Association between health financial capacity of local governments and health behaviors of local residents: a cross-sectional study / 대한지역사회영양학회지

Objectives@# The budget gap in the health sector of local governments affects the supply of health services, which can cause the health gap. This study classified local governments according to their financial characteristics, such as local financial independence and health budget level. It analyzed the health behaviors and disease prevalence of local residents to examine the effect of local government financial investment on the health of local residents. @*Methods@# To classify types according to the financial characteristics of local governments, financial independence and the health budget data for 17 local governments were collected from the local fiscal yearbook of the Ministry of Public Administration and Security. The prevalence of chronic diseases and healthy behavior was compared using the 16,333 data of adults between the ages of 30 and 65 years among the original data of the National Health and Nutrition Examination Survey (2016–2020). @*Results@# Cluster analysis was used to classify local governments into five clusters according to the health financial capacity type. A comparison of the prevalence of local residents by cluster revealed a similar prevalence of hypertension, diabetes, and hypercholesterolemia. On the other hand, the obesity rate (P < 0.01), high-risk drinking rate (P < 0.01), aerobic physical activity rate (P < 0.001), and healthy eating practice rate (P < 0.001) were significantly different. In addition, an analysis of the odds ratio based on the Seoul area revealed a higher risk of health behavior of non-Seoul residents. @*Conclusions@# It is necessary to review the universal health promotion project budget considering the degree of regional financial vulnerability from the viewpoint of health equity to narrow the health gap among regions.

Relationship between Complementary Feeding Introduction and Early Childhood Caries: Results from the Korea National Health and Nutrition Examination Survey 2008–2015 / 대한지역사회영양학회지

OBJECTIVES: This study examined whether the infant feeding type and duration are related to the introduction of complementary feeding, and whether the appropriate introduction of complementary feeding in infancy is related to tooth decay in toddlers. METHODS: The subjects were 1,521 toddlers among 2~3 year old children in the Korea National Health and Nutrition Examination Survey from 2008 to 2015. The toddlers were divided into the appropriate group (4~6 months) and delayed group (>6 months) according to the timing of complementary feeding introduction. RESULTS: The delayed group were 26.5% of subjects and the formula feeding period in the appropriate group and delayed group was 8.4 and 10.3 months, respectively (P=0.002). On the other hand, there was no difference in the breastfeeding period between the appropriate group and delayed group (P=0.6955). Early childhood caries was more common in the delayed group (P=0.0065). The delayed introduction of complementary feeding was associated with a risk of early childhood caries according to the logistic models (OR 1.81, 95% CI 1.27–2.57). CONCLUSIONS: The introduction of complementary feeding is associated with early childhood caries. Therefore, the importance of the proper introduction of complementary feeding in infancy should be emphasized, and public relations and education for maternal care and breastfeeding should be provided through health care institutions.

Relationship between Complementary Feeding Introduction and Early Childhood Caries: Results from the Korea National Health and Nutrition Examination Survey 2008–2015 / 대한지역사회영양학회지

OBJECTIVES: This study examined whether the infant feeding type and duration are related to the introduction of complementary feeding, and whether the appropriate introduction of complementary feeding in infancy is related to tooth decay in toddlers. METHODS: The subjects were 1,521 toddlers among 2~3 year old children in the Korea National Health and Nutrition Examination Survey from 2008 to 2015. The toddlers were divided into the appropriate group (4~6 months) and delayed group (>6 months) according to the timing of complementary feeding introduction. RESULTS: The delayed group were 26.5% of subjects and the formula feeding period in the appropriate group and delayed group was 8.4 and 10.3 months, respectively (P=0.002). On the other hand, there was no difference in the breastfeeding period between the appropriate group and delayed group (P=0.6955). Early childhood caries was more common in the delayed group (P=0.0065). The delayed introduction of complementary feeding was associated with a risk of early childhood caries according to the logistic models (OR 1.81, 95% CI 1.27–2.57). CONCLUSIONS: The introduction of complementary feeding is associated with early childhood caries. Therefore, the importance of the proper introduction of complementary feeding in infancy should be emphasized, and public relations and education for maternal care and breastfeeding should be provided through health care institutions.

