Atherogenic index of plasma and its association with food group intake in Korean adults: based on the baseline data of KoGES-HEXA study / 한국영양학회지

Purpose@#The atherogenic index of plasma (AIP) is gaining recognition as a superior predictor of coronary artery disease. This study examined the relationship between the AIP and the intake of various food groups in Korean adults, using the baseline data from the Korean Genome and Epidemiology Study-The Health Examinees (KoGES-HEXA) study. @*Methods@#This study included 133,381 adults (46,288 men, 87,093 women) who completed the nutrition survey and biochemical tests of the KoGES-HEXA study. The AIP was calculated as the log (triglycerides/high-density lipoprotein-cholesterol) and was divided into quintiles according to sex for further analysis. Data on food group intake were obtained using the semi-quantitative food frequency questionnaire, and daily food group intake (g/d) was evaluated for each individual. The association between the food group intake and the AIP was examined using the linear regression analysis after adjusting for the confounding variables. @*Results@#In this study population, there was a positive correlation between energy intake and the AIP in men whereas an inverse assocation was shown in women (p < 0.001). In women, a rise in the AIP significantly correlated with an increased percentage of energy intake derived from carbohydrates but decreased percentages of energy from protein and fat (p < 0.001). In men and women, the consumption of grains and kimchi/pickles increased as the AIP rose, while the intake of legumes, nuts, meat and its products, eggs, fish, and milk and dairy products decreased. Among men, individuals in the highest AIP group showed higher intake of wheat products than those in the lowest group of the AIP. In women, the AIP was inversely correlated with potatoes and beverages consumption. @*Conclusion@#This study highlights the importance of a balanced diet, including various protein sources, milk and dairy products, legumes, and nuts, for preventing cardiovascular diseases. Further research into sex-specific dietary patterns is essential for tailoring appropriate dietary recommendations.

Dietary intake and food sources of essential fatty acids among Korean adolescents: a cross-sectional study based on the 2016–2021 KNHANES data / 대한지역사회영양학회지

Objectives@#This study evaluated dietary intake and food sources of essential fatty acids in Korean adolescents. @*Methods@#This study was comprised of 3,932 adolescents (9–18 years) who participated in the 2016–2021 Korea National Health and Nutrition Examination Surveys. Dietary intake and food sources of essential fatty acids, including alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and linoleic acid (LA) were evaluated using data obtained from one-day 24-hour dietary recall. The proportions of adolescents consuming ALA, EPA + DHA, and LA above or below the adequate intake (AI) of the 2020 Dietary Reference Intakes for Koreans were calculated. All statistical analyses accounted for the complex sampling design effect and appropriate sample weights. @*Results@#The mean intakes of ALA, EPA, DHA, and LA among Korean adolescents were 1.29 g/day, 69.6 mg/day, 166.0 mg/day, and 11.1 g/day, respectively. Boys had higher intakes of all essential fatty acids compared to girls. By age group, adolescents aged 15–18 years showed lower intakes of EPA and DHA compared to adolescents in younger age groups. The 9–11-yearold adolescents had lower intakes of ALA and LA than older adolescents. The proportions of adolescents who consumed more than AI were 35.7% for ALA, 30.4% for EPA + DHA, and 41.5% for LA. Adherence to the AI for ALA did not differ by sex or age group, although boys showed a lower adherence to the AI for EPA + DHA than girls. Major food sources for ALA and LA were plant-based oils, mayonnaise, pork, and eggs. Mackerel was the most significant contributor to EPA and DHA intake (EPA, 22.6%; DHA, 22.2%), followed by laver, squid, and anchovy. @*Conclusions@#The proportion of Korean adolescents who consumed EPA + DHA more than AI was low. Our findings highlight that nutrition education emphasizing an intake of essential fatty acids from healthy food sources is needed among Korean adolescents.

Food sources of zinc and nutritional status with usual dietary zinc intake in Korean toddlers and preschool children

BACKGROUND/OBJECTIVES@#This study aimed to evaluate the food sources of zinc and the usual intake of dietary zinc among Korean toddlers and preschool children. @*SUBJECTS/METHODS@#A total of 2,679 children aged 1–5 years was selected from the 2009– 2013 Korea National Health and Nutrition Examination Survey (KNHANES) data. Dietary data collected from a single 24-h recall were used to evaluate the food sources of zinc. To estimate usual zinc intake, the distribution obtained from single 24-h recall data in the total sample was adjusted using the ratio of within-to-between-person variance in zinc intake obtained from 2-day 24-h recall sub-sample data of the 2009 KNHANES. The proportion of children with usual zinc intake below the estimated average requirement (EAR) and above the tolerable upper intake level (UL) was assessed. @*RESULTS@#The main sources of zinc in Korean children were grains, dairy products, and meat.The mean usual intakes of zinc among all individuals, those aged 1–2 yrs, and those aged 3–5 yrs were 5.50, 5.01, and 5.83 mg/d, respectively. In all participants, 1.1% of the children consumed zinc below the EAR, whereas 10.7% exceeded the UL. The proportion of children with excessive zinc intake was 25.6% in the 1–2 yrs age group and 0.6% in the 3–5 yrs age group. @*CONCLUSIONS@#According to the current UL, the risk of excessive zinc intake appears to be high among Korean toddlers. Future studies that monitor the health effects of excessive zinc intake are needed to appropriately guide zinc intake in children.

