Intuitive eating in youth: Its relationship with nutritional status / Alimentação intuitiva na juventude: sua relação com o estado nutricional

ABSTRACT Objective To determine intuitive eating in young adults and the effects of factors such as gender, Body Mass Index and dietary intake, and dietary adequacy on intuitive eating. Methods This cross-sectional study was conducted with students at Gazi University in Ankara (N=665; 17.6% men; 82.4% women). The questionnaire, including the general characteristics, anthropometric measurements, Intuitive Eating Scale-2, and 24-H Dietary Recall sections, were applied to all participants. For the evaluation of the diet, Nutrient Adequacy Ratio and Mean Adequacy Ratio were used. Results The mean Intuitive Eating Scale-2 score was 3.2±0.33; men's and women's scores were 3.3±0.37 and 3.2±0.32, respectively (p<0.05). According to linear regression analysis, gender, age and mean adequacy ratio had an effect on the model for the score (p<0.05). In addition, there was a negative correlation between Intuitive Eating Scale-2 scores and Body Mass Index values in women (rp=-0.095, p=0.026). Conclusion The intuitive eating scores varied according to gender, dietary adequacy and age. Intuitive eating may be effective in the formation of long-term behavioral changes, which is beneficial for the treatment of obesity. The result of this study may encourage the development of this behavior in groups (may vary according to gender), that is thought to be effective by considering the changes of intuitive eating behavior.

RESUMO Objetivo Determinar a alimentação intuitiva em adultos jovens e os efeitos de fatores como sexo, índice de massa corporal, ingestão alimentar e adequação da dieta na alimentação intuitiva. Métodos Este estudo transversal foi realizado em estudantes da Universidade de Gazi, em Ancara (N=665; 17,6% homens; 82,4% mulheres). O questionário, incluindo as características gerais, medidas antropométricas, Escala de Alimentação Intuitiva 2 e recordatório alimentar de 24 horas foi aplicado aos participantes. Para a avaliação da dieta, foram utilizados o Índice de Adequação de Nutrientes e a Razão de Adequação Média. Resultados A Escala Média de Escala de Comportamento Intuitivo-2 foi de 3,2±0,33, dos homens e das mulheres, foi de 3,3±0,37 e 3,2±0,32, respectivamente (p<0,05). De acordo com a análise de regressão linear, sexo, idade a Razão de Adequação Média tiveram efeito no modelo formado pelo escore (p<0,05). Além disso, houve uma correlação negativa entre os escores da Escala de Alimentação Intuitiva-2 e os valores do índice de massa corporal nas mulheres (rp=-0,095, p=0,026). Conclusão Os escores alimentares intuitivos variaram de acordo com o gênero, com adequação da dieta e com a idade. A alimentação intuitiva pode ser eficaz na formação de mudanças a longo prazo no comportamento, o que é benéfico para o tratamento da obesidade. O resultado deste estudo pode encorajar o desenvolvimento deste comportamento em grupos (talvez variar de acordo com o gênero) que é considerado efetivo considerando-se as mudanças do comportamento alimentar intuitivo.

Dietary Habits and Nutritional Status of Young Women according to Breakfast Frequency in Seoul / 대한지역사회영양학회지