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.

Investigation on Influencing Environmental Factors on Health Status of Korean Septuagenarians Dwelling in Longevity Region in Jeonla Province / 대한지역사회영양학회지

OBJECTIVES: To evaluate the critical environmental factors on healthy-aging of Korean people, we investigated the significant factors influencing health status of septuagenarians living in rural area of Jeonla province, known to be one of the representative longevity regions in Korea. METHODS: We divided subjects into healthy group (36M/25F) or poor-health group (26M/73F) based on self-reported health status, body mass index, a number of prescription, and blood test data. General characteristics, physical measurements, lifestyle, dietary behavior and nutrient intake, physical health and mental health data were statistically compared between the two groups. RESULTS: Average age was not different between healthy group and poor-health group in men and women, respectively. In men, significantly favorable factors to health were observed to be higher education, regular exercise, higher grip strength and walking function, body mass index (> or = 18.5 kg/m2), moderate frequency of drinking and eating-out, non-smoking, normal red blood cell (RBC) count, higher serum dehydroepiandrosterone-sulfate (DHEAS) level, good digestive function and appetite, normal hearing function, regular meals, adequate vegetable and fruit intake, diverse food intake, adequate energy and nutrients (protein, vitamin B1, B6, C and E, folate, niacin, P, Zn and K) intake, higher mini-nutrient status assessment (MNA) score and low level of depression. On the other hand, in women, those were literacy, living arrangement, moderate frequency of drinking, healthy teeth, higher grip strength and walking function, bone mineral density, normal RBC and white blood cell (WBC) count, higher DHEAS concentration, higher MNA score, normal cognition and memory function, having snack and adequate fruit intake. CONCLUSIONS: These results could be useful to plan effective strategies to increase health-life expectancy of Korean old people living in rural areas.

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.

Comparison of anthropometric data and clinical health indicators according to the serum vitamin B12 status in female older adults living in a rural area of Jeonla province, Korea / 한국영양학회지

Subclinical vitamin B12 deficiency is common in the elderly worldwide. We investigated the change of serum vitamin B12 concentration with aging and compared anthropometric data and clinical health indicators between normal (> or = 340 pg/mL) and low (< 340 pg/mL) serum vitamin B12 groups in 470 Korean women aged 65 years and over living in a rural area. Serum vitamin B12 concentration showed inverse correlation with age (r = -0.0992, p < 0.05). The normal B12 group showed significantly (p < 0.05) higher red blood cell count, hemoglobin, and hematocrit compared to the low B12 group, however, no difference in mean corpuscular volume was observed between the two groups. The normal B12 group showed significantly lower serum homocysteine concentration (p < 0.01) and prevalence of vitamin D (p < 0.01) or folate deficiency (p < 0.001). Bone mineral density (T-score) was significantly higher (p < 0.05) in the normal B12 group, compared with that in the low B12 group, and showed positive correlation (r = 0.1490, p < 0.01) with serum vitamin B12 concentration after adjusting for age, body weight, and body mass index. No differences in anthropometric data, physical activity, and smoking and drinking habits were observed between the two groups. In conclusion, it could be suggested that older female adults with normal serum vitamin B12 level would be less anemic and osteoporotic and more resistant to hyperhomocysteinemia associated chronic diseases than those with low serum vitamin B12 level.

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.