Dietary Behaviors Associated with Health Perception of Korean Adolescents from Multicultural Families: based on data from the 2017 ~ 2019 Korea Youth Risk Behavior Surveys / 대한지역사회영양학회지

Objectives@#This study examined the association between dietary behaviors and perceived health status among Korean adolescents from multicultural families. @*Methods@#This cross-sectional study included 2,459 Korean adolescents from multicultural families (aged 13 ~ 18 years) who participated in the 2017 ~ 2019 Korea Youth Risk Behavior Surveys. Information on the sociodemographic variables, dietary behaviors, and lifestyle variables was selfreported using a web-based questionnaire. The dietary behaviors analyzed in this study were the breakfast and food intake frequencies, including fruit, vegetable, milk, fast food, carbonated drink, sweet drink, and high caffeine/energy drinks. The adolescents’ health perception was self-rated as healthy, average, or unhealthy. The dietary behaviors associated with health perception were examined using a multiple logistic regression after adjusting for the confounding variables. @*Results@#In this study population, 7.6% of adolescents perceived their health status as unhealthy, and 25.4% perceived it as average. The adolescents who were girls, middle school students, and in households with a low economic status showed significantly higher percentages of poor health perception (P-values < 0.001). Skipping breakfast was significantly associated with a negative health perception. Compared to the adolescents who consumed fruits every day, those who did not consume fruits during the previous week showed a higher odd ratio (OR) for a negative health perception [OR = 2.29, 95% confidence interval (CI) = 1.32–3.97]. The adolescents who frequently consumed carbonated drinks ( 5 times/week) perceived their health status as unhealthy relative to those who did not consume carbonated drinks (OR = 2.15, 95% CI = 1.25–3.71). Skipping breakfast was significantly associated with an increased OR for a negative health perception in girls but not in boys. Compared to adolescents with a normal weight, those with overweight/ obesity (OR = 1.75, 95% CI = 1.21–2.52) and underweight (OR = 2.19, 95% CI = 1.25–3.82) showed higher ORs for negative health perception. Positive associations of overweight/obesity and underweight with negative health perception were observed in boys but not in girls. @*Conclusions@#Dietary behaviors and weight status were associated with the health perception in Korean adolescents from multicultural families. These findings suggest that nutrition interventions on breakfast intake and healthy food choices for this population might effectively improve their weight and perceived health status.

Increasing trends in dietary total fat and fatty acid intake among Korean childr

BACKGROUND/OBJECTIVES@#The prevalence of obesity has been increasing in Korean children. As an unhealthy diet is known as one of the major determinants of childhood obesity, assessing and monitoring dietary fat intake of children is needed. @*SUBJECTS/METHODS@#This analysis included 9,998 children aged 3–11 yrs from the 2007– 2017 Korea National Health and Nutrition Examination Surveys. Dietary data were obtained from a single 24-h dietary recall. Intakes of total fat and fatty acids, including saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), polyunsaturated fatty acid (PUFA), n-3 fatty acid (n-3 FA), and n-6 fatty acid (n-6 FA) were evaluated as the absolute amount (g) and proportion of energy from each fatty acid (% of energy). The total fat and SFA intake were also assessed according to compliance with dietary guidelines. Linear trends in the dietary fats intake across the survey period were tested using multiple regression models. @*RESULTS@#Total fat intake significantly increased from 38.5 g (20.3% of energy) to 43.4 g (23.3% of energy) from 2007 to 2017. This increase was mainly accounted for the increases in intakes of SFA (7.2% to 8.4% of energy) and MUFA (6.2% to 7.5% of energy). PUFA intake increased from 4.4 to 4.7% of energy during the 11-yrs period: from 0.57 to 0.63% of energy for n-3 FA and from 3.8 to 4.1% of energy for n-6 FA. The proportions of children who consumed amounts exceeding the dietary guidelines for total fat and SFA significantly increased from 2007 to 2017, with increases from 9.8% to 17.4% for total fat and from 36.9% to 50.9% for SFA. @*CONCLUSIONS@#Prominent increasing trends in the consumption of total fat and SFA but tiny change in n-3 FA intake were observed in Korean children. The healthy intake of dietary fats should be emphasized in this population.

