Dietary sodium and potassium intake of Koreans estimated using 2 different sources of their contents in foods, Food & Nutrient Database and the Korean Total Diet Study : a comparative study / 대한지역사회영양학회지

Objectives@# Based on the results from the Korean Total Diet Study (KTDS), the sodium (Na) and potassium (K) intake of Koreans were estimated and compared with intake estimates from the Food & Nutrient Database (FNDB), as in the Korea National Health and Nutrition Examination Survey (KNHANES) to verify the validity of these estimates. @*Methods@# One hundred and thirty-four representative foods (RFs) covering 92.5% of the total food intake of Koreans were selected, and 228 pairs of corresponding ‘RF x representative cooking method’ were derived by reflecting the methods used mainly in terms of frequency and quantity in their cooking.RF samples were collected from three cities with a larger population size in three regions (nine cities) nationwide, and six composite samples were made for each RF, considering its regional and/or seasonal characteristics. One thousand three hundred and sixty-eight ‘RF x representative cooking method’ pair samples were prepared, and the Na and K contents were assessed using inductively coupled plasma atomic emission spectrometry (ICP-MS). The Na and K intake of the Korean population was estimated by linking the content with the food intake data from the 7th KNHANES. @*Results@# The mean Na and K intake of Koreans were 2,807.4 mg and 2,335.0 mg per person per day, respectively. A comparison with the Na and K intake from KNHANES, including only RFs of KTDS, showed comparable results with less than 5% variation. While the contribution and ranking of food items to Na intake were similar between KNHANES and KTDS, there were differences in K intake.This was attributed to the large discrepancies in the K content of rice and coffee between KTDS results and the values in the 9th Revision of the National Food Composition Table used in KNHANES. @*Conclusions@# The Na and K intake of Koreans estimated based on the KTDS, which performed nutrient analysis on samples prepared to a ‘table-ready’ state using foods of the representative collection, was similar and comparable with that of KNHANES. This supports the validity and usefulness of FNDB-based nutrient intake estimation at the population level. The list of nutrients studied in KTDS is expected to be expanded, allowing for intake estimation of nutrients with currently insufficient or absent information in the FNDBs in use.

Dietary Iron Intake of Koreans Estimated using 2 Different Sources of Iron Contents are Comparable: Food & Nutrient Database and Iron Contents of Cooked Foods in the Korean Total Diet Study / 대한지역사회영양학회지

Objectives@#This study was conducted to find out if the dietary iron intake of Koreans estimated by 2 different methods (iron content sources) using the food intake data from the Korea National Health and Nutrition Examination Survey (KNHANES) are comparable. One method was based on the KNHANES's Food & Nutrient Database (FND) derived mainly from the Korean Food Composition Table and the other used the iron content (IC) of food samples processed in the Korean Total Diet Study (KTDS). @*Methods@#Dietary intake data from the 2013-2016 KNHANES was used to select representative foods (RFs) in KTDS for iron analysis. Selection of the RFs and cooking methods for each RF (RF × cooking method pair) was performed according to the ‘Guidebook for Korean Total Diet Studies’ and resulted in a total of 132 RFs and 224 ‘RF × cooking method’ pairs. RFs were collected in 9 metropolitan cities nationwide once or twice (for those with seasonality) in 2018 and made into 6 composites each, based on the origin and season prior to cooking. Then, the RF composites prepared to a ‘table ready’ state for KTDS were analyzed by Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). Dietary iron intake of the Korean population was estimated using only RFs’ intake data based on the 2 sources of iron content, namely FND-KNHANES and IC-KTDS. @*Results@#RFs in KTDS covered 92.0% of total food intake of Koreans in the 2016-2018 KNHANES. Mean iron intake of Koreans was 7.77 mg/person/day by IC-KTDS vs 9.73 mg/person/day by FND-KNHANES. The major food groups contributing to iron intake were meats (21.7%), vegetables (20.5%), and grains & cereals (13.4%) as per IC-KTDS. On the other hand, the latter source (FND-KNHANES) resulted in a very different profile: grains & cereals (31.1%), vegetables (16.8%), and meats (15.3%). While the top iron source was beef, accounting for 8.6% in the former, it was polished rice (19.2%) in the latter. There was a 10-fold difference in the iron content of polished rice between 2 sources that iron intakes excluding the contribution by polished rice resulted in very similar values: 7.58 mg/person/day by IC-KTDS and 7.86 mg/person/day by FNDKNHANES. @*Conclusions@#This study revealed that the dietary iron intake estimated by 2 different methods were quite comparable, excluding one RF, namely polished rice. KTDS was thus proven to be a useful tool in estimating a ‘closer-to-real’ dietary intake of nutrients for Koreans and further research on various nutrients is warranted.