Anthropometric Index, Dietary Habits and Nutrient Intake of the Oldest-old Population Aged 95 and Over Living in Seoul / 대한지역사회영양학회지

The population aged 95 years and older in Seoul approximately increased to five-fold over the past 10 years, while nationwide rates increased to three-fold. In order to examine the dietary habit and nutritional status of oldest-old population living in Seoul, we recruited 87 subjects (25 males and 62 females) aged 95 years and older. The prevalence of underweight (BMI or = 25 kg/m2) were 18.2% and 18.2% in males, and 20.8% and 9.4% in females, respectively. In self-assessment of health, only 25.3% answered to be unhealthy. More males exercised regularly and reported a wide range of activities than females. The average of %Kcal from carbohydrate, protein and fat (C : P : F) was 64.9 : 13.8 : 21.2 in males and 68.1 : 14.2 : 17.7 in females. The average daily energy intake was 1,307 kcal in males and 1,304 kcal in females. More than 75% of subjects were taking under estimated average requirements (EAR) for vitamin B1, B2 & C and Ca. The average of mean adequacy ratio (MAR) was 0.66 in males and 0.70 in females, and 28.8% of males and 12.9% of females were in MAR < 0.50. Based on MAR, 32.0% of males and 14.5% females were classified as normal and 16.0% of males and 25.8% of females were classified as malnourished. Our subjects were taking more animal food, especially milk and its products, compared to those living, in rural areas. However, a significant proportion did not meet the EAR for vitamin B1, B2 & C and Ca.

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.

Development and Evaluation of a Nutrition Education Website for the Prevention and Management of Childhood Obesity / 대한지역사회영양학회지

Childhood obesity has rapidly increased worldwide and is one of the most serious health problems in this age group. In order to prevent and manage childhood obesity, we developed a nutrition education website. The website consisted of three parts. The first part was made for self-assessment with regard to obesity index, dietary habits, food frequency, dietary attitude, nutrition knowledge, nutrient intake, energy expenditure, and the stage of behavioral change, and tailored messages and advice according to the assessment results. A total of 612 real-size food photos as well as a nutrient database of 3,346 foods and 541 dishes were created to help children estimate nutrient intakes accurately. In addition, an energy expenditure database of 156 activities for children was established to calculate calorie consumption. The second part was made for setting long-term and short-term goals and keeping track of the changes in energy intake and expenditure in one's own page. The third part was made for education. Various types of nutrition information were provided; texts, pictures, calculators and games. The readability and design of the website were evaluated by 46 obese children. Usefulness, design and readability of the website were found to be desirable for children. This website is expected to be used by an obese child alone or with parents or nutrition teachers in order to control body weight through healthy dietary habits and physical activities. In addition, a non-obese child can also use this website for maintaining healthy dietary habits and preventing obesity.

Zinc status and growth of Korean infants fed human milk, casein-based, or soy-based formula: three-year longitudinal study

To evaluate the effect of feeding methods on growth and zinc nutritional status of infants early in life, we monitored from birth to 36 months in 51 infants who were exclusively fed human milk (HM, n = 20), casein-based formula (CBF, n = 12), or soy-based formula (SBF, n = 19) during the first five months of life. Zinc status was assessed by analyzing serum zinc concentrations and zinc intakes. Zinc contents in HM and formulas were measured. Zinc intake was estimated by weighing infants before and after feeding in the HM group and by collecting formula-intake records in the CBF and SBF groups. After solid foods were introduced, all foods consumed were also included to estimate zinc intake. The growth of infants in all groups was similar to that established for normal Korean infants. Human milk zinc concentrations declined as lactation progressed. Zinc concentrations in all formulas tested in this study were higher than HM and were also higher than those claimed by the manufacturers. During the first twelve months, mean serum zinc concentrations of infants were similar in all groups, although infants in the HM group consistently had the lowest zinc intake among the groups, and the overall zinc intake in infants fed SBF was highest. This finding could be explained by the different zinc bioavailability of HM and formulas. In conclusion, infants fed HM, CBF or SBF has normal growth up to three years of age, although HM contained the lowest zinc concentration followed by CBF, then SBF.

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.

