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.

Growth, Nutritional Status, and Dietary Intake Patterns Associated With Prolonged Breastfeeding in Young Korean Children: A Nationwide Cross-Sectional Study

Background@#Although the optimal duration of breastfeeding remains unclear, breastfeeding is generally recommended exclusively for the first 6 months of life, which continues into late infancy. However, the awareness regarding the effects of long-term breastfeeding is relatively low compared with that of breastfeeding in early infancy. We aimed to investigate the growth and nutritional characteristics of the children with prolonged breastfeeding (PBF) over 1 year. @*Methods@#This cross-sectional study was based on the data of children aged 12 to 23 months from the National Health and Nutrition Examination Survey (2010–2020) conducted by the Korean Center for Disease Control and Prevention. Data on anthropometric measurements, dietary behavior, and food and nutrient intake were extracted, and the association between PBF and growth, nutritional status, and dietary patterns were analyzed. @*Results@#Of the 872 children with a birth weight of ≥ 2.5 kg in the final analysis, 34.2% continued breastfeeding over 12 months of age, and their median breastfeeding duration was 14.2 months. Children with PBF were more likely to have lower current body weight (P < 0.001) and weight gain (P < 0.001), lower daily protein (P = 0.012), calcium (P < 0.001), and iron (P < 0.001) intake per calorie compared with children weaned by 12 months of age or those who were never breastfed. Furthermore, they were started on complementary food at 6 months or later rather than 4–5 months (P < 0.001), consumed cow’s milk earlier (P = 0.012), and consumed probiotics as dietary supplements (P < 0.001) significantly less commonly. When comparing the intake of food groups, children with PBF had a significantly higher intake of cereals and grains (P = 0.023) and fruits (P = 0.020) and a significantly lower intake of bean products (P = 0.020) and milk and dairy products (P = 0.003). @*Conclusion@#Korean children who continued breastfeeding over 12 months of age showed distinct characteristics in terms of growth, nutritional status, and dietary patterns in the second year of life compared to children who did not. Long-term additional research on their growth and nutritional status may be needed; however, these findings are significant as important fundamental data for nutritional counseling to establish healthy PBF.

Problems Encountered in Analyzing the Market Size, Purchase, and Consumption of HMR in the Republic of Korea / 대한지역사회영양학회지

Objectives@#This study examined the problems encountered when analyzing the market size, purchase, and consumption of HMR (home meal replacements) in the Republic of Korea. @*Methods@#The macro data relevant to the market size and purchase status of HMR were critically summarized. The micro data retrieved from the 2019 & 2020 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed to understand the consumption of HMR. @*Results@#The Korea Agro-Fisheries & Food Trade Corporation and the Ministry of Food and Drug Administration reported the market size of HMR, whereas the Korean Rural Economic Institute and the Rural Development Administration reported the purchase expense and frequencies of HMR. Since the values on the market size and purchase status were calculated or surveyed using different scopes of HMR, there have been reliability issues for the data presented. Additionally, lack of consensus on the use of Korean terms corresponding to HMR was found to be a problem. To examine the consumption of HMR, analysis of the food intake data from KNHANES presented results with very low validity due to the inappropriate survey and coding scheme not reflecting the inclusion of new food types. @*Conclusions@#Several problematic discrepancies were encountered in the statistics on HMR. The fundamental cause of these problems was the absence of agreement on the scope of HMR and the Korean terms corresponding to it. Considering the increasing importance of HMR in Korean diets, urgent cooperative efforts are required between the government and academia to derive an agreed Korean term and establish the scope of HMR.

Inter-eye Comparison of the Lamina Cribrosa Depth in Patients with Bilateral Normal-tension Glaucoma with Asymmetrical Damage

Purpose@#To evaluate the association between lamina cribrosa depth (LCD) and the severity of glaucomatous damage in patients with normal-tension glaucoma (NTG). @*Methods@#The optic nerve heads (ONHs) of patients with bilateral NTG showing asymmetrical damage were scanned using spectral-domain optical coherence tomography. LCDs were measured on ONH horizontal B-scan images at three locations equidistant across the vertical optic disc diameter and compared between the more damaged and contralateral eyes. Conditional logistic regression analysis was performed to identify ocular risk factors associated with more severe damage between the eyes. @*Results@#One hundred and four eyes of 52 patients with bilateral NTG were included. The mean age was 66.0 ± 15.0 years; there were 31 males and 21 females. The more damaged eyes exhibited a higher baseline intraocular pressure (IOP) (p < 0.001), a thinner global retinal nerve fiber layer thickness (p < 0.001), and worse visual field mean deviation (p < 0.001) and a pattern standard deviation (p < 0.001), than the contralateral eyes. In contrast, we found no significant inter-eye difference in either the spherical equivalent or the axial length. The average LCD was significantly larger in the more damaged eyes (529.4 ± 116.7 vs. 482.9 ± 107.5 μm, p < 0.001). On conditional logistic regression analysis, the higher the baseline IOP (p = 0.006) and the larger the LCD (p = 0.003), the higher the risk of having more severe damage compared to the contralateral eye under similar systemic conditions. @*Conclusions@#The LCD was significantly larger in the more damaged eyes of patients with bilateral NTG, suggesting that LC deformation might be associated with glaucomatous ONH damage in NTG eyes.