Food behaviors accounting for the recent trends in dietary fatty acid profiles among Korean adults

BACKGROUND/OBJECTIVES@#This study examined the changes in food behaviors of dietary fatty acids over 2007–2018 among Korean adults. @*SUBJECTS/METHODS@#This study used data from the 4th (2007–2009), 5th (2010–2012), 6th (2013–2015), and 7th (2016–2018) Korea National Health and Nutrition Examination Surveys. A total of 46,307 adults aged 19–64 yrs were selected and dietary data were obtained from a single 24-h recall. In the 4th and 7th data, the major food sources for each fatty acid based on the contributing percentage of the food item were compared. The consumption trends in the major food sources were presented as grams per day over 2007–2018 and compared across the survey periods using the multiple regression model. @*RESULTS@#From 2007 to 2018, for total fat, saturated fatty acid (SFA), and monounsaturated fatty acid, the contribution of animal food sources, including beef, chicken, and eggs increased but plant food sources (e.g., tofu, soybean, and plant oil) decreased. As polyunsaturated fatty acid sources, mayonnaise, eggs, and bread showed higher contributions, whereas soybean and tofu showed lower contributions in the 7th data compared to the 4th data. For n-3 fatty acids, the contribution of fish decreased between the 4th and 7th data. Over 12 yrs, the significant increases in the absolute amount of consumption from animal sources were observed. In contrast, decreases in the consumption from plant sources and fish were seen across the survey periods. @*CONCLUSIONS@#In Korean adults, increases in the intake of dietary fatty acids along with changes in the food behaviors during 2007–2018 have evoked great concern for SFA intake, which is a cardiovascular disease risk factor. Healthy food sources of dietary fatty acids should be emphasized in this population.

Association of added sugar intake with all-cause and cardiovascular disease mortality: a systematic review of cohort studies

BACKGROUND/OBJECTIVES@#The long-term health impacts of dietary sugar have begun to be reported. The committee on the 2020 Dietary Reference Intakes for Koreans for sugar intended to update the scientific evidence on the association of added sugar intake with health outcomes, including mortality. This study evaluated the evidence on the association of dietary sugar with the all-cause and cardiovascular disease mortality from cohort studies. @*SUBJECTS/METHODS@#The PubMed and ScienceDirect databases were searched until July 2021. The search terms were based on multiple combinations of keywords, such as added sugar, beverage, and mortality, included in the title or abstract. Two authors independently assessed the eligibility criteria of study selection and extracted the information from each selected article for this systematic review. @*RESULTS@#The literature search identified 276 articles. Seventeen cohort studies met the inclusion criteria and were included in this systematic review. This study extracted information on the cohort and participants, dietary assessment methods, exposure and its comparison groups, health outcomes, and risk measures. Five articles reported added sugar intake, and 15 articles reported the food sources of the added sugar in the association with mortality. Increased mortality was observed in higher added sugar intake and a lower intake of less than 5% of energy, while higher discrepancies between gender, age groups, and countries were noted. In addition, nutritious sugary foods and beverages did not increase mortality. @*CONCLUSIONS@#A ‘U’ or ‘J’ shaped relationship between the added sugar intake and mortality was estimated. The observed discrepancy indicated the need for more evidence to establish the dose-response relationship for Koreans.

Relationship between the Dietary Behavior of Young Children and Their Mothers in Daejeon, Korea Using the Nutrition Quotient for Preschoolers and Adults / 대한지역사회영양학회지

Objectives@#This study examined the association between the dietary behavior and weight status of preschool children and their mothers in Daejeon, Korea. @*Methods@#A total of 301 mother–preschool children (aged 3~6 years) dyads were included in this study. The dietary behavior of children and their mothers was assessed using the Nutrition Quotient (NQ) questionnaire for preschoolers and adults, respectively. The NQ questionnaires were completed by the mothers. The overweight/ obesity status of children and their mothers was determined using data on height and body weight reported by the mothers. Multiple logistic regression was performed to examine the relationship between the dietary behavior and weight status of children and their mothers. @*Results@#The mean NQ score was 58.9 ± 9.7 in children and 55.6 ± 9.2 in mothers. The NQ score was higher in boys than girls but did not vary by age. The prevalence of overweight/obesity was 27.5% in children and 46.5% in mothers. The physical activity level of mothers and their NQ scores were positively associated with the NQ scores of the children. After adjustment for covariates, the mothers in the highest tertile of NQ scores showed a lower odds ratio (OR) for the unhealthy dietary behavior of children (OR = 0.24, 95% CI = 0.11~0.53, P< 0.001) compared to those in the lowest tertile.The obese mothers showed a higher OR for children’s overweight/obesity (OR = 3.38, 95% CI = 1.68~6.80, P = 0.001) compared to normal weight mothers. @*Conclusions@#The dietary behavior and weight status of young children and their mothers were closely linked. Nutrition education programs targeting mothers are necessary for improving maternal and child nutrition. Specifically, these programs need to be tailored to the socioeconomic characteristics or weight status of mothers.