Assessment of Food Consumption, Dietary Diversity and Dietary Pattern during the Summer in Middle Aged Adults and Older Adults Living in Gugoksoondam Logevity Area, Korea / 대한지역사회영양학회지

The purpose of this study was to investigate food intake, dietary diversity and dietary pattern during the summer in middle aged and older adults living in Gugoksundam (Gurye, Goksung, Sunchang and Damyang counties), Jeonla Province located in southern part of Korea and known as one of the representative Korean longevity areas. Food intake and dietary diversity were assessed by using the data from 2 day-24 hour recall of 1,051 subjects (394 males and 711 females) aged 45 years and older (45-93 years in male, 45-105 years in female). The average ages of males and females were 70.7 years and 71.1 years, respectively. Average total daily food intake was significantly decreased with aging in both genders, and the average animal food intake ratio to total food intake was ranged 10~14% in 3 different age groups, 45~64 years, 65~74 years and 75 years and older. The contribution of each food group, in weight, to total food intake showed the descending order of grains, fruits, vegetables and alcohols in males, and grains, fruits, potatoes and meats in females. On daily intake amount of each food item, rice, watermelon, soju, kimchi, and potato were ranked on top 5 in descending order in males, and rice, watermelon, potato, kimchi and ylmukimchi in females. On intake frequency, rice, kimchi, onion, green pepper and potato were ranked on top 5 in descending order in both genders. Dietary variety score (DVS) and dietary diversity score (DDS) for the assessment of dietary diversity and balance were significantly decreased with aging in both genders. In food group intake pattern (DMGFV), 01101 type without consumption of dairy and fruits was the most prevalent, and only 3.6% of male and 3.9% of female subjects showed 11111 type, consumed all the 5 food groups a day. Dietary pattern of subjects was analyzed by cluster analysis with 18 food groups intake. Overall dietary pattern was classified into two clusters, one was more desirable and the other was less desirable. The percentage of subjects with more desirable dietary pattern was about 15% in male and 32% in female. In conclusion, most of our subjects living in Gugoksundam area were taking very simple diet with low amount of dairy products and fruits. These results indicate that nutrition intervention and education for older people living in rural areas should be focused on various food intake including dairy products and fruits.

Anthropometric Index and Nutrient Intake in Korean Aged 50 Plus Years Living in Kugoksoondam Longevity-belt Region in Korea / 대한지역사회영양학회지

As the older adult period (> or = 65 y) is increasing, it is needed to investigate the trend of aging-dependent anthropomeric index and nutrient intake, and establish the more specific dietary guide for the different stages of aging period. To find the difference in nutrient intake among the Koreans aged 50-64, 65-74 and 75 years and older, and also any characteristics of dwellers in longevity area, we recruited 1,083 subjects (385 male and 698 female) aged 50-95 years (mean age, 71.3 yrs) living in Kugoksoondam area (Kurye, Goksung, Soonchang and Damyang counties), known as a longevity-belt region in Jeonlaprovince, Korea. We measured some anthropometric index and collected 2 day-dietary record. Nutrient intakes were analyzed by using DW24 program. The mean height and weight of subjects aged 75 years and older were lower than Korean national reference. BMI and obesity (BMI > or = 25 kg/m2) prevalence were significantly decreasing with aging. Underweight (BMI or = 80 cm) was very high in females (about 89%). In both genders, the average proportional contribution of carbohydrate, protein and fat to energy intake was not different between 65-74 years and 75 years and older. On overall, nutrient intake and quality of diet of females were inferior to those of males so that many of females aged 75 years and older assumed to be at risk of malnourished status. Fiber, folate and vitamin E intakes were substantially higher compared to those in 2007 KNHNES and other some studies in rural area. While almost nutrient %EAR was significantly decreased with aging in females, there was no significant difference in %EAR for protein, vitamin A, B1, B6, B12, niacin, Ca and Zn between 65-74 years and 75 years and older in males. Vitamin B2 for male aged 50-64 years, vitamin B2 and Ca for male aged 65 years and over and female aged 50-74 years, and vitamin B2, vitamin C, Ca and folate intake for female aged 75 years and older were assessed to be at risk to undernutrition based on the prevalence of intake below EAR. MAR of 13 nutrients and the number of nutrients consuming below EAR were significantly decreasing with aging in both genders, however, the number of nutrients of INQ < 1 and the average mini-nutritional assessment score were not significantly different between 65-74 years and 75 years and older. Taken together, decreasing tendency of nutrients intake and the quality of diet with aging was more evident in females than in males, and it is unique that our subjects consumed substantially higher fiber, folate and vitamin E compared to not only urban but also some other rural areas.