Estimation of Dietary Iodine Intake of Koreans through a Total Diet Study (TDS) / 대한지역사회영양학회지

Objectives@#This study was conducted to estimate the dietary iodine intake of Koreans by a Total Diet Study (TDS) which provides ‘closer-to-real’ estimates of exposure to hazardous materials and nutrients through an analysis of table-ready (cooked) samples of foods. @*Methods@#Dietary intake data from 2013-2017 Korea National Health and Nutrition Examination Survey (KNHANES) was used to select representative foods (RFs) for iodine analysis. A total of 115 RFs were selected and 158 ‘RF × cooking method-combination’ pairs were derived by pairing each RF to corresponding cooking method(s) used more frequently. RFs were collected from 9 mega-markets in 9 metropolitan cities nationwide and mixed into composites prior to cooking preparation to a ‘table ready’ state for iodine analysis by inductively coupled plasma mass spectrometry. Iodine intake of Koreans was estimated based on the food intake data of the 2016-2018 KNHANES. @*Results@#High iodine content was detected in seaweeds such as sea mustard and kelp. The mean iodine intake/capita/day was 418.4 ㎍ and the median value was 129.0 ㎍. Seaweeds contributed to 77.4% of the total iodine intake and the contribution by food item was as follows: sea mustard (44.0%), kelp (20.4%), laver (13.1%), milk (3.9%), egg (3.5%). Compared to the Dietary Reference Intakes for Koreans 2020, the proportion of people with iodine intake exceeding the tolerable upper intake level or below the estimated average requirement was high in the physiologically vulnerable groups (infants, children, pregnant women, and lactating women). @*Conclusions@#The results, drawn from a TDS, are regarded closer to real estimates for iodine intake of Koreans compared with values in existing literature, which were based on a very limited variety of foods. On the other hand, it seems necessary to seek out solutions for the problematic iodine intake among physiologically vulnerable groups through in-depth analyses on food intake data collected with significant scale & quality.

Estimation of Dietary Iodine Intake of Koreans through a Total Diet Study (TDS) / 대한지역사회영양학회지

Objectives@#This study was conducted to estimate the dietary iodine intake of Koreans by a Total Diet Study (TDS) which provides ‘closer-to-real’ estimates of exposure to hazardous materials and nutrients through an analysis of table-ready (cooked) samples of foods. @*Methods@#Dietary intake data from 2013-2017 Korea National Health and Nutrition Examination Survey (KNHANES) was used to select representative foods (RFs) for iodine analysis. A total of 115 RFs were selected and 158 ‘RF × cooking method-combination’ pairs were derived by pairing each RF to corresponding cooking method(s) used more frequently. RFs were collected from 9 mega-markets in 9 metropolitan cities nationwide and mixed into composites prior to cooking preparation to a ‘table ready’ state for iodine analysis by inductively coupled plasma mass spectrometry. Iodine intake of Koreans was estimated based on the food intake data of the 2016-2018 KNHANES. @*Results@#High iodine content was detected in seaweeds such as sea mustard and kelp. The mean iodine intake/capita/day was 418.4 ㎍ and the median value was 129.0 ㎍. Seaweeds contributed to 77.4% of the total iodine intake and the contribution by food item was as follows: sea mustard (44.0%), kelp (20.4%), laver (13.1%), milk (3.9%), egg (3.5%). Compared to the Dietary Reference Intakes for Koreans 2020, the proportion of people with iodine intake exceeding the tolerable upper intake level or below the estimated average requirement was high in the physiologically vulnerable groups (infants, children, pregnant women, and lactating women). @*Conclusions@#The results, drawn from a TDS, are regarded closer to real estimates for iodine intake of Koreans compared with values in existing literature, which were based on a very limited variety of foods. On the other hand, it seems necessary to seek out solutions for the problematic iodine intake among physiologically vulnerable groups through in-depth analyses on food intake data collected with significant scale & quality.

