Metachronous carcinoma at the colostomy site after abdominoperineal resection of rectal cancer: a case report

Metachronous carcinoma at the colostomy site is very rare after abdominoperineal resection. A 53-year-old male patient underwent an abdominoperineal resection 6 years earlier for rectal cancer developed metachronous carcinoma at the site of stoma. A portion of the colon, including the stoma and the surrounding skin, was resected and a new stoma was created in the transverse colon. Although the occurrence of carcinoma at the stoma site is a rare condition, careful observation for the stoma and colonoscopy for surveillance are necessary.

Development of nutrition quotient for elementary school children to evaluate dietary quality and eating behaviors / 한국영양학회지

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.

Development of nutrition quotient for elementary school children to evaluate dietary quality and eating behaviors / 한국영양학회지

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.

Erratum: Tables Correction. Development of NQ-E, Nutrition Quotient for Korean elderly: item selection and validation of factor structure / 한국영양학회지

The original version of this article contained errors in Tables. The contents of Table 4, 5, and 6 should be corrected.

Development of Nutrition Quotient for Korean adults: item selection and validation of factor structure / 한국영양학회지

PURPOSE: This study was conducted to develop a nutrition quotient (NQ) to assess overall dietary quality and food behaviors of Korean adults. METHODS: The NQ was developed in three steps: item generation, item reduction, and validation. Candidate items of the NQ checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the Korea National Health and Nutrition Examination Survey (2010 ~ 2013) data, and national nutrition policies and recommendations. A total of 368 adults (19 ~ 64 years) participated in a one-day dietary record survey and responded to 43 items in the food behavior checklist. Pearson's correlation coefficients between responses to the checklist items and nutritional intake status of the adults were calculated. Item reduction was performed, and 24 items were selected for a nationwide survey. A total of 1,053 nationwide adult subjects completed the checklist questionnaires. Exploratory and confirmatory factor analyses were performed to develop a final NQ model. RESULTS: The 21 checklist items were used as final items for NQ. Checklist items were composed of four factors: nutrition balance (seven items), food diversity (three items), moderation for the amount of food intake (six items), and dietary behavior (five items). The four-factor structure accounted for 41.8% of the total variance. Indicator tests of the NQ model suggested an adequate model fit (GRI = 0.9693, adjusted GFI = 0.9617, RMR = 0.0054, SRMR = 0.0897, p < 0.05), and item loadings were significant for all subscales. Standardized path coefficients were used as weights of the items. The NQ and four-factor scores were calculated according to the obtained weights of the questionnaire items. CONCLUSION: NQ for adults would be a useful tool for assessing adult dietary quality and food behavior. Further investigations of adult NQ are needed to reflect changes in their food behavior, environment, and prevalence of chronic diseases.

Comparison of nutrients and food intakes of young children according to lunch places: based on the fifth Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study examined whether there was a difference in the nutrients and food intake of young children depending on their lunch places. METHODS: The dietary survey data of the fifth Korea National Health and Nutrition Examination Survey (2010 ~ 2012) were used. The children were grouped into either a child care center lunch group (n = 728) or home lunch group (n = 592) and their nutrients and food intakes were compared. RESULTS: No differences in the 24-hr energy intake and energy intakes from lunch and dinner according to the lunch places were observed. The percentage of breakfast energy was lower in the child care center lunch group, whereas the percentage of snack energy was higher. In children aged 3 ~ 5 years, the sodium, potassium, and vitamin C intakes were high in the child care center lunch group. The 1 ~ 2 years and 3 ~ 5 year old children's vegetable intake from lunch was significantly higher in the child care center lunch group than in the home lunch group. Children aged 3 ~ 5 years in the child care center lunch group consumed more beans and fish at lunch. The adequacy of nutrients and food diversity of child care center lunch appear better than home lunch. CONCLUSION: Parents and care providers need to make efforts to use diverse foods, such as vegetables and fish, in children's meals to provide balanced diets and promote healthy eating behaviors to their children.