Development of an Eating Habit Checklist for Screening Elementary School Children at Risk of Inadequate Micronutrient Intake

The purpose of the study was to develop an eating habit checklist for screening elementary school children at risk of inadequate micronutrient intake. Eating habits, food intake, and anthropometric data were collected from 142 children (80 boys and 62 girls) in the 4th to 6th grades of elementary schools. Percentage of Recommended Intakes (RI) and Mean Adequacy Ratio (MAR) of six micronutrients; vitamin A, riboflavin, vitamin C, calcium, iron, zinc, and the number of nutrients the children consumed below EAR among the six nutrients were used as indices to detect the risk of inadequate micronutrient intake. Pearson correlation coefficients were calculated between eating habit scores andinadequate micronutrient intake indices in order to select questions included in the checklist. Meal frequency, enough time for breakfast, regularity of dinner, appetite, eating frequencies of Kimchi, milk, fruits and beans showed significant correlations with indices of inadequate micronutrient intake. Stepwise regression analysis was performed to give each item a different weight by prediction strength. To determine the cut-off point of the test score, sensitivity, specificity, and positive predictive values were calculated. The 8-item checklist with test results from 0 to 12 points was developed, and those with equal or higher than 6 points were diagnosed as high-risk group of inadequate micronutrient intake, and those with 4 or 5 points were diagnosed as moderate-risk group. Among our subjects 14.1% was diagnosed as high-risk group, and 30.3% as moderate-risk group. The proportions of the subjects who consumed below EAR of all micronutrients but vitamin C were highest in the high-risk group, and there were significant differences in the proportions of the subjects with intake below EAR of all micronutrients except vitamin B6 among the three groups. This checklist will provide a useful screening tool to identify children at risk of inadequate micronutrient intake.

Folate Content of Fast Foods and Processed Foods

A trienzyme extraction method (use of alpha-amylase, protease and folate conjugase) for food folate assay has been used to release folate from the food matrix. In order to reduce the incubation time with three enzymes, folate values were compared between two incubation protocols; separate incubation (SI, incubated with alpha-amylase and conjugase separately for 2 hours after protease treatment) and combined incubation (CI, incubated with alpha-amylase and conjugase together for 2 hours after protease treatment) using 88 food items from 12 kinds of fast foods and processed foods. We found that folate values by CI were comparable to or higher than those by SI, indicating that CI might be a better extraction procedure to shorten the entire incubation time. We measured folate contents in 49 fast foods and 26 processed foods by microbiological assay after CI. Mean folate contents of one serving of various burgers ranged from 43.1 to 62.0 microgram. One serving of French fries, pizza, sandwich and triangled kimbab contained a mean of 53.3, 28.4, 47.4, and 25.7 microgram of folate, respectively. Folate contents of non-alcoholic beverages were very low, ranging from 1.0 to 5.2 microgram/100 g. Some of our values were comparable to the values in the folate database published in Korean Nutrition Society, however, some of the published values were 140 times higher than the measured values in this study. Folate values measured by the more recent modifications here can be used to update Korean folate database to accurately estimate dietary folate intake

Development of an Eating Habit Checklist for Screening Elementary School Children at High Risk of Energy Overintake

