70. No significant differences were observed according to anti-smoking education, while students in higher grades and male showed significant favorable attitude toward smoking. 3) Among the students of respondents, 5.3% answered they had the experience of smoking. The smoking experience of the education group was significantly higher than those of non-education group. 96.0% of the students would not smoking in the future. No significant differences were observed according to anti-smoking education. CONCLUSION: The results suggested that a systematic strategy required to lead desirable attitude and behavior about smoking of students.