OBJECTIVES: Although breakfast is important to nutrition balance, prevention of overeating, and weight control, people in their 20s (males: 55.1%, females: 49.9%) were reported to have the highest rate of skipping breakfast in 2016 Korea Health Statistics. This study aims to examine dietary habits and nutrient intake depending on breakfast frequency among young women in Seoul. METHODS: The subjects were 655 young women in Seoul from August to October 2016, and the survey was performed by using a questionnaire that included general characteristics, dietary habits, and eating behavior. Body composition was determined by bioelectric impedance analysis. Nutritional status was examined by the 24-hour recall method. RESULTS: The participants were classified by breakfast intake frequency; ‘≥ 5 times/week (n=160)’, ‘1–4 times/week (n=327)’, and ‘breakfast skipping (n=168)’. The ‘breakfast skipping’ group had lower frequency and regularity of meals. In addition, the ‘breakfast skipping’ group had a higher frequency of eating-out and late-night meals. There was no difference in total calories between the ‘breakfast skipping’ group and other groups, but the ‘breakfast skipping’ group had significantly low carbohydrate and fiber intakes. The participants showed lower intakes of calories, fiber, vitamin A, vitamin C, niacin, folic acid, calcium, potassium, and zinc in comparison with recommended intakes. Especially, the ‘breakfast skipping’ group had significantly lower fiber, vitamin A, vitamin C, calcium, potassium levels compared to the ‘≥ 5 times/week’ group. For Mean Adequacy Ratio (MAR), the ‘breakfast skipping’ group recorded a ratio of 0.60, which was lower than those of other groups. Index of Nutritional Quality (INQ) including fiber, vitamin C, calcium and phosphorus were significantly lower in the breakfast skipper group, compared to the breakfast eater group. CONCLUSIONS: The ‘breakfast skipping’ group showed low regularity of meals and a high frequency of eating-out and late-night meals. The breakfast regular eater group showed high intake of micronutrients and quality of meals was high in general. Skipping breakfast could lower nutrient intake and quality of meals, which requires attention.

Dietary Habits and Nutritional Status of Young Women according to Breakfast Frequency in Seoul / 대한지역사회영양학회지

OBJECTIVES: Although breakfast is important to nutrition balance, prevention of overeating, and weight control, people in their 20s (males: 55.1%, females: 49.9%) were reported to have the highest rate of skipping breakfast in 2016 Korea Health Statistics. This study aims to examine dietary habits and nutrient intake depending on breakfast frequency among young women in Seoul. METHODS: The subjects were 655 young women in Seoul from August to October 2016, and the survey was performed by using a questionnaire that included general characteristics, dietary habits, and eating behavior. Body composition was determined by bioelectric impedance analysis. Nutritional status was examined by the 24-hour recall method. RESULTS: The participants were classified by breakfast intake frequency; ‘≥ 5 times/week (n=160)’, ‘1–4 times/week (n=327)’, and ‘breakfast skipping (n=168)’. The ‘breakfast skipping’ group had lower frequency and regularity of meals. In addition, the ‘breakfast skipping’ group had a higher frequency of eating-out and late-night meals. There was no difference in total calories between the ‘breakfast skipping’ group and other groups, but the ‘breakfast skipping’ group had significantly low carbohydrate and fiber intakes. The participants showed lower intakes of calories, fiber, vitamin A, vitamin C, niacin, folic acid, calcium, potassium, and zinc in comparison with recommended intakes. Especially, the ‘breakfast skipping’ group had significantly lower fiber, vitamin A, vitamin C, calcium, potassium levels compared to the ‘≥ 5 times/week’ group. For Mean Adequacy Ratio (MAR), the ‘breakfast skipping’ group recorded a ratio of 0.60, which was lower than those of other groups. Index of Nutritional Quality (INQ) including fiber, vitamin C, calcium and phosphorus were significantly lower in the breakfast skipper group, compared to the breakfast eater group. CONCLUSIONS: The ‘breakfast skipping’ group showed low regularity of meals and a high frequency of eating-out and late-night meals. The breakfast regular eater group showed high intake of micronutrients and quality of meals was high in general. Skipping breakfast could lower nutrient intake and quality of meals, which requires attention.

Major Foods and Nutrient Intake Quality According to Body Image Perception among Korean Women: Based on the 2010 Korea National Health and Nutrition Examination Survey Data

The prevalence of obesity is continuing to increase. Self-perceived body image among women has drawn a lot of attention in Korea due to unhealthy weight control trials. This study was conducted to determine the relationship between self-perceived body image and dietary intakes among Korean women. For the analysis, 1,747 subjects were selected after eliminating those who were likely to have recently altered their diet based on the 2010 Korea National Health and Nutrition Examination Survey (KNHANES) data. The subjects were divided into three groups: underweight, normal, and obese groups according to their perception of body image. Daily nutrient intakes, NAR (Nutrient Adequacy Ratio), and food intake frequency were assessed according to age group and body image perception. Only energy intake showed differences among the three body image perception groups across all age groups, but not statistical differences. Analysis of NAR and the order of most frequently consumed food items confirmed these findings. The ratio of underweight women that perceived their body size as normal or overweight was higher with younger age. Incorrect body image perception and unhealthy weight control behaviors can cause nutritional problems. This study confirmed that nutritional knowledge is important for healthy weight control trials. Nutritional education for healthy dieting should be emphasized among Korean women.