Preconceptional use of folic acid and knowledge about folic acid among low-income pregnant women in Korea

BACKGROUND/OBJECTIVES: Folic acid supplementation before pregnancy is known to significantly reduce the risk of having a baby with neural tube defects (NTDs). Therefore, it is important for women to be aware of the effects of folic acid supplementation before pregnancy. The purpose of this study was to investigate the awareness and preconceptional use of folic acid and to assess the current knowledge about folic acid among low-income pregnant women in Korea. SUBJECTS/METHODS: A questionnaire survey was conducted in 2012. Five hundred pregnant women were selected from the waiting list for the Nutriplus program implemented in public health centers using a multistage clustered probability sampling design. Data from 439 women were analyzed after excluding ones with incomplete answers. RESULTS: Among women who responded to the questionnaire, 65.6% had heard of folic acid before pregnancy, and 26.4% reported on the preconceptional use of folic acid. Women with a university degree or higher education were more likely to be aware of folic acid and to take folic acid in the preconception period. In a multivariate logistic regression, when age, education level, household income, employment status, gravidity, parity, and folic acid awareness were included in the model, folic acid awareness was a strong predictor of preconceptional folic acid use. As of interview, 85.4% and 77.7% of women were aware of the NTD-preventive role of folic acid and the appropriate time to take folic acid, respectively. The main sources of information on folic acid were healthcare professionals (41.2%), friends and family members (31.2%), and the media (26.5%). CONCLUSIONS: Our results suggest that public health strategies are needed to increase the preconceptional use of folic acid among Korean women.

Food Ingestion Factors of the Korean Exposure Factors Handbook / 예방의학회지

The purpose of this study was to establish food ingestion factors needed to assess exposure to contaminants through food ingestion. The study reclassified the raw data of the Korean National Health and Nutrition Examination Survey in 2001 into 12 subcategories including grain products, meat products, fish and shellfish, and vegetables for international comparability of exposure evaluation. The criteria for food intake calculation were unified according to the characteristics of food groups, and recommended values for food ingestion factors were calculated through moisture correction and recategorization of cooked, processed, and mixed foods for each group. The average intake rate for grain and grain products was 6.25 g/kg-d per capita and the men's intake rate was approximately 8% higher than that of the women. The average intake rate of meat and meat products was 1.62 g/kg-d per capita and the men's intake rate was 30% higher than that of the women, on average. The average intake rate of fish and shellfish was 1.53 g/kg-d per capita, and the age groups of 1 to 2 and 3 to 6 recorded higher capita intake rates than other age groups, 2.62 g/kg-d and 2.25 g/kg-d, respectively. The average intake rate of vegetables was 6.47 g/kg-d per capita, with the age group of 1 to 2 recording the highest per capita intake rate of 9.79 g/kg-d and that of 13 to 19 recording the lowest mean. The study also offers recommended values for food ingestion factors of other food groups by gender, age, and region. The food ingestion exposure factors will need future updates in consideration of ongoing changes in food consumption behavior.

Weight misperception and its association with dieting methods and eating behaviors in South Korean adolescents