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.

Correlation between Physical Activity and Lung Function in Dusty Areas: Results from the Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) Cohort / 결핵및호흡기질환

BACKGROUND@#Although physical activity is known to be beneficial to lung function, few studies have been conducted to investigate the correlation between physical activity and lung function in dusty areas. Therefore, the purpose of this study is to investigate the correlation between physical activity and lung function in a Korean cohort including normal and COPD-diagnosed participants.@*METHODS@#Data obtained from the COPD in dusty areas (CODA) cohort was analyzed for the following factors: lung function, symptoms, and information about physical activity. Information on physical activity was valuated using questionnaires, and participants were categorized into two groups: active and inactive. The evaluation of the mean lung function, modified Medical Research Council dyspnea grade scores, and COPD assessment test scores was done based on the participant physical activity using a general linear model after adjusting for age, sex, smoking status, pack-years, height, and weight. In addition, a stratification analysis was performed based on the smoking status and COPD.@*RESULTS@#Physical activity had a correlation with high forced expiratory volume in 1 second (FEV₁) among CODA cohort (p=0.03). While the active group exhibited significantly higher FEV₁ compared to one exhibited by the inactive group among past smokers (p=0.02), no such correlation existed among current smokers. There was no significant difference observed in lung function after it was stratified by COPD.@*CONCLUSION@#This study established a positive correlation between regular physical activity in dusty areas and lung function in participants.

Identification of Serial DNA Methylation Changes in the Blood Samples of Patients with Lung Cancer / 결핵및호흡기질환

BACKGROUND@#The development of lung cancer results from the interaction between genetic mutations and dynamic epigenetic alterations, although the exact mechanisms are not completely understood. Changes in DNA methylation may be a promising biomarker for early detection and prognosis of lung cancer. We evaluated the serial changes in genome-wide DNA methylation patterns in blood samples of lung cancer patients.@*METHODS@#Blood samples were obtained for three consecutive years from three patients (2 years before, 1 year before, and after lung cancer detection) and from three control subjects (without lung cancer). We used the MethylationEPIC BeadChip method, which covers the 850,000 bp cytosine-phosphate-guanine (CpG) site, to conduct an epigenome-wide analysis. Significant differentially methylated regions (DMRs) were identified using p-values <0.05 in a correlation test identifying serial methylation changes and serial increase or decrease in β value above 0.1 for three consecutive years.@*RESULTS@#We found three significant CpG sites with differentially methylated β values and 7,105 CpG sites with significant correlation from control patients without lung cancer. However, there were no significant DMRs. In contrast, we found 11 significant CpG sites with differentially methylated β values and 10,562 CpG sites with significant correlation from patients with lung cancer. There were two significant DMRs: cg21126229 (RNF212) and cg27098574 (BCAR1).@*CONCLUSION@#This study revealed DNA methylation changes that might be implicated in lung cancer development. The DNA methylation changes may be the possible candidate target regions for the early detection and prevention of lung cancer.

Identification of Serial DNA Methylation Changes in the Blood Samples of Patients with Lung Cancer / 결핵

BACKGROUND: The development of lung cancer results from the interaction between genetic mutations and dynamic epigenetic alterations, although the exact mechanisms are not completely understood. Changes in DNA methylation may be a promising biomarker for early detection and prognosis of lung cancer. We evaluated the serial changes in genome-wide DNA methylation patterns in blood samples of lung cancer patients. METHODS: Blood samples were obtained for three consecutive years from three patients (2 years before, 1 year before, and after lung cancer detection) and from three control subjects (without lung cancer). We used the MethylationEPIC BeadChip method, which covers the 850,000 bp cytosine-phosphate-guanine (CpG) site, to conduct an epigenome-wide analysis. Significant differentially methylated regions (DMRs) were identified using p-values <0.05 in a correlation test identifying serial methylation changes and serial increase or decrease in β value above 0.1 for three consecutive years. RESULTS: We found three significant CpG sites with differentially methylated β values and 7,105 CpG sites with significant correlation from control patients without lung cancer. However, there were no significant DMRs. In contrast, we found 11 significant CpG sites with differentially methylated β values and 10,562 CpG sites with significant correlation from patients with lung cancer. There were two significant DMRs: cg21126229 (RNF212) and cg27098574 (BCAR1). CONCLUSION: This study revealed DNA methylation changes that might be implicated in lung cancer development. The DNA methylation changes may be the possible candidate target regions for the early detection and prevention of lung cancer.