A Better Diet Quality is Attributable to Adequate Energy Intake in Hemodialysis Patients

Poor diet quality is one of strong predictors of subsequent increased mortality in hemodialysis patients. To determine diet quality and to define major problems contributing to poor diet quality in hemodialysis patients, a cross-sectional study was conducted between June 2009 and October 2010. Sixty-three hemodialysis patients (31 men, 32 women; aged 55.3 +/- 11.9 years) in stable condition were recruited from the Artificial Kidney Center in Kyung Hee University, Seoul, Korea. Three-day diet records were obtained for dietary assessment. Mean adequacy ratio (MAR) is the average of the ratio of intakes to Dietary Reference Intakes (DRI) for 12 nutrients. Index of nutritional quality (INQ) was determined as the nutritional density per 1,000 kcal of calories. Overall diet quality was evaluated using the Diet Quality Index-International (DQI-I). Statistics were used to determine diet quality, comparing dietary intake to DRI. Dietary calories (21.9 +/- 6.7 kcal/kg/day) and protein (0.9 +/- 0.3 g/kg/day) were found insufficient in the participants. The overall intake of 12 nutrients appeared to be also inadequate (0.66 +/- 0.15), but INQs of overall nutrients, except for folate (0.6) and calcium (0.8), were found relatively adequate (INQ > or = 1). As a result of diet quality assessment using DQI-I, dietary imbalance and inadequacy were found to be the most problematic in hemodialysis patients. This study suggests that the main reason for insufficient intake of essential nutrients is insufficient calorie intake. Hemodialysis patients should be encouraged to use various food sources to meet their energy requirements as well as satisfy overall balance and nutrient adequacy.

Validity of dietary diversity score as an indicator of nutrient adequacy among older adults in Pasay City, Philippines

OBJECTIVE:The study was conducted to determine the validity of Dietary Diversity Score (DDS) as an alternative indicator for nutrient adequacy among older adults in Pasay City, Philippines.METHODS: An analytic cross sectional study design was used on a representative sample of older adults (n = 82) in all barangays under the Doña Marta Health Center in Pasay City. A 5-stage multiple pass single 24-hour food recall was performed to determine the dietary intake of each respondent. Subject's nutrient intake was obtained using the FCT+Menu Eval software. Nutrient Adequacy Ratio (NAR) was then computed using the ratio of subject's nutrient intake to the Recommended Energy and Nutrient Intakes (RENI) for Filipinos.  The Mean Adequacy Ratio (MAR) was then obtained by computing for the average of the NARs, expressed as a ratio ranging from 0 - 1. Dietary Diversity Score was calculated using the DDS Questionnaire recommended by the FAO Guideline. For the statistical analysis, Pearson's correlation was used to determine the relationship between MAR and DDS. ROC curve analysis was done to determine the most appropriate cut-off points for using DDS among the older adults.RESULTS: The selected older adults of Pasay City had a mean DDS of 4.15 (0.14) and a mean MAR of 0.64 (0.02). There was a significant and strong correlation between MAR and DDS (r = 0.519; P CONCLUSION: DDS may be used as an indicator of nutrient adequacy among the randomly selected older adults.