BACKGROUND/OBJECTIVES: There is little information on the association between weight misperception and eating behavior in Korean adolescents. Therefore, we investigated the association of food intake habits and dieting method and disturbed eating behavior (DEB) in relation to weight misperception. SUBJECTS/METHODS: Data was collected by using a nationwide online panel survey from 6,943 adolescents enrolled in middle/high school. DEB was measured with the Eating Attitudes Test (EAT-26) and those who scored > or = 20 on the EAT-26 were considered to have eating disorder. Logistic regressions were conducted to examine the association between weight misperception based on self-reported weight status and dieting method and eating behaviors. RESULTS: The proportion of weight underestimation was 23.5% and that of overestimation was 24.0%. Weight overestimating girls were more likely to engage in various unhealthy dieting practices (OR = 1.69 for fasting; OR = 1.88 for laxative or diuretic use; OR = 2.05 for self-induced vomiting after meals; P < 0.05). Moreover, there was a strong association between overestimation and undesirable eating behaviors, especially among girls, e.g.: having breakfast (OR = 0.85), high consumption of fast foods (OR = 1.28) and regular sodas (OR = 1.39), but not among boys. In both genders, weight overestimation appears to be a major risk factor for DEB (OR = 1.34 for boys and OR = 1.41 for girls; P < 0.05). CONSLUSIONS: Weight overestimation is associated with unhealthy weight control practices and eating behaviors. We particularly found a significant association between weight overestimation and DEB among nationwide Korean adolescents.

Dietary total sugar intake of Koreans: Based on the Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2011 / 한국영양학회지

PURPOSE: The aim of this study is to estimate total sugar intake and identify major food sources of total sugar intake in the diet of the Korean population. METHODS: Dietary intake data of 33,745 subjects aged one year and over from the KNHANES 2008-2011 were used in the analysis. Information on dietary intake was obtained by one day 24-hour recall method in KNHANES. A database for total sugar content of foods reported in the KNHANES was established using Release 25 of the U.S. Department of Agriculture National Nutrient Database for Standard Reference, a total sugar database from the Ministry of Food and Drug Safety, and information from nutrition labeling of processed foods. With this database, total sugar intake of each subject was estimated from dietary intake data using SAS. RESULTS: Mean total sugar intake of Koreans was 61.4 g/person/day, corresponding to 12.8% of total daily energy intake. More than half of this amount (35.0 g/day, 7.1% of daily energy intake) was from processed foods. The top five processed food sources of total sugar intake for Koreans were granulated sugar, carbonated beverages, coffee, breads, and fruit and vegetable drinks. Compared to other age groups, total sugar intake of adolescents and young adults was much higher (12 to 18 yrs, 69.6 g/day and 19 to 29 yrs, 68.4 g/day) with higher beverage intake that beverage-driven sugar amounted up to 25% of total sugar intake. CONCLUSION: This study revealed that more elaborated and customized measures are needed for control of sugar intake of different subpopulation groups, even though current total sugar intake of Koreans was within the range (10-20% of daily energy intake) recommended by Dietary Reference Intakes for Koreans. In addition, development of a more reliable database on total sugar and added sugar content of foods commonly consumed by Koreans is warranted.

Characteristics of the dietary intake of Korean elderly by chewing ability using data from the Korea National Health and Nutrition Examination Survey 2007-2010 / 한국영양학회지

The purpose of this study was to examine the characteristics of the dietary intake of Korean elderly according to chewing ability using data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted during 2007-2010. Among subjects aged 65 years and over, more than half, 54.3% of elderly people, were classified as the difficulty in chewing group (DC). The DC group had lower nutrients and food intakes than those of in the no difficulty in chewing group (NDC). Findings showed that subjects in the DC group consumed fewer foods, especially fruits and vegetables. In addition, the DC group had significantly lower intakes of pan-fried food, stir-fried food, braised food, and seasoned-cooked vegetables, which could not be easily cooked or chewed. On the other hand, the number of soups and stews included in the top 30 largely consumed dishes were higher in the DC group than in the NDC group. No difference in numbers of daily meal/snack intake was observed between the two groups, however, the DC group had lower numbers of side-dishes compared to the NDC group. Fewer side-dishes per meal could be related to lower intakes of nutrients in dietary quality. Findings of this study demonstrated that dietary intake was influenced by chewing ability of elderly Korean people. Therefore, study of factors affecting dietary intake such as convenient cooking methods to decrease cooking time and skills to extend preservation and storage time of foods will necessary. In addition, development of food products and new techniques of cooking considering health status, chewing, and swallowing ability is required for the elderly, followed by establishment of standards for senior-friendly food products.