Regional Differences in Dietary Total Fat and Saturated Fatty Acid Intake and Their Associations with Metabolic Diseases among Korean Adults: Using the 2016~2019 Korea National Health and Nutrition Examination Surveys / 대한지역사회영양학회지

Objectives@#This study examined regional differences in the intake of dietary total fat and saturated fatty acid (SFA) and their food sources among Korean adults. We also investigated the associations of SFA intake with metabolic diseases by region. @*Methods@#This study included 13,926 adults ( 19y) who participated in the 2016 ~ 2019 Korea National Health and Nutrition Examination Surveys. The regions were divided into urban and rural areas according to the administrative districts where the participants lived. Using dietary data obtained from a 24-h recall, intake of total fat and SFA and their food sources were assessed by region. Metabolic diseases included obesity, abdominal obesity, and elevated total cholesterol and their association with SFA intake by region were examined using multiple logistic regression. @*Results@#Of the participants, 19.6% lived in rural areas. In urban areas, the total fat and SFA intakes were higher than in rural areas: 21.2% of energy (%E) came from total fat and 6.9%E from SFA in urban areas, whereas 18.0%E came from total fat and 5.8%E from SFA in rural areas. The percentage of participants who exceeded the dietary reference intakes for total fat and SFA in urban areas was 16.5% and 41.9%, respectively, but 43.4% of participants in rural areas showed lower intake levels for total fat compared to the reference level. Young adults did not show regional differences in fat intake, and the percentage of subjects who exceeded the reference for SFA was high both in urban (58.5%) and rural (55.7%) areas. Among middle-aged and older adults, intake of fatty acids except for n-3 fatty acid was significantly higher in urban areas than in rural areas. About 69% of older adults in rural areas showed a lower intake of total fat compared to the reference level. The food sources for total fat and SFA were meat, soybean oil, eggs, and milk in both areas. The intake of fat from eggs, milk, mayonnaise, and bread was higher in urban areas, but the intake of fat from white rice and coffee mix was higher in rural areas. The SFA intake was positively associated with elevated serum total cholesterol in urban areas (4th quartile vs. 1st quartile, OR: 1.22, 95% CI: 1.06-1.40, P for trend: 0.043), but not in rural areas.

Relationship between the Dietary Behavior of Young Children and Their Mothers in Daejeon, Korea Using the Nutrition Quotient for Preschoolers and Adults / 대한지역사회영양학회지

Objectives@#This study examined the association between the dietary behavior and weight status of preschool children and their mothers in Daejeon, Korea. @*Methods@#A total of 301 mother–preschool children (aged 3~6 years) dyads were included in this study. The dietary behavior of children and their mothers was assessed using the Nutrition Quotient (NQ) questionnaire for preschoolers and adults, respectively. The NQ questionnaires were completed by the mothers. The overweight/ obesity status of children and their mothers was determined using data on height and body weight reported by the mothers. Multiple logistic regression was performed to examine the relationship between the dietary behavior and weight status of children and their mothers. @*Results@#The mean NQ score was 58.9 ± 9.7 in children and 55.6 ± 9.2 in mothers. The NQ score was higher in boys than girls but did not vary by age. The prevalence of overweight/obesity was 27.5% in children and 46.5% in mothers. The physical activity level of mothers and their NQ scores were positively associated with the NQ scores of the children. After adjustment for covariates, the mothers in the highest tertile of NQ scores showed a lower odds ratio (OR) for the unhealthy dietary behavior of children (OR = 0.24, 95% CI = 0.11~0.53, P< 0.001) compared to those in the lowest tertile.The obese mothers showed a higher OR for children’s overweight/obesity (OR = 3.38, 95% CI = 1.68~6.80, P = 0.001) compared to normal weight mothers. @*Conclusions@#The dietary behavior and weight status of young children and their mothers were closely linked. Nutrition education programs targeting mothers are necessary for improving maternal and child nutrition. Specifically, these programs need to be tailored to the socioeconomic characteristics or weight status of mothers.