Assessment of Menu Plan Prepared by Middle School Students According to Ordinary Meal Pattern and Single Serving Size / 대한지역사회영양학회지

It is important to prepare and execute the menu plan for proper and balanced intake of nutrients in the adolescence. This study investigated the new approach for planning menu by ordinary meal pattern based on cooked foods groups. The amounts of cooked foods in the menu plan assumed to be single serving size. The middle school second graders participated for the study. A total of 313 questionnaires were analyzed using CAN-pro 3.0 and SPSS WIN 12.0 program. The average content of energy in the menu plan was 2,453 kcal, the average ratios of energy contribution by carbohydrate, protein and fat were 54.3%, 17.9%, 27.8%, respectively. A total of 56.9% menu plans (94.9% of male and 8.7% of female students') were below the lowest limit of optimum carbohydrate energy ratio of 55%. A total of 29.1% menu plans (33.1% of male and 23.9% of female students') were exceed the highest limit of optimum fat energy ratio of 30%. The NAR of minerals and vitamins were all 1.0 except for calcium (0.92) and folate (0.88). When INQ of the individual cooked food groups were calculated, kimch was the highest in all minerals and vitamins examined, suggesting that kimch may be the best source for all minerals and vitamins, including calcium and folate with the minimum change in energy content. In conclusion, the menu plan by ordinary meal pattern in this study was low in carbohydrate, high in fat, and contained enough minerals and vitamins except for calcium and folate for middle school students.

Nutrient Intake Status of Korean Drinkers: Analysis of Data from Korea National Health and Nutrition Examination Survey (KNHANES), 2011

This study analyzed the dietary habits and nutrient intake status of adult drinkers in Korea. Alcohol drinking patterns were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES). Among 4,968 persons, 91.5% were drinkers. Classification of their drinking patterns by the Alcohol Use Disorders Identification Test (AUDIT) score showed 64.5% of the drinkers were normal drinkers, 22.4% problem drinkers and 13.2% alcohol-dependent drinkers. Overall, 47% of the drinkers were considered alcohol-dependent in the Rapid Alcohol Problems Screen (RAPS4). Significant differences were found between those who abstained from alcohol (86.8%) and alcohol-dependent drinkers (68.9%); when asked about breakfast habits 73.4% of non-drinkers often had family meals, while only 55.4% of the alcohol-dependent drinkers had family meals. Dietary energy, alcohol energy, and total energy intake significantly increased for the alcohol-dependents (P<0.001). In addition, the intake of eight nutrients (protein, vitamin A, vitamin B1, vitamin B2, niacin, calcium, phosphorous and iron), significantly increased in the following order (least to highest): abstainers, normal drinkers, drinkers with a moderate addiction to alcohol and alcohol-dependent drinkers (P<0.05). Nutrient Adequacy Ratios (NAR) of all nutrients, except vitamin C, and the Mean nutrient Adequacy Ratio (MAR) significantly increased in the following order (least to highest): abstainers, normal drinkers, drinkers with a moderate addiction to alcohol and alcohol-dependent drinkers (P<0.05). The intake of vitamin B1, vitamin B2, and niacin per 1,000 kcal, according to drinking pattern, decreased in the order of abstainers, normal drinkers, drinkers with a moderate addiction to alcohol, and alcohol-dependent drinkers (P<0.001). The above results show that the nutrient intake of normal drinkers, drinkers with a moderate addiction to alcohol, and alcohol-dependent drinkers are higher than abstainers. However, overall intake of vitamin B1, vitamin B2, and niacin per 1,000 kcal was low. Therefore it is necessary to increase vitamin B1, vitamin B2, and niacin intake for drinkers.

Nutritional Assessment of Menu Plan Prepared according to the Target Pattern: Menu Prepared by Home Economics Teachers and Middle-School Girls / 대한지역사회영양학회지

The nutritional balance of the menu plans prepared according to the target pattern was examined. Total of 81 home economics teachers throughout the nation and 161 3rd-grade middle-school girls in Chungnam area participated. The data was collected by questionnaire and analyzed by using SPSS WIN 12.0. Although both teacher and student groups had fairly good knowledge on preparing menu plans related concepts, they rarely make use any menu planning currently. More than 85% of menu plans investigated exceeded their energy goal in the target pattern. The energy contribution ratios of carbohydrate: protein: fat were 56.1%: 17.4%: 26.5% in teachers' menu plan and 55.1%: 17.2%: 27.7% in students' menu plan. The NAR of the protein, phosphorous, iron, zinc, vitamin A and C, thiamin, riboflavin, niacin, B6 was 1 or near 1. But in case of calcium, 56.5% of the menu plan prepared by the students was less than 1, and in case of folate 75.3% of teachers', and 85.1% of students' were less than NAR 1. The MAR of the 12 nutrients examined were 0.98, 0.97, and the DVS were 51, 49 for menu plan prepared by teachers and students, respectively.