Dairy Product Intake Is Inversely Associated with Metabolic Syndrome in Korean Adults: Anseong and Ansan Cohort of the Korean Genome and Epidemiology Study

The objective of this study was to examine the relationship between dairy product intake and the incidence of metabolic syndrome (MetS) and its components among middle-aged Koreans. We examined 7,240 adults aged 40-69 yr without MetS at baseline over a 45.5-month follow-up period. They were taken from the Anseong and Ansan cohort of the Korean Genome and Epidemiology Study. Dairy product intake including milk, yogurt, and cheese was assessed with food frequency questionnaire. At the follow-up, the incidence of MetS was 17.1%. The incidences of MetS components were as follows: low HDL cholesterol (16.2%), abdominal obesity (14.0%), hypertriglyceridemia (13.8%), hyperglycemia (13.3%), and hypertension (13.1%). Adjusting for potential confounders, dairy product consumption frequency was inversely associated with the risk of MetS and abdominal obesity. Hazard ratio (HR) (95% confidence interval) for dairy product consumption more than 7 times/week compared to never was 0.75 (0.64-0.88, P for trend < 0.001) for MetS and 0.73 (0.61-0.88, P for trend < 0.001) for abdominal obesity. HR for milk intake was 0.79 for MetS and 0.82 for abdominal obesity. The results of this study suggest that daily intake of dairy products protects against the development of MetS, particularly abdominal obesity, in middle-aged Koreans.

Elevation of Morning Blood Pressure in Sodium Resistant Subjects by High Sodium Diet

The present study evaluated the response of blood pressure (BP) by dietary sodium in sodium resistant (SR) subjects. One hundred one subjects (mean age, 46.0 yr; 31 hypertensives) were admitted and given low sodium-dietary approaches to stop hypertension (DASH) diet (LSD, 100 mM NaCl/day) for 7 days and high sodium-DASH diet (HSD, 300 mM NaCl/day) for the following 7 days. On the last day of each diet, 24 hr ambulatory BP was measured. Morning systolic BP (SBP) and diastolic BP (DBP) were elevated after HSD in all subjects (P 0.05). In hypertensive subjects, morning DBP elevation was greater than daytime DBP elevation (P = 0.036), although both DBPs were significantly elevated after HSD. The augmented elevation of morning DBP in hypertensive subjects was contributed by the absolute elevation of morning DBP (P = 0.032) and relative elevation to daytime DBP (P = 0.005) in sodium resistant (SR) subjects, but not by sodium sensitive subjects. Although there was no absolute elevation, SR subjects with normotension showed a relative elevation of morning SBP compared to daytime SBP change after HSD (P = 0.009). The present study demonstrates an absolute and relative elevation of morning BP in SR subjects by HSD.

Breast-feeding and Obesity in Early Childhood: Based on the KNHANES 2008 through 2011 / 대한지역사회영양학회지

Although there has been a significant increase in breast-feeding (BF) rate in Korea, it is plateaued since 2008 and still low compared with that of other countries. Because BF has been related to lower obesity prevalence in many studies and the increase in childhood obesity became evident in Korea, we wondered if a relatively lower BF rate has anything to do with this increase. Therefore, we looked into the relationship between mode & duration of BF during infancy and weight status of toddlers using the data from Korea National Health and Nutrition Examination Survey 2008 through 2011. Number of 2-3 year old toddlers with complete information on BF, anthropometry and normal birth weight was 674. While 87% of them were ever-breastfed, 6.2% each of them were either obese or overweight based on the Standard Growth Chart for Korean Children. Not only the obesity prevalence was different among groups of different mode of feeding, but also the mean duration of BF was significantly longer in normal weight group (9.2 mo.) compared with obese group (5.5 mo.). Accordingly, overweight and obesity prevalence of the toddlers breast-fed for 12 months or longer was significantly lower than that of the toddlers breast-fed for less than 12 months (OR 0.53, 95% CI 0.32-0.87). This study revealed that both BF and duration of BF affect the childhood obesity and, BF for 12 months or longer should be encouraged more aggressively as one of the main strategies to prevent and/or decrease childhood obesity in Korea.