Development of NQ-E, Nutrition Quotient for Korean elderly: item selection and validation of factor structure / 한국영양학회지

PURPOSE: The purpose of this study was to develop a valid instrument for measuring the dietary quality and behaviors of Korean elderly. METHODS: The development of the Nutrition Quotient for Elderly (NQ-E) was conducted in three steps: item generation, item reduction, and validation. The 41 items of the NQ-E checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Pearson's correlation was used to determine the level of agreement between the questionnaires and nutrient intake level, and 24 items were selected for a nationwide survey. A total of 1,000 nationwide elderly subjects completed the checklist questionnaire. The construct validity of the NQ-E was assessed using confirmatory factor analysis, LISREL. RESULTS: The nineteen checklist items were used as final items for NQ-E. Checklist items were composed of four-factors: food behavior (6 items), balance (4 items), diversity (6 items), and moderation (3 items). The standardized path coefficients were used as the weights of the items. The NQ-E and four-factor scores were calculated according to the obtained weights of the questionnaire items. CONCLUSION: NQ-E would be a useful tool for assessing the food behavior and dietary quality of the elderly.

Comparison Surgical Outcomes between Laparoscopic and Conventional Distal Gastrectomy for Early Gastric Cancer in Obese Patients

PURPOSE: In this study, we explored the safety of laparoscopic gastrectomy in obese gastric cancer patients compared with conventional open gastrectomy based on early surgical outcomes. METHODS: A total of 462 patients who underwent curative gastrectomy for early gastric adenocarcinoma from January 2000 to December 2014 were enrolled. Two obesity cohorts were defined according to a body mass index (BMI) of ≥25 kg/m² versus ≥30 kg/m². Those cohorts were further divided into the laparoscopic distal gastrectomy (LDG) and open distal gastrectomy (ODG) groups, and clinicopathologic characteristics were compared with early surgical results. RESULTS: There were no significant differences in clinicopathologic characteristics between the LDG and ODG groups in the BMI ≥25 or BMI ≥30 cohorts. For the overall complication rate, fewer complications were observed in the LDG than ODG group in both cohorts. Among the overall complications, significant differences were observed in the minor complication rates (Clavien-Dindo I or II), but no significant difference was observed in the rate of Clavien-Dindo III or higher complications. For risk factor analysis of postoperative complications, open distal gastrectomy, age >60 years, and BMI ≥30 were independent risk factors for postoperative morbidity among all obese patients. CONCLUSION: LDG may be a better procedure to improve surgical outcomes in patients with obesity undergoing surgery for early gastric cancer in terms of less excessive blood loss, shorter operation time, and lower complication rates.

Development of NQ-A, Nutrition Quotient for Korean Adolescents, to assess dietary quality and food behavior / 한국영양학회지

PURPOSE: The purpose of this study was to develop a nutrition quotient for adolescents (NQ-A) to assess overall dietary quality and food behavior of Korean adolescents. METHODS: Development of the NQ-A was undertaken in three steps: item generation, item reduction, and validation. Candidate items of the NQ-A checklist were selected based on literature reviews, results of the fifth Korea National Health and Nutrition Examination Survey data, dietary guidelines for Korean adolescents, expert in-depth interviews, and national nutrition policies and recommendations. A total of 213 middle and high school students participated in a one-day dietary record survey and responded to 41 items in the food behavior checklist. Pearson's correlation coefficients between the responses to the checklist items along with nutritional status of the adolescents were calculated. Item reduction was performed, and 24 items were selected for the nation-wide survey. A total of 1,547 adolescents from 17 cities completed the checklist questionnaire. Exploratory factor and confirmatory factor analyses were performed to develop a final NQ-A model. RESULTS: Nineteen items were finalized as the checklist items for the NQ-A. Checklist items were composed of five factors (balance, diversity, moderation, environment, and practice). The five-factor structure accounted for 47.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-A and five-factor scores were calculated based on the obtained weights of the questionnaire items. CONCLUSION: Nutrition Quotient for adolescents (NQ-A) would be a useful instrument for evaluating dietary quality and food behavior of Korean adolescents. Further research on NQ-A is needed to reflect changes in adolescent's food behavior and environment.