Association between Dietary Carbohydrate Intake and Cardiovascular Risk Factors According to Low-Density Lipoprotein Cholesterol Levels in Korean Adults

Background@#Low-density lipoprotein (LDL) cholesterol is a strong predictor of cardiovascular disease, resulting in the promotion of low-fat diets that emphasize the need to lower LDL cholesterol levels. We investigated the relationship between dietary carbohydrate intake and cardiovascular risk factors according to LDL cholesterol levels in Korean adults who typically consumed high-carbohydrate, low-fat diets. @*Methods@#A total of 25,925 Korean adults were selected from the 2007-2015 Korea National Health and Nutrition Examination Surveys. Dietary carbohydrate intake was grouped into quintiles and cardiovascular risk factors included obesity, metabolic syndrome, type 2 diabetes, and dyslipidemia. Multiple logistic regression models were used to examine association between carbohydrate intake and cardiovascular risk factors by sex and LDL cholesterol levels. @*Results@#Subjects with LDL cholesterol ≥130 mg/dL had significantly less energy and fat intake than those with LDL cholesterol <130 mg/dL both in men and women. In men, a higher carbohydrate intake was related to increased prevalence of atherogenic dyslipidemia and low high-density lipoprotein (HDL) cholesterol regardless of LDL cholesterol levels. Meanwhile, dietary carbohydrate intake was positively associated with low HDL cholesterol but inversely associated with hypercholesterolemia only in women with LDL cholesterol <130 mg/dL. @*Conclusions@#High carbohydrate intake in Korean adults is associated with low HDL cholesterol or atherogenic dyslipidemia regardless of LDL cholesterol levels. Carbohydrate intake should be carefully recommended according to the lipid profiles of individuals for the prevention and management of cardiovascular disease.

Association between Dietary Carbohydrate Intake and Cardiovascular Risk Factors According to Low-Density Lipoprotein Cholesterol Levels in Korean Adults

Background@#Low-density lipoprotein (LDL) cholesterol is a strong predictor of cardiovascular disease, resulting in the promotion of low-fat diets that emphasize the need to lower LDL cholesterol levels. We investigated the relationship between dietary carbohydrate intake and cardiovascular risk factors according to LDL cholesterol levels in Korean adults who typically consumed high-carbohydrate, low-fat diets. @*Methods@#A total of 25,925 Korean adults were selected from the 2007-2015 Korea National Health and Nutrition Examination Surveys. Dietary carbohydrate intake was grouped into quintiles and cardiovascular risk factors included obesity, metabolic syndrome, type 2 diabetes, and dyslipidemia. Multiple logistic regression models were used to examine association between carbohydrate intake and cardiovascular risk factors by sex and LDL cholesterol levels. @*Results@#Subjects with LDL cholesterol ≥130 mg/dL had significantly less energy and fat intake than those with LDL cholesterol <130 mg/dL both in men and women. In men, a higher carbohydrate intake was related to increased prevalence of atherogenic dyslipidemia and low high-density lipoprotein (HDL) cholesterol regardless of LDL cholesterol levels. Meanwhile, dietary carbohydrate intake was positively associated with low HDL cholesterol but inversely associated with hypercholesterolemia only in women with LDL cholesterol <130 mg/dL. @*Conclusions@#High carbohydrate intake in Korean adults is associated with low HDL cholesterol or atherogenic dyslipidemia regardless of LDL cholesterol levels. Carbohydrate intake should be carefully recommended according to the lipid profiles of individuals for the prevention and management of cardiovascular disease.

Evaluation of Total Fat and Fatty Acids Intakes in the Korean Adult Population using Data from the 2016–2017 Korea National Health and Nutrition Examination Surveys / 대한지역사회영양학회지

OBJECTIVES: This study evaluated dietary intakes of total fat and fatty acids among the Korean adult population. METHODS: This cross-sectional study used the 2016–2017 Korea National Health and Nutrition Examination Survey data. A total of 10,772 subjects aged ≥19 y for which dietary data were available were selected. Data pertaining to energy and nutrient intakes were obtained by a 24-h recall method. Total fat and fatty acids intakes were evaluated based on the Acceptable Macronutrient Distribution Ranges (AMDR) of 2015 Dietary Reference Intakes for Koreans by sex and age groups. All statistical analyses accounted for the complex sampling design effect and sampling weights. RESULTS: The mean intakes of energy and total fat were 1,952 kcal (95% CI: 1928–1977) and 46.1 g (45.2–47.1), respectively, and about 21% of the energy was obtained from fat in this study population (21.7% in men and 20.2% in women). The mean percentages of energy from saturated, monounsaturated, and polyunsaturated fatty acids were 6.4%, 6.7%, and 5.2%, respectively. About 18% of adults exceeded the AMDR for fat (30% of energy), whereas 37.6% exceeded the AMDR for saturated fatty acids (7% of energy). The proportions of subjects who consumed more than the AMDR for fat and saturated fatty acids decreased across age groups in both sexes. Among young adults (19–29 y), about 63% of the subjects obtained ≥7% of their energy from saturated fatty acids. About 61% of older adults obtained less than 15% of their energy from total fat. CONCLUSIONS: Increased intake of fat energy was prominent in saturated fatty acids. Our findings suggest current information on total fat and fatty acids intakes in Korean adults and can be used to provide dietary guidelines for the improvement of public health.