Correlation between Physical Activity and Lung Function in Dusty Areas: Results from the Chronic Obstructive Pulmonary Disease in Dusty Areas (CODA) Cohort / 결핵

BACKGROUND: Although physical activity is known to be beneficial to lung function, few studies have been conducted to investigate the correlation between physical activity and lung function in dusty areas. Therefore, the purpose of this study is to investigate the correlation between physical activity and lung function in a Korean cohort including normal and COPD-diagnosed participants. METHODS: Data obtained from the COPD in dusty areas (CODA) cohort was analyzed for the following factors: lung function, symptoms, and information about physical activity. Information on physical activity was valuated using questionnaires, and participants were categorized into two groups: active and inactive. The evaluation of the mean lung function, modified Medical Research Council dyspnea grade scores, and COPD assessment test scores was done based on the participant physical activity using a general linear model after adjusting for age, sex, smoking status, pack-years, height, and weight. In addition, a stratification analysis was performed based on the smoking status and COPD. RESULTS: Physical activity had a correlation with high forced expiratory volume in 1 second (FEV₁) among CODA cohort (p=0.03). While the active group exhibited significantly higher FEV₁ compared to one exhibited by the inactive group among past smokers (p=0.02), no such correlation existed among current smokers. There was no significant difference observed in lung function after it was stratified by COPD. CONCLUSION: This study established a positive correlation between regular physical activity in dusty areas and lung function in participants.

Distribution and Exposure Prevalence of Carbohydrate-based Food Intake among Obese Korean Adults Based on the Health Examinees (HEXA) Study / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to estimate the distribution and exposure prevalence of total carbohydrate intake and the carbohydrate-based foods such as rice, noodles, sweet potatoes, sweet drinks, milk and fruits and to characterize intake patterns among obese Korean adults. METHODS: Subjects included 137,363 adults aged 40 years or older who participated in a Health Examinees (HEXA) Study. Multiple regression analysis of data from Semi-Quantitative Food Frequency Questionnaire (SQFFQ) identified food sources of carbohydrates. Weight, height and waist circumstance (WC) were measured, and the body mass index (BMI) was calculated. Obesity was defined as BMI ≥ 25 kg/m2 and abdominal obesity as WC ≥ 90 cm and ≥ 85 cm for males and females, respectively. RESULTS: Obese adults appeared to have a higher total carbohydrate intake in the univariate analysis but had eaten less after adjustment for general and lifestyle factors, compared to normal weight adults (OR 0.78, 95% CI 0.73-0.82 for general obesity; OR 0.79, 95% CI 0.74-0.85, for abdominal obesity; P trend < 0.0001, respectively). Based on advance analysis for the food sources of carbohydrates, obese subjects had lower intake of rice (OR 0.86, 95% CI 0.68 -1.09 for general obesity; OR 0.87, 95% CI 0.67-1.13, for abdominal obesity; P trend < 0.0001, respectively) and higher intake of noodles (OR 1.21, 95% CI 1.16-1.27 for general obesity; OR 1.25, 95% CI 1.19-1.32, for abdominal obesity; P trend < 0.0001 respectively). With regard to other food sources of carbohydrates such as milk and fruits, intake was lower among obese compared to normal weight subjects. CONCLUSIONS: In the Korean middle-aged and older obesity groups, the intake of carbohydrates and the related foods was lower than in normal weight subjects, except for noodles. We conclude that a higher intake of noodles may enhance weight-gain. Therefore, this study suggested that the guidelines should consider the types of carbohydrate sources and the amount consumed from foods in order to provide proper guidance with regard to control and prevent obesity among Korean adults.

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.