Development of nutrition quotient for Korean preschoolers (NQ-P): Item selection and validation of factor structure / 한국영양학회지

PURPOSE: Screening of preschool-age children for nutrition programs to improve dietary intake and behaviors requires cost-effective and easily administered validated assessment tools. The purpose of this study was to develop a parent/caregiver-administered instrument for measuring diet quality and behaviors of preschoolers as a nutrition quotient for preschoolers (NQ-P). METHODS: Development of NQ-P was carried out in three steps: item generation, item reduction, and validation. The 24-h dietary record was selected as the gold standard reference tool. The 38 items of the NQ-P checklist were derived from a systematic literature review, expert in-depth interviews, statistical analysis of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Self-administered questionnaires were delivered to parents who recorded 24-h dietary intakes of 100 responders aged 3~5 yr. Pearson's correlation was used to measure the level of agreement between questionnaires. Item reduction was performed, and 20 items were selected based on survey results, expert reviews, and priorities of national nutrition policy and recommendations. The 412 nationwide subjects sampled through daycare centers completed the 20-item checklist questionnaire. The construct validity of the NQ-P was assessed using confirmatory factor analysis, LISREL. RESULTS: After analyses of exploratory factors, NQ-P items identified three dimensions of diet (balance, moderation, and environment). The three-factor structure accounted for 49.28% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-P and three-factor scores of the subjects were calculated by the obtained weights of the questionnaire items. CONCLUSION: A food behavior checklist for preschoolers' NQ would be a useful and suitable instrument for evaluating nutrition adequacy and dietary quality of Korean preschoolers.

Sex- and age group-specific associations between intakes of dairy foods and pulses and bone health in Koreans aged 50 years and older: Based on 2008~2011 Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study was performed to examine associations of intakes of milk and dairy products, pulses, and soy foods with bone health in Koreans aged 50 yr and older. METHODS: A total of 3,201 men and 3,581 women aged 50 yr and older who participated in the 2008~2011 Korea National Health and Nutrition Examination Survey were grouped by sex and age groups of 50~64 yr and 65 yr and older. Subjects within each sex and age group were divided into three bone health groups: normal, osteopenia, and osteoporosis groups based on bone mineral density. Intakes of nutrients and foods derived from 24-hour recall data were compared among three bone health groups. Associations between intake frequencies of foods, including milk, yogurt, tofu, or soy milk, and osteoporosis risk were evaluated based on confounding risk factor-adjusted logistic regression. RESULTS: Calcium intake was in the order of normal, osteopenia, and osteoporosis in men (p < 0.01) and women (p < 0.05) aged 50~64 yr as well as in men aged 65 yr and older (p < 0.001). In women aged 50~64 yr, intake of milk and dairy products was lower in the osteoporosis group (p < 0.01) as compared with the osteopenia group. Intake of pulses or tofu was not significantly different among bone health groups. Odds ratio (OR) for milk intake frequency (≥ 2 times/week) compared to intake frequency less than 1 time/month was 0.45 (95% CI 0.24~0.85, p for trend = 0.022) in men aged 65 yr and older. The OR for yogurt intake frequency (1 time/month~1 time/week) was 0.47 (95% CI 0.30~0.73, p for trend = 0.019) in women aged 50~64 yr. Intake frequency of tofu or soy milk was not associated with reduced risk of osteoporosis in all groups. CONCLUSION: Dairy food intake was significantly associated with bone health, and its effect was sex- and age group-specific, whereas soy food intake was not. Dietary intervention to prevent osteoporosis would be effective for women aged 50~64 yr old and for men aged 65 yr and older.