Contribution of foods to absolute nutrient intake and between-person variations of nutrient intake in Korean preschoolers

BACKGROUND/OBJECTIVES: The aim of this study was to analyze specific foods influencing absolute nutrient intake and between-person variations of nutrient intake among Korean preschoolers. SUBJECTS/METHODS: This study included 2,766 participants aged 1–5 years in the 2009–2013 Korea National Health and Nutrition Examination Surveys. Dietary data were obtained from a 24-h dietary recall method. Major food sources of absolute nutrient intake were evaluated based on percent contribution of each food. To assess the contribution of specific foods to between-person variations in nutrient intake, stepwise multiple regressions were performed and cumulative R2 was used. RESULTS: White rice and milk were main food sources of energy, protein, carbohydrate, phosphorus, iron, potassium, thiamin, riboflavin, and niacin. The percentage of fat contributed by milk was 21.3% which was the highest, followed by pork, soybean oil, and egg. White rice accounted for 25% and 40% of total variability in total energy and carbohydrate intakes, respectively. About 39% of variation in calcium intake was explained by milk while 40% of variation in phosphorous intake was explained by cheese. The top 10 foods contributing to between-person variations in nutrient intakes were similar with food items that mainly contributed to absolute nutrient intakes. The number of foods explaining 90% of absolute amounts of nutrient intakes varied from 28 for vitamin A to 80 for iron. CONCLUSIONS: This study identified specific foods that contributed to absolute nutrient intakes and between-person variations in nutrient intakes among Korean preschoolers. Our findings can be used to develop dietary assessment tools and establish food-based dietary guidelines for young children.

Assessment of dietary behaviors among preschoolers in Daejeon: using Nutrition Quotient for Preschoolers (NQ-P) / 한국영양학회지

PURPOSE: The aim of this study was to evaluate the dietary behaviors of preschoolers in Daejeon using the Nutrition Quotient for Preschoolers (NQ-P). METHODS: The study subjects were recruited from child-care centers and kindergartens located in Daedeok-gu, Daejeon between August and September 2018. A total of 411 preschoolers aged 3 ~ 6 years were included in the data analyses. A questionnaire of NQ-P, which consisted of 14 checklist items on dietary behaviors, was completed by the parents or guardians of the study subjects. The NQ-P scores and its three factors, including “balance”, “moderation”, and “environment” factors, were calculated according to sex, age, and weight status. Differences in the NQ-P scores and their factors according to sex, age, and weight status were tested using a student's t-test. RESULTS: The mean NQ-P score of the total subjects was 58.5 ± 9.2, which was within the medium-low grade. The NQ-P score was 58.5 ± 9.4 in boys and 58.6 ± 9.0 in girls (p = 0.955). The NQ-P score was similar regardless of the age groups (57.8 ± 9.4 in 3 ~ 4 years vs. 59.2 ± 9.0 in 5 ~ 6 years, p = 0.124), whereas subjects aged 5 ~ 6 years showed a significantly higher scores of environment factors than those aged 3 ~ 4 years (67.9 ± 16.8 vs. 61.7 ± 17.3). The mean score of the moderation factor was lower in the overweight/obese children compared to the non-overweight/obese children (46.6 ± 13.3 vs. 51.0 ± 16.2, p = 0.012). Compared to children aged 3 ~ 4 years, children aged 5 ~ 6 years had higher intakes of vegetable dishes and processed meat. The overweight/obese group showed a higher consumption of processed beverages than the non-overweight/obese group. CONCLUSION: The current study indicates that the dietary behaviors of preschoolers residing in Daejeon need to be improved. These findings suggest that nutrition education or health interventions targeting young children is necessary for improving their nutritional health status.