Cost-benefit Analysis of Sodium Intake Reduction Policy in Korea / 대한지역사회영양학회지

It is well established that excessive sodium intake is related to a higher incidence of chronic diseases such as hypertension, stroke, coronary heart disease, cardiovascular disease and gastric cancer. Although the upper limit of the current sodium intake guideline by WHO is set at 2,000 mg/day for adults, sodium intake of Koreans is well over 4,700 mg/capita/day implying an urgent need to develop and implement sodium intake reduction policy at the national level. This study investigated the cost-effectiveness of the sodium intake reduction policy, for the first time, in Korea. Analyses were performed using most recent and representative data on national health insurance statistics, healthcare utilization, employment information, disease morbidity/mortality, etc. The socioeconomic benefits of the policy, resulting from reduced morbidity of those relevant diseases, included lower medical expenditures, transportation costs, caregiver cost for inpatients and income losses. The socioeconomic benefits from diminished mortality included reductions in earning losses and welfare losses caused by early deaths. It is estimated that the amount of total benefits of reducing sodium intake from 4.7 g to 3.0 g is 12.6 trillion Korean Won; and the size of its cost is 149 billion Won. Assuming that the effect of sodium intake reduction would become gradually evident over a 5-year period, the implied rate of average return to the sodium reduction policy is 7,790% for the following 25 years, suggesting a very high cost-effectiveness. Accordingly, development and implementation of a mid-to-long term plan for a consistent sodium intake reduction policy is extremely beneficial and well warranted.

Development of Nutrition Education Program for Hypertension Based on Health Belief Model, Applying Focus Group Interview / 대한지역사회영양학회지

Health Belief Model is a socio-psychological theory of decision making to individual health-related behaviors. This study was aimed to develop an effective education program for hypertension based on health belief model. The main factors of health belief model were investigated by focus group interview (FGI) with 23 hypertensive or prehypertensive subjects aged over fifty years. 'Perceived susceptibility' to hypertension was family history, neglect of health care, preference for salty food, broth of soup and stew. Lifelong medication, complications, and medical costs were reported as 'perceived severity' of hypertension. 'Perceived benefits' of hypertension management were decrease of medicinal dose, reduction of medical costs, and healthy eating habits of the family, while 'perceived barriers' were lack of palatability of low salt diet, convenience-oriented dietary habits, and limited choice of foods when eating out. Subjects mentioned TV health programs, public health center programs, and advice from doctors and family as 'cues to action' of hypertension management. These qualitative information provided basis for developing a nutrition education program for hypertension which could be implemented in the public health center. Eight week program was composed of understanding hypertension, risk factor management (eating habits, weight), low salt diet (principles, cooking), advanced management for healthy diet in 2 sessions, and summary. Each session was designed to alert the susceptibility and severity, to emphasize the benefits, and to reduce the barriers by providing dietary monitoring, practical advice, and action tips.

Measures for a closer-to-real estimate of dietary exposure to total mercury and lead in total diet study for Koreans

Previous Korean total diet studies (KTDSs) have estimated dietary exposure to toxic chemicals based on 110-120 representative foods selected from over 500 foods appeared in the Korea National Health & Nutrition Examination Surveys (KNHANES), which would result in a possible underestimation. In order to find measures for a closer-to-real estimate of dietary exposure to heavy metals, this study examined the feasibility of mapping foods to the representative foods in the KTDS by comparing estimates. In mapping, those foods not analyzed in the 2009 KTDS (443 out of 559 foods appeared in the 2007 KNHANES) were mapped to the 114 representative foods used in the 2009 KTDS based on the closeness in regards to biological systematics and morphological similarity. Dietary exposures to total mercury and lead were re-estimated using the content of total mercury and lead in 114 foods analyzed in the 2009 KTDS, food intake, and individual's own body weight for respondents in the 2007 KNHANES instead of mean body weight of Koreans used in the 2009 KTDS. The re-estimates of exposure with mapping were approximately 50% higher than the original estimates reported in the 2009 KTDS. In addition, mapping enabled the comparison of percentile distribution of the exposure among populations of different age groups. In conclusion, estimates via mapping resulted in a more comprehensive estimation of dietary exposure to heavy metals present in foods that Koreans consume.