Evaluation of items for the food behavior checklist and nutrition quotient score on children in rural areas of Gyeongbuk / 한국영양학회지

The aim of this study was to determine whether Nutrition Quotient (NQ) for children, which has been developed from data on urban children, can be applied to children in rural areas. A total of 200 children (108 boys and 92 girls) in fifth and sixth grade at three elementary schools in rural areas of Gyeongbuk participated in the survey conducted during June 2012. Questionnaires consisted of items on food intake frequency and dietary behavior. Food intake data were obtained using the 24-hour recall method, and nutrient intake was calculated using the CAN-Pro 4.0 Program. Percentages of children who took less than the estimated average requirement were 76.5%, 49.5%, 45.5%, 33.5%, and 26.0% for calcium, vitamin C, iron, vitamin A, and folate, respectively. Significant associations were observed between intake frequencies of vegetables, kimchi, and fruits, and intake of vitamin C, folate, and dietary fiber. White milk and legumes showed positive correlation with intake of calcium and vitamin A. Eating breakfast, meal regularity, and diverse side dishes showed positive correlation with intake of folate and calcium. The 19 food checklist items could be categorized according to five factors. The mean NQ score of the subjects was 62.0, which was similar to that of urban children, 64.4. NQ score and factor scores for balance, regularity, and practice were significantly lower in children with lower socioeconomic level as compared to those with higher socioeconomic level. Higher NQ score showed an association with increased intake of vitamin B2, folate, vitamin C, and calcium. In conclusion, NQ offers a valuable instrument for evaluation of food habit and dietary quality of rural children as well as urban children, and children with low socioeconomic status should be monitored by testing with NQ checklist before implementation of nutrition programs.

A Study on Dietary Behavior and Nutrient Intake of Children with Developmental Disorders in Gyeongbuk Area

This study investigated dietary behavior and nutrient intake in children with developmental disorders as compared with non-disabled children and assessed the relationship between dietary behavior and nutrient intake. The survey was conducted on 118 students (4th and 5th grade) of four special education schools and 244 students of an elementary school (control group). The survey was carried out using a questionnaire and an interview. Of the disabled children, children with a mental disorder comprised 72.9% and those with emotional disorders including autism comprised 26.3%. The average percentages of height and weight to standards for age were significantly lower in the disabled female children as compared with the non-disabled female children. Scores for table utensil handling skills, eating behavior, and an unbalanced diet were lower in the disabled children compared with those in the non-disabled children. Dietary behavior scores were not significantly different by either gender or age in the disabled children. Mean energy intake was less than the estimated energy requirement in both groups. Nutrients taken at less than the recommended intake level were calcium, iron, vitamin A, and folate in both groups. Food behavior score at mealtime, personal hygiene score at mealtime, and an unbalanced diet score were significantly correlated with iron and vitamin A intake in disabled male children. Personal hygiene score at mealtime was significantly correlated with calcium, iron, and vitamin A intake, and unbalanced diet score was significantly correlated with iron and vitamin A intake in disabled female children. Although the nutritional status of disabled children with developmental disorders was appropriate in general, improvement in their dietary behaviors through education and practice would allow them to eat balanced diets with essential nutrients.

Production and evaluation of children's dietary life safety index data on metropolitan cities and provinces in Korea

This pilot study was performed to produce data of the Children's Dietary Life Safety (CDLS) Index which is required by the Special Act on Safety Management of Children's Dietary Life and to evaluate the CDLS Index for 7 metropolitan cities and 9 provinces in Korea. To calculate the CDLS Index score, data regarding the evaluation indicators in the children's food safety domain and children's nutrition safety domain were collected from the local governments in 2009. For data regarding the indicators in the children's perception & practice domain, a survey was conducted on 2,400 5th grade children selected by stratified sampling in 16 local areas. Relative scores of indicators in each domain were calculated using the data provided by local governments and the survey, the weights are applied on relative scores, and then the CDLS Index scores of local governments were produced by adding scores of the 3 domains. The national average scores of the food safety domain, the nutrition safety domain and the perception and practice domain were 23.74 (14.67-26.50 on a 40-point scale), 16.65 (12.25-19.60 on a 40-point scale), and 14.88 (14.16-15.30 on a 20-point scale), respectively. The national average score of the CDLS Index which was produced by adding the scores of the three domains was 55.27 ranging 46.44-58.94 among local governments. The CDLS Index scores produced in this study may provide the motivation for comparing relative accomplishment and for actively achieving the goals through establishment of the target value by local governments. Also, it can be used as useful data for the establishment and improvement of children's dietary life safety policy at the national level.