Association of Antioxidants With Allergic Rhinitis in Children From Seoul

PURPOSE: The prevalence of allergic diseases has risen over the last few decades. Many factors, including environmental factors such as those related to diet, have been considered. Among dietary factors, intake of antioxidant-related nutrients has been associated with the risk of allergic disease. We investigated the association of antioxidant nutritional status with allergic rhinitis (AR) in Korean schoolchildren aged 6-12 years. METHODS: Subjects were 4,554 children in Seoul, Korea. The risk of allergic disease was measured using the Korean version of the International Study of Asthma and Allergies in Childhood, and dietary intake was measured by a semi-quantitative food frequency questionnaire. Intake of vitamins A (including retinol and beta-carotene), C, and E was used in the analysis. RESULTS: Vitamin C intake was negatively associated with an increased risk of current symptoms (adjusted odds ratio, 0.886; 95% confidence interval, 0.806-0.973). There was no association between AR and intake of vitamin A, retinol, beta-carotene, or vitamin E. Total serum IgE level and sensitization to allergen did not differ according to nutrient intake. CONCLUSIONS: The group of children with increased vitamin C consumption had fewer AR symptoms, despite the lack of a difference in total serum IgE level or allergen sensitization. These findings suggest that nutrient intake, especially that of vitamin C, influences AR symptoms.

Weight Status and Dietary Factors Associated with Sugar-Sweetened Beverage Intake among Korean Children and Adolescents: Korea National Health and Nutrition Examination Survey, 2008-2011

There has been growing concern about the role of sugar-sweetened beverages (SSBs) in the development of obesity. This study investigated factors associated with SSB intake among Korean children (7-12 years) and adolescents (13-18 years). We examined associations between SSB intake and demographic and dietary factors using nationally representative data from the 2008-2011 Korea National Health and Nutrition Examination Survey, and 3,179 children and 2,242 adolescents were included in the final analysis. We calculated adjusted odds ratios (ORs) for factors associated with high SSB intake (> or = 300 ml/day) by multivariable logistic regression. The mean daily SSB intake of school children was 98.7 ml/day, with a mean of 64.7 ml/day for those aged 7-12 years and 120.2 ml/day for those aged 13-18 years. SSB intake of > or = 300 ml/day was found in 12.0% of the children and adolescents. Factors associated with a greater OR for high SSB intake were high energy intake (> or = 125% of EER; OR = 3.17 for boys aged 7-12 years, OR = 2.74 for girls aged 7-12 years, OR = 3.0 for girls aged 13-18 years), low milk consumption (< 1 cup/day; OR = 1.93 for boys aged 7-12 years; OR = 2.53 for girls aged 7-12 years; OR = 1.83 for boys aged 13-18 years), and not meeting the recommended fruit and vegetable intake (< 400 g/day; OR = 1.71 for boys aged 7-12 years). Being overweight and obese was significantly associated with greater ORs for high SSB intake among boys aged 7-12 years (OR = 1.72). These findings may be used to develop targeted education programs for reducing SSB intake and encouraging healthier food choices.

Dietary factors affecting bone mineral density in Korean rural postmenopausal women

This study was conducted to investigate dietary factors, bone status, and bone loss in postmenopausal women in rural areas. A total of 189 women participated in the follow-up study after two years. Radius, Tibia, and Phalanx SOS (Speed of Sound) was measured on two occasions 2 years apart by ultra-sonic-metry, and % body fat was measured by bioelectrical impedance analysis at the baseline and after 2years. Dietary intake data were collected 4 times at different season by 24-hour recall method, and then calculated as average. Bone density of radius decreased by 4.2% during the two year period. When the subjects were divided into three groups, by bone decline level during two years, the lowest bone loss group had higher potassium and vegetable intake than other groups. Age and calcium intakes showed significant correlation with bone decline rate at tibia. In multiple regressions, the baseline SOS, vitamin A, vegetables and eggs intakes were found to be significant factors for tibia bone decline. In conclusion, dietary factors, such as higher vegetable intake, seem to affect the changes in bone mineral density in more favorable way. Therefore, efforts are needed to enhance the access to nutritional care for rural elderly postmenopausal women.

Changes of Eating Habits of the Residents of Taean, Korea after the Herbei Oil Spill Accident Based on Focus Group Interviews / 대한지역사회영양학회지

Hazardous chemicals, such as polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs) and heavy metals, are known as being harmful to human health were included in oils released by the Herbei Spirit Oil Spill accident in December 2007. To investigate changes of eating habits by the exposure to harmful substances, we conducted 5 focus group interviews for residents at Taean coast areas, who had experienced the oil spill accident. Participants included 46 women (mean age: 57.2 +/- 10.9) who were mainly responsible for preparing family meals. Focus group discussions were audio-taped, transcribed and categorized by themes. Participants expressed more frequent illness symptoms such as dizziness, vomiting