Dietary and Lifestyle Factors Associated with Weight Status among Korean Adolescents from Multicultural Families: Using Data from the 2017–2018 Korea Youth Risk Behavior Surveys / 대한지역사회영양학회지

OBJECTIVES: This study investigated dietary and lifestyle factors associated with the weight status among Korean adolescents in multicultural families.METHODS: This cross-sectional study analyzed 1,751 multicultural families' adolescents who participated in the 2017–2018 Korea Youth Risk Behavior Surveys. Information on dietary and lifestyle factors was self-reported using a web-based questionnaire and this information included breakfast and foods consumption, perceived health status, alcohol drinking, smoking, physical activity, and weight control efforts. Body mass index (BMI) was calculated based on the self-reported height and body weight (kg/m²). Weight status was assessed according to the 2017 Korean National Growth Chart: underweight (weight-for-age <5(th) percentiles), overweight (85(th)≤ BMI-for-age <95(th) percentiles), and obese (BMI-for-age ≥95(th) percentiles). Multiple logistic regression analysis was performed to examine the dietary and lifestyle factors associated with weight status after adjustment for covariates.RESULTS: Among Korean adolescents from multicultural families, the prevalence of overweight/obesity was 20.9%, whereas about 7% of adolescents were underweight. The weight status did not show differences according to gender, school level, area of residence, and household income. Compared to adolescents who did not have breakfast during the previous week, those who had breakfast 3–4 days/week and ≥5 days/week had a 42% (p=0.021) and a 37% (p=0.009) lower prevalence of overweight/obesity, respectively. The adolescents who frequently consumed carbonated soft drinks (≥5 times/week) showed an odds ratio (OR) of 1.69 (95% CI=1.01–2.83) for overweight/obesity relative to those adolescents who did not consume carbonated soft drinks. The OR of being underweight for adolescents who ate fast food ≥3 times/week was 1.97 (95% CI=1.04–3.71) compared to those adolescents who had not eaten fast food during the previous week.CONCLUSIONS: Dietary and lifestyle factors were associated with overweight/obesity as well as underweight among Korean adolescents in multicultural families. Our findings could be used to design and provide nutrition interventions for this specific population.

Dietary intake of fat and fatty acids by 1–5-year-old children in Korea: a cross-sectional study based on data from the sixth Korea National Health and Nutrition Examination Survey

BACKGROUND/OBJECTIVES: We examined dietary fat intake and the major food sources by young children in Korea. SUBJECTS/METHODS: A total of 1,041 children aged 1–5 years were identified from the 2013–2015 Korea National Health and Nutrition Examination Survey. Data on total fat and fatty acid intake were obtained by a single 24-h dietary recall. Food sources were identified based on the amounts of total fat and fatty acids consumption according to each food. Fat and fatty acid intakes and their food sources were presented by age group (1–2-y, n = 401; 3–5-y, n = 640). Fat and fatty acid intakes were also evaluated according to socioeconomic characteristics. RESULTS: The mean intake of fat was 27.1 ± 0.8 g in the 1-2-y group and 35.5 ± 0.7 g in the 3-5-y group, and about 23% of the total energy was obtained from fat in both age groups. The mean intake of saturated fatty acids (SFA) was 10.5 ± 0.3 g in the 1-2-y group and 12.7 ± 0.3 g in the 3-5-y group, with the 1-2-y group obtaining more energy from SFA than the 3-5-y group (9.2% vs. 8.3%). The mean intake of polyunsaturated fatty acids (PUFA) was 6.3 ± 0.1 g in the total subjects, with 0.8 ± 0.03 g of n-3 fatty acids and 5.5 ± 0.1 g of n-6 fatty acids being consumed. Milk, pork, and eggs were major food sources of total fat, SFA, and monounsaturated fatty acids, and soybean oil was the main contributor to PUFA in both age groups. In the 1-2-y group, children in rural areas had significantly higher intake of PUFA and n-3 fatty acids than did those in urban areas. CONCLUSIONS: Our findings provide current information on dietary fat intake among young Korean children and could be used to establish dietary strategies for improvement of health status.

High-Carbohydrate Diets and Food Patterns and Their Associations with Metabolic Disease in the Korean Population

PURPOSE: Although an Asian diet is typically high in carbohydrate and low in fat, there has been a steady increase in the rate of cardiometabolic disease in Asian countries over the past decade. We evaluated food patterns of a high-carbohydrate diet and examined their associations with metabolic disease. MATERIALS AND METHODS: Using data from the 2013–2015 Korean National Health and Nutrition Examination Survey, we included a total of 13106 subjects aged 20 years or older in this study. Diet was divided into seven groups according to the percentage of energy from carbohydrates. Food patterns were evaluated as individual servings per food group. Multivariate logistic regression was conducted to estimate odds ratios (OR) for metabolic disease. RESULTS: The proportions of men and women exceeding the recommended range of carbohydrate intake were 58.0% and 60.0%, respectively. A higher carbohydrate diet was associated with intake of low energy and saturated fats, with more grains and fruit, but less meat, fish, egg, bean (MFEB), and dairy consumption. Carbohydrate intake decreased by 3.0–3.4% per serving of MFEB and milk. In men, the highest carbohydrate group showed an OR of 1.35 [95% confidence interval (CI), 0.91 to 1.99] for metabolic syndrome, although this failed to show statistical significance. In women, the highest carbohydrate group had an OR of 1.38 (95% CI, 1.06 to 1.80) for a reduced level of high-density lipoprotein cholesterol. CONCLUSION: This study suggests that a very-high-carbohydrate diet for the Korean population is attributable to lower consumption of MFEB and dairy products and is associated with several metabolic risk factors. The appropriate distribution of macronutrients for the prevention and management of metabolic disease should be explored.