Selecting items of a food behavior checklist for the development of Nutrition Quotient (NQ) for children

The objective of this study is to select a simple and easy measurable food behavior checklist for the development of Nutrition Quotient (NQ) for children, which reflects children's diet quality, as well as to evaluate the validity of the items in the food behavior checklist. The first 36 items in the checklist were established by an expert review, modifying the preliminary 50 items in the checklist, which had been selected by a literature review and the Korean National Health and Nutrition Examination Survey data. 341 children in 5th and 6th grades at an elementary school participated in a one-day dietary record survey, and later responded to 36 food behavior questions of the checklist. Pearson's correlation coefficients between the responses to the food behavior checklist items along with the mean nutrient intakes of the children were calculated. From the result, in which responses of food frequency and food behavior items showed certain association with the dietary record data, a second checklist with 22 items was selected. A survey was conducted by using the second checklist. 1,393 children in the 5th and 6th grades at 12 elementary schools in metropolitan cities, such as Seoul, Busan, Gwangju, Daegu, Daejeon, and Incheon, participated in the survey. Further, an exploratory factor analysis was performed. After the analysis, 19 items (10 items from food frequency and 9 items from food behavior) were finalized as the food behavior checklist items for the NQ. The final 19 food behavior checklist items were composed of 5 factors: 'Balance', 'Diversity', 'Moderation', 'Regularity', and 'Practice'. This study is a significant first trial to establish a comprehensive system for evaluating children's food habit and diet quality. This checklist might need continuous modification and revision reflecting the change of children's dietary life and the social environment.

Perception and action plans for school breakfast program by school nutrition teachers and dietitians in Gyeongbuk province

This study aimed at investigating the perception and action plans of the school breakfast program (SBP) proposed by nutrition teachers and dietitians at elementary, middle, and high schools in Gyeongbuk province. The survey was carried via questionnaires throughout April to May 2010. Two hundred ten questionnaires were returned (52.5%) and out of the total, 194 were used for analysis. Of the respondents, 73% disagreed and 27% agreed to the implementation of SBP, although most respondents agreed to the importance of eating breakfast in children. The percentage of disagreement was higher among subjects with working experience of 15 years and more, age of 40 years and more, and those who were employed at elementary schools. The primary reasons of disagreement were 'eating breakfast with family is better' and 'it increases the cost of school foodservice'. The respondents preferred students' optional participation (62.9%) over universal participation (37.1%) of SBP. Action plans of SBP, which were proposed by nutrition teachers and dietitians, included direct operating system by the school, food delivery schedule prior to the day of serving, 2-3 hours of preparation time, serving food 50 minutes before the start of classes, and convenient style menu served at the school cafeteria. Efforts to lessen foodservice employees' workload as well as support from school principals and the Office of Education were suggested as prerequisites for a successful SBP implementation.

Development of a Nutrition Quotient (NQ) equation modeling for children and the evaluation of its construct validity

The objective of this study was to develop and evaluate the construct validity of a Nutrition Quotient (NQ) for children. In a previous report (Kang, et al., 2012), the food behavior checklist for children's NQ, consisting of 19 items, was grouped into a 5-factor structure according to the exploratory factor analysis: balance, diversity, moderation, regularity, and practice. In this study, the construct validity of the NQ was assessed using a confirmatory factor analysis. Elementary school students (n = 1,393) from six large cities completed the NQ test. Indicator tests suggested an adequate model fit (goodness of fit index = 0.9613; adjusted GFI = 0.95; standardized root mean square residual = 0.0464; chi-square test statistics of < 0.001 p-value, 82.1), and item loadings were significant for all subscales (p < 0.05). The standardized path coefficients were used as the weights of the items. The NQ and the 5 factor scores of the student were calculated by the obtained weights of the questionnaire items. Logistic regression was applied to find the significant factors in order to affect a specific nutrient status. The receiver operation characteristic curve analyses were performed in order to find diagnostic cut-off points of the five factors. The food behavior checklist for children's NQ would be a handy and suitable instrument for evaluating dietary behaviors of Korean children.

Is Yoga Beneficial for Improving Physical Fitness, Autonomic Nervous Functions, and Psychosocial Health in Older Female Adults?

