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

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

Breakfast patterns are associated with metabolic syndrome in Korean adults

The Korean diet, including breakfast, is becoming more Western, which could increase the risk of metabolic syndrome. Our aim was to assess whether breakfast patterns are associated with risk for metabolic syndrome in Korean adults. The study subjects (n = 371; 103 men, 268 women) were employees of Jaesang Hospital in Korea and their acquaintances, and all subjects were between 30 and 50 years old. The data collected from each subject included anthropometric measurements, three-day food intake, blood pressure (BP) and blood analyses. The three breakfast patterns identified by factor analysis were "Rice, Kimchi and Vegetables", "Potatoes, Fruits and Nuts" and "Eggs, Breads and Processed meat". The "Rice, Kimchi and Vegetables" pattern scores were positively correlated with systolic (SBP) and diastolic blood pressure (DBP) measurements in men (P < 0.05) and with serum triglyceride (TG) levels in women (P < 0.05). The "Eggs, Breads and Processed meat" pattern scores correlated positively with weight, body mass index (P < 0.05) and serum TGs (P < 0.01) in men. The "Potatoes, Fruits and Nuts" pattern was associated with lower risk of elevated BP (OR 0.49, 95% CI 0.28-0.88) and fasting glucose levels (OR 0.51, 95% CI 0.26-1.00). In contrast, the "Eggs, Breads and Processed meat" pattern was associated with increased risk of elevated TGs (OR 2.06, 95% CI 1.06-3.98). Our results indicate that reducing the consumption of eggs, western grains and processed meat while increasing fruit, nut and vegetable intake for breakfast could have beneficial effects on decreasing metabolic syndrome risk in Korean adults.

Skipping breakfast is associated with diet quality and metabolic syndrome risk factors of adults

The aim of the present study was to assess the effects of skipping breakfast on diet quality and metabolic disease risk factors in healthy Korean adults. Subjects included 415 employees (118 men, 297 women; 30-50 years old) of Jaesang Hospital in Korea and their acquaintances. Data collected from each subject included anthropometric measurements, 3-day dietary intake, blood pressure, and blood analyses. The subjects were classified into three groups based on the number of days they skipped breakfast: 'Regular breakfast eater', 'Often breakfast eater', or 'Rare breakfast eater'. Participants in the 'Rare breakfast eater' group consumed less rice, potatoes, kimchi, vegetables, fish and shellfish, milk and dairy products, and sweets than did participants in the other two groups (P for trend < 0.05) and ate more cookies, cakes, and meat for dinner (P for trend < 0.05). Participants in the 'Rare breakfast eater' group consumed less daily energy, fat, dietary fiber, calcium, and potassium than did participants in the other groups (P for trend < 0.05). The percent energy from carbohydrates was lower and fat intake was higher in the 'Rare breakfast eater' group than in the other groups (P for trend < 0.01). When diets were compared using the Acceptable Macronutrient Distribution Range for Koreans, 59.1% of subjects in the 'Rare breakfast eater' group consumed more energy from fat compared with the other two groups (P < 0.005). According to the Estimated Average Requirements for Koreans, intake of selected nutrients was lower in the 'Rare breakfast eater' group than in the other two groups (P < 0.05). The risk of elevated serum triglycerides was decreased in the 'Rare breakfast eater' group (OR, 0.3 [0.1-1.0], P for trend = 0.0232). We conclude that eating breakfast regularly enhances diet quality, but may increase the risk of elevated serum triglycerides.