Association between nutrient intake and serum high sensitivity C-reactive protein level in Korean adults: Using the data from 2015 Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: There have been limited studies investigating the relationship between high-sensitivity C-reactive protein (hsCRP), metabolic diseases, and dietary factors in Korean adults. Here, we examined the association between nutrient intake and serum hsCRP among Korean adults. METHODS: Using data on 2,624 healthy Korean adults (1,537 women and 1,087 men) from the 2015 Korea National Health and Nutrition Examination Survey, demographic, anthropometric, biochemical, and dietary factors were analyzed once the subjects were grouped into either sex, age, or BMI. Nutrient intake was evaluated using the dietary data obtained by one-day 24-hour recall. Based on the guidelines of the US Centers for Disease Control and Prevention and the American Heart Association, hsCRP level was classified as HCRPG (High CRP Group, hsCRP > 1 mg/L) and LCRPG (Low CRP Group, hsCRP ≤ 1 mg/L). Proc surveyreg procedure was performed to examine the associations between nutrient intake and hsCRP after adjustment for potential confounding variables. RESULTS: The average hsCRP level of healthy Korean adults was 0.95 ±0.03 mg/L (0.97 ±0.04 mg/L in men, 0.92 ±0.05 mg/L in women). Obese subjects had significantly higher hsCRP than non-obese subjects in both sexes. The hsCRP level was positively associated with current smoking, physical inactivity, BMI, waist circumference, fasting blood glucose, triglycerides, total cholesterol, LDL-cholesterol, and blood pressure and inversely associated with HDL-cholesterol. LCRPG had significantly higher intake of dietary fiber compared to HCRPG in women. High hsCRP level was associated with more dietary cholesterol intake but less omega-3 fatty acid intake among subjects aged ≥ 50y. HCRPG of obese subjects had higher intakes of fat and saturated fatty acid than LCRPG. CONCLUSION: The hsCRP level is closely associated with several lifestyle variables and nutrient intake in healthy Korean adults. Individuals with high hsCRP level show low intakes of dietary fiber and omega-3 fatty acids but high intakes of dietary fat and cholesterol. Our findings suggest that a potential anti-inflammatory role for nutrients and lifestyle in the Korean adult population.

The association of snack consumption, lifestyle factors, and pediatric obesity with dietary behavior patterns in male adolescents / 한국영양학회지

PURPOSE: Along with the adaptation of a Western dietary pattern and low physical activity, pediatric obesity is increasing in Korea, especially for boys. The aim of this study was to identify dietary behavior patterns and examine the snack consumption, dietary habit, and pediatric obesity by pattern groups. METHODS: Boys aged 15~19 years were recruited from one high school in Seoul. A questionnaire including dietary behaviors and lifestyle factors was administered and height and weight were measured. A total of 932 boys participated except boys who had missing or incomplete response (n = 30). Three dietary behavior patterns were identified by cluster analysis; 'Healthy pattern', 'Mixed pattern' and 'Unhealthy pattern'. RESULTS: Snack consumption differed according to dietary behavior patterns group. The healthy and mixed patterns showed higher frequencies of white milk and fruit consumption while the unhealthy pattern as well as the mixed patterns showed higher frequencies of sweetened snack and ice cream consumption. Food availability at home of each food differed according to pattern groups but showed a similar trend with food consumption. Regarding dietary habits, the mixed pattern showed higher proportion of taking dietary supplement and eating dessert while the unhealthy pattern showed lower proportion of eating regular meals and appropriate amount of meals. When the healthy pattern was set as a reference group, the odds ratio of pediatric obesity was 1.11 (CI 0.65-1.87) in the mixed pattern group and 1.88 (CI 1.14-3.10) in the unhealthy pattern group. CONCLUSION: In conclusion, dietary behaviors including snack consumption and lifestyle factors were connected. Unbalanced diet and undesirable dietary practice are important determinants in pediatric obesity.