BACKGROUND: The purpose of this study is to identify the benefits of yoga in improving fitness and psycho-physiologic functions in females over 65 years, and to explain the mechanism of yoga's mind-body effect. METHOD: Participants were recruited from a senior welfare center in C city and randomly assigned to either the yoga group or the control group. The yoga group attended classes 3 days per week for 12 weeks while the control group continued with their regular daily activities. Senior fitness tests were performed, heart rate variability measured, and depression and quality of life (QOL) scores were obtained through a questionnaire before and after the 12 weeks. RESULTS: Overall, health-related physical fitness, except cardiorespiratory endurance, improved significantly in the yoga group. Likewise, parasympathetic nervous tone (high frequency power [HF]/low frequency power+HF) increased in this group, possibly due to meditation and yogic breathing. Depression and QOL scores significantly decreased and increased, respectively. CONCLUSIONS: Yoga can be considered beneficial, improving health-related fitness, autonomic functions, and psychosocial health. Carefully planned yoga classes are an appropriate form of exercise for the elderly.

Meal skipping relates to food choice, understanding of nutrition labeling, and prevalence of obesity in Korean fifth grade children

This study was performed to investigate the differences in food choice, nutrition labeling perceptions, and prevalence of obesity due to meal skipping in Korean elementary school children. A national survey was performed in 2010 to collect data on food intake frequency, understanding of nutrition labeling, and body mass index from 2,335 fifth grade students in 118 elementary schools selected from 16 metropolitan local governments by stratified cluster sampling. The data were analyzed using the SAS 9.1 and SUDAAN 10.0 packages. Students who consumed three meals for 6-7 days during the past week were classified into the regular meal eating (RM) group (n = 1,476) and those who did not were placed into the meal skipping (MS) group (n = 859). The daily intake frequency of fruits, vegetables, kimchi, and milk was significantly lower in the MS group compared to that in the RM group (P < 0.001), whereas the daily intake frequency of soft drinks and instant noodles (ramyeon) was significantly higher in the MS group than that in the RM group (P < 0.05). The MS group demonstrated a significantly lower degree of understanding with regard to nutrition labeling and high calorie foods containing low nutritional value than that in the RM group. The distribution of obesity based on the percentile criteria using the Korean growth chart was different between the MS and RM groups. The MS group (8.97%) had a higher percentage of obese subjects than that in the RM group (5.38%). In conclusion, meal skipping was related to poor food choice, low perception of nutrition labeling, and a high prevalence of obesity in Korean fifth grade children.

Development of Evaluation Indicators for a Children's Dietary Life Safety Index in Korea

This study was performed to develop a children's dietary life safety index required by the Special Act on Safety Management of Children's Dietary Life enacted in 2009. An analytical hierarchy process was used to obtain initial weights of dietary life safety evaluation indicators. The Delphi method was applied to develop the weights along with 98 food and nutrition professionals. Three representative policy indicators, nine strategy indicators, 11 main evaluation indicators, and 20 detailed evaluation indicators were selected for the children's dietary life safety assessment. Three policy indicators and nine strategy indicators were the following: children's food safety indicator (support level of children' safety, safety management level of children's favorite foods, and safety management level of institutional food service), children's nutrition safety indicator (management level of missing meals and obesity, nutrition management level of children's favorite foods, and nutrition management level of institutional food service), and children's perception and practice level indicator ("Dietary Life Law" perception level, perception, and practice level for dietary life safety management, perception, and practice level for nutrition management). Weights of 40%, 40%, and 20% were given for the three representative policy indicators. The relative importance of nine strategic indicators, which were determined by the Delphi method is as follows: For children's food safety, support level of children's safety, safety management level of children's favorite foods, and safety management level of institutional food service were given weights of 12%, 9%, and 19%, respectively. For children's nutrition safety, the missing meals and obesity management level, nutrition management level of children's favorite foods, and the nutrition management level of institutional food service were given weights of 13%, 11%, and 16%, respectively. The "Dietary Life Law" perception level, perception and practice level of dietary life safety management, and perception and practice level of nutrition management were given weights of 4%, 7%, and 9%, respectively.