Major Sources of Sodium Intake of the Korean Population at Prepared Dish Level: Based on the KNHANES 2008 & 2009 / 대한지역사회영양학회지

We attempted to define the sources of sodium intake for the Korean population at prepared dish level to provide a basis for developing sustainable nutrition policies and feasible programs for sodium intake reduction. Dietary intake data from 2008 and 2009 Korea National Health and Nutrition Examination Survey was used in the analysis for sodium intake sources. Sodium intake from individual dish consumed by each subject was calculated and used in delineating major sodium sources at dish and dish group level for sub-populations of different sex and age. Also, sodium intake was compared between eaters and non-eaters of some specific dish groups with considerable contribution to total sodium intake. The number of subjects included in the analysis was 18,022 and mean sodium intake was 4,600 mg/capita/day. Major sources of sodium intake at dish group level were in the following order: kimchi (1125 mg, 24.5%), noodles (572 mg, 12.4%), soups (488 mg, 10.6%), stews (399 mg, 8.7%), and cooked rice (284 mg, 6.2%). The magnitude of contribution to total sodium intake by soups and stews was different by age group. Sodium intake difference between eaters and non-eaters was much larger for kimchi group (2,343 mg for male, 1,452 mg for female) than for soups or stews. Interaction between consumption of aforementioned specific dish groups and age was highly significant (p < 0.0005) for both sexes. This study revealed an importance of having not only the control over sodium content of foods/dishes, but also the customized approach for different groups of population to accomplish an appreciable reduction in sodium intake.

Characteristics of Sodium Sensitivity in Korean Populations

Sodium sensitivity (SS) is a variable response of blood pressure (BP) to changes in sodium intake. The present study evaluated the existence and the characteristics of subjects with SS in Koreans. One hundred one subjects with (n = 31, 57.7 +/- 9.8 yr) or without hypertension (n = 70, 40.8 +/- 16.5 yr) were given a low-sodium dietary approache to stop hypertension (DASH) diet (LSD) for 7 days and a high-sodium DASH diet (HSD) for the following 7 days. The prevalence of SS in the present study population was 27.7% (17.6% in the non-hypertensive subjects and 51.6% in the hypertensive subjects). Analysis of the non-hypertensive subjects showed that systolic BP, diastolic BP, and mean arterial pressure at baseline and after HSD were higher in the subjects with SS than the subjects without SS, and there were no differences after LSD. In the hypertensive subjects, there was no difference in the BP at baseline and after HSD whether or not the subjects had SS. However, the systolic BP of hypertensive subjects with SS was lower than hypertensive subjects without SS after LSD. In the present study population, subjects with SS have distinctive BP features unlike to subjects without SS.

Influencing Factors on the Dietary supplements Consumption among Children in Korea / 대한지역사회영양학회지

With a recent increase in dietary supplements (DS) consumption among children in Korea, this study was performed to examine the influencing factors on children's DS consumption. A nationwide survey was conducted employing 3 representative samples of children for summer & fall of 2008 and spring of 2009 by stratified multistage sampling of 120 survey sites per season based on the 2005 census population. Approximately 30 households from each survey site were screened for residing children of 0-19 years and about 1,700 households remained as eligible samples per season. Trained dietitians visited households to perform face-to-face interview to children and/or parents regarding DS consumption including health functional foods (HFF), vitamins/minerals (V/M) supplements and other food supplements during 1 month prior to interview. Out of 5,328 children responded, 18.7% reported DS consumption. Consumption rate was higher in boys (19.9% vs. 17.3% in girls, P < 0.05) and youngsters (22.8% compared to 15.0% in adolescents, P < 0.001). Children from higher income family (P < 0.001), those living in apartments (P < 0.001), those residing in metropolitan area (P < 0.001), and those of mothers with higher education (P < 0.001) were more likely to take DS. Also, mother's employment status and occupation were significantly associated with children's DS consumption. The most popular DS was HFF (72.1%), which was consumed more in children of higher income family. It is revealed that socioeconomic factors affect children's DS consumption significantly. Also it is necessary to estimate children's V/M intake from DS and foods together especially because there are tolerable upper limits set for V/M for safety purposes.