The purpose of the study was to develop an eating habit checklist for screening elementary school children at high risk of energy overintake. Dietary habits, food intake, anthropometric data were collected from 142 children (80 boys and 62 girls) in the 4th to 6th grades of elementary schools. Energy intake, fat intake, and percentage of Estimated Energy Requirement (%EER) were used as indices to detect the risk of energy overintake of the children. Pearson correlation coefficients were calculated between dietary habit scores and energy overintake indices in order to select questions included in the checklist. TV watching during the meal, meal speed, meal amount, overintake frequency, eatingout frequency, snack frequency, frequency of eating Ramyun or fast foods showed significant correlations with energy overintake indices. Stepwise regression analysis was performed to give each item a different weight by prediction strength. To determine the cut-off point of the test score, sensitivity, specificity, and positive predictive values were calculated. The 7-item checklist with test results from 0 to 13 points was developed, and those with equal or higher than 5 points were diagnosed as a risk group of energy overintake. Among our subjects 13.4% was diagnosed as the risk group. Mean energy intake of the subjects in the risk group and the normal group were 2,650 kcal and 1,640 kcal, respectively. However, there were no significant differences of Index of Nutritional Quality (INQ) of the other nutrients except eating fiber between the risk group and the normal group. This checklist will provide a useful screening tool to identify children at high risk of energy overintake.

Additional Data for the Folate Database for Foods Common in Korea

A reliable nutrient database is a prerequisite for accurate calculation of dietary intakes. The folate database currently available in Korea, however, is not reliable because the values were obtained from published data in other countries using ineffective methods to extract folates from the food matrix. The purpose of this study was to complement the folate database by analyzing folate content in foods using a more effective method to extract food folates (trienzyme treatment). Folate content per unit weight was highest in laver, fermented soybeans, soybean, spinach, black soybeans, crown daisy, mung beans, and quail's egg in descending order. Legumes, leafy greens, eggs, and seaweeds were rich in folate, and meats, chicken, fish, and some fruits contained less folate. Some of the analyzed values were 10 times higher than those in the currently available database. Folate values of 423 foodcodes out of 2,932 foodcodes (14.4%) in the database in the 7th revision in the Recommended Dietary Allowances for Koreans can be replaced by those analyzed in this study. Since folate values of rice and Kimchi, which are core dishes of Koreans, in the newly established database are higher than those in the current database, folate intake assessed using our data will be higher than that using the current available database. Folate content in more foods commonly consumed in Korea are needed to update the folate database. Meanwhile, folate values presented here can be used to assess dietary folate intake of the Korean population.

Comparisons of Food Intake Patterns and Iron Nutritional Status by Dietary Iron Density Among College Students

Food intake patterns and iron nutritional status of male and female college students were studied based on dietary iron density. Dietary data were collected using the method of 24-hour recalls for 3 consecutive days from 106 students, and fasting blood were drawn to measure iron nutritional status indicators such as total iron binding capacity, serum iron, hematocrit, hemoglobin, and red blood cell count. Mean daily iron intakes of male and female students were 13.3mg and 10.0mg, which were 107% and 63% of the RDA, respectively. However, dietary iron density were similar between male and female students as 5.9mg/1,000kcal and 5.7mg/1,000kcal, respectively. The diets were divided into two groups according to iron density; high iron density group (6mg/1,000kcal or more) and low iron density group (less than 6mg/1,000kcal). The students in high density group had lower intakes of energy, especially fat, than those in low density group. Female students in high density group showed significantly higher intakes of iron, and non-heme iron and folate than those of low density group. The students in high density group consumed more rice, hamburger, and eggs, while those in low density group consumed more Ra-myon and alcoholic beverages. The students in high density group consumed greater proportions of iron from plant-origin foods. Vegetables, legumes and seasonings were the food groups that female students in high density group consumed significantly more than those in low density group. Also the percentages of female students with iron deficiency were higher in low density group. These results suggest that diet with high iron density is important to improve iron nutritional status of women, and further research about the effective way to increase iron density in our diet is needed.