Composition of Food Groups Appropriate for Evaluation of Diet Quality of Korean Adolescents: Based on Kant's Minimum Amount

The purpose of this study was to determine composition of food groups appropriate for the evaluation of the quality of total diet or food guide, using the data from the 1998 National Health and Nutrition Survey. Twenty-fourhour-dietary recalls of total 1,110 Korean adolescents aged 13 - 19 years (male 543, female 567) were analyzed for food group consumed (Dietary Diversity Score, DDS), intake patterns of food group, mean index of nutritional quality (mINQ) and nutrient adequacy ratio (NAR). Considering Korean food pattern different from the Americans, this study is to check if Korean 5 food groups with both of oil & sugar group and vegetable &fruit group, and a minimum amount of 30 g in grain group and 15 g in meat group modified from Kant's minimum amount, 15 g in grain and 30 g in meat, could also be appropriate for the diet evaluation of Korean adolescents. Combination of food group and minimum food intake per each food group used in the first trial were categorized into 6 kinds of types: 1) American 5 food groups with Kant's minimum amount as control or 2) American 5 food groups with modified Kant's minimum amount 3) Korean 5 food groups excluded by sugar with the modified amount 4) Korean 5 food groups with modified amount 5) American food groups added oil group with the modified amount 6) American food groups added oil & sugar group with the modified amount. In case of oil group or oil and sugar group, 5 g was quoted for the minimum amount. Correlation between DDS and indices of other diet quality in each type of food group composition were analyzed and the best food group composition was traced by comparing the correlation coefficients of DDS and mINQ or MARs at alpha < 0.01. There was no meaningful difference in weight length index of the subjects of eating or not-eating oil or oil & sugar, while the values of mINQ showed higher in the subjects eating oil but no difference in the subjects eating oil & sugar, compared to the group not-eating, respectively. In comparison of type 1 and type 2, correlation between DDS and indices of other diet quality showed higher in type 1 using Kant's amount. And comparing the type of a combined group of fruit & vegetable (type 3 and 4) and the type of separated group of fruit and vegetable (type 5 and 6). six groups of separated vegetable and fruit showed the higher correlation of DDSs and indices of diet quality. In case of being classified into six groups with oil, DDS showed correlation of r = 0.293 with INQ. While, being classified into six groups with oil & sugar instead of oil only, DDS showed correlation of r = 0.249 with INQ. Accordingly the type 5 with oil is regarded as the better food group type than the type 6 with oil & sugar. Since better result was shown in the composition of six groups with Kant's minimum amount, the comparative analysis on both of type 1 with oil and oil & sugar was finally performed. Then oil added type 1 showed higher correlation of DDS and indices of diet quality. These result indicated that it would be more appropriate to use six food groups with separate vegetable and fruit including oil group (oil-added type 1) rather than oil &sugar group for evaluat ion of dietary quality of Korean adolescents using DDS.

The Relationship between the Diversity of Food Intake and Nutrient Intake among Korean College Students Participating in a Nutrition Education Class via the Internet / 대한지역사회영양학회지

The purpose of this study was to evaluate the relationship between the diversity of food intake and nutrient intake among Korean college students participating in a nutrition education class via the internet. The subjects were 796 college students throughout South Korea (278 males, 518 females). A 3 days dietary recall survey was conducted and results were analyzed using the Computer-aided Nutritional Analysis Program. Dietary variety was assessed by DDS (dietary diversity score), MBS (meal balance score), and DVS (dietary variety score). Dietary quality was assessed by NAR (nutrient adequacy ratio), and MAR (mean adequacy ratio). As the DDS, MBS and DVS increased, the NAR and MAR improved. The subjects with a DDS of above 4 or a MBS of above 10 or a DVS of above 11 met two-thirds of the Korean recommended dietary allowance for most nutrients. The DDS, MBS and DVS correlated positively and significantly with the NAR and MAR. Associations between the NAR and high levels of DVS were more positive than those between the NAR and the DDS. Based on these results, the food intake of these subjects was not adequate. Specially, the dietary intake of calcium and iron were not adequate. Therefore, dietary guidelines should be made considering nutritional characteristics so as to improve the intake from all of the major food groups and provide a variety of foods in their diets.

A Longitudinal Study on the Change of Nutrients and Food Consumption with Advance in Age among Middle-aged and the Elderly / 대한지역사회영양학회지

The purpose of this study is to investigate diet quality and changes in nutrient and food intake with increase in age. Subjects were 69 patients(28 males, 41 females) living in Jeon-ju city, over middle-aged, and they were the same patients studied 4-7 years ago in a previous study. Dietary survey with one day 24-hour recall method was used. Energy, calcium, vitamin A and vitamin B2 intakes were lower than the RDA and vitamin C was in excessive status in pre-test and post-test. In food groups examrned, the consumption of potatoes, beans, vegetables, seaweeds, beverages, seasonings, oils, fish & shells and milks was increased amount than 4-7 years before but the consumption of cereals(p<0.01), sugars, seeds, fruits, processed food, meats and eggs was decreased. Diet quality was assessed by %RDA, nutrient adequacy ratio(NAR), mean adequacy ratio(MAR), dietary diversity score(DDS), meal balance and food group pattern. In %RDA, those proportion of appropriate intake in post-test in were higher than those in pre-test. For most nutrient except vitamin A, the levels of NAR in post-test were higher than in pretest. The MAR, an index of overall dietary quality, was 0.77 for pre-test and 0.83 for post-test(p<0.05). When we counted the major food groups consumed(KDDS), 62.3% of subjects had a KDDS of 3 in pre-test and 42.0% of subjects had a KDDS of 4 in post-test. Based on these results, in terms of variety and balance, total diet quality was improved with advancing of age

Strategies to Improve Elderly Nutrition : Comparisons of Dietary Behavior according to the Mean Nutrient Adequacy Ratio / 대한지역사회영양학회지

A deep understanding of the dietary patterns and nutrient intake is important for assessment of possilbe nutritional risk and for establishing nutrition improvement strategies. This study was conducted toexamine the dietary characteristics of a nutritionally poor elderly group compared to the middle-and highly-nourished group. Elderly participant was recruited from local elderly centers in Suwon city in 1998. Trained dietitians interviewed 119 elderly(35 males, 84 females) aged 60 years and over for collecting dietary data(24-hour recall) and related variables. Male and female subjects were grouped into high, middle, and low according to the mean nutrient adequancy ratio(MAR) tertiles. An analysisof the percentage of RDA(Recommended Daily Allowances of Korea) for each of the 10 nutrients showed that the male low-MAR group consumed below the RDA in all kinds of nutrients, and the female low-MAR group consumed nutrients below the RDA except vitamin C. An evaluation of nutrient density by Index of Nutritonal Quality(INQ) also showed a similar tendency. Thus, the INQ level of the male low-MAR group was significantly lower than the middle-or high-MAR group, especially in protein, vitamin A, thiamin, riboflavin, and phosphorus(p<0.05). Moreover, INQ level of female low-MAR group was significantly lower than that of the high group(p<0.05) in all nutrients. The female low-MAR group's daily food intake were also lower than those of the high-MARgroup in gains, fish, fruits, oil and beverages. The energy distribution from carbohydrates, fats and proteins showed that the male low-MAR group had significantly higher carbohydrate and lower fat proportions compared to each gender high-MAR group, respectively. The male and female low-MAR group had low scores about eating all side dishes. These findings indicate that a moderate increase of the meat/egg/fishes intake was needed by the male low-MAR group for improving nutrition adequacy, and an overall increase of the food quantity and quality was desired for the female low-MAR group. These data could be used for planning a community elderly nutrition program and establishing strategies for tailored guidelines for the individuals.