Development of supplemental nutrition care program for women, infants and children in Korea: NutriPlus+

Onto the world-fastest ageing of society, the world-lowest fertility rate prompted a development of various policies and programs for a betterment of the population in Korea. Since the vulnerability of young children of low socio-economic class to malnutrition was clearly shown at the in-depth analysis of the 2001 Korea National Health and Nutrition Examination Survey data, an effort to devise supplemental nutrition care program for pregnant/breastfeeding women, infants and preschool children was initiated. The program was designed to offer nutrition education tailored to fit the needs of the participants and special supplementary foods, using USDA WIC program as a benchmark. Based on the dietary intake of those age groups, target nutrients were selected and their major food sources were searched through nutrient content of foods and dietary pattern analysis. As a result, we developed 6 kinds of food packages using combinations of 11 different food items. The amount of each item in a food package was determined to supplement the intake deficit in target nutrients. Nutrition education in NutriPlus + aims to improve the nutrition knowledge, attitude, and dietary behaviors of the participants, and is provided through group lessons, individual counseling sessions and home visits. Breastfeeding is promoted with top priority in education for the health of both mother and baby. The eligibility guidelines were set for residency, household income, age, pregnancy/breastfeeding and nutritional risk such as anemia, stunting, underweight, and/or inadequate nutrient intake. Income eligibility was defined as household income less than 200 percent of the Korean poverty guidelines. A pilot study to examine the feasibility of program implementation was run in 3 public health centers in 2005 and expanded to 15 and 20 in the following 2 years. The result of 3-year pilot study will be reported separately along with the ultimate nationwide implementation of the NutriPlus + in 2008.

2008 Dietary Goals and Dietary Guidelines for Korean Adults

Recently the Ministry of Health and Welfare, Republic of Korea, announced the "Dietary Guidelines for Korean Adults (DGKA)", which includes ten Dietary Goals, six Dietary Guidelines, and twenty-three Action Guidelines. DGKA are developed as the revision of the 2003 Dietary Guidelines for Koreans, targeting adult population. Dietary Guidelines are developed for general purpose as well as for different age groups. They are revised periodically to accommodate changes in diet and health problems of the population. The process of developing new DGKA can be summarized as 1) selection of focus areas, 2) analysis and review of available data for each area selected, and 3) derivation of guidelines based on the analyzed data, and 4) finalizing the guidelines after open discussions among the experts and general public. Five focus areas were selected by examining the Nutrition Goals of the Health Plan 2010 of Korea, soliciting proposals from the experts in the related fields, and reviewing existing and international guidelines. Five areas selected were 1) adequate intake of nutrients and foods, 2) balance of energy intake and physical activities, 3) alcohol intake, 4) food security and nutrition service, and 5) food safety. Adequacy of nutrient and food intakes of the Korean adult population was assessed using 2005 Korea National Health and Nutrition Examination Survey (KNHANES) data. Newly developed Dietary Reference Intakes for Koreans were used as reference values to assess the prevalence of inadequacies and excesses in nutrient intakes. Energy balance was examined with energy intake of 2005 KNHANES survey and results of physical activity questionnaire in the survey. Alcohol intake was also examined using 2005 KNHANES results of dietary intakes as well as the results of questionnaire survey on alcohol intakes. Food security, nutrition services, and food safety were analyzed using various government data and published results on the issues. Ten Dietary Goals and six Dietary Guidelines were developed after data analysis and were subjected to reviews of experts and general public. The final DGKA are: 1) Eat a variety of foods from each food group, 2) Increase physical activity and maintain healthy weight, 3) Eat proper amount of clean foods, 4) Avoid salty foods and try to eat foods with bland taste, 5) Avoid foods with high fat contents and deep-fried foods, and 6) When you drink alcohol, limit the amount. Twenty-three action guidelines are developed in order to achieve these guidelines in actual diet and life among the population. The government is disseminating the guidelines with "337" slogan and emblem. "337" indicates everyone should practice "3" guidelines of promoting good eating practice, "3" guidelines to limit or decrease in your diet, and you should practice them for "7" days a week. The guidelines will be useful in promoting healthy food habits and good nutritional status which will result in decrease nutrition related health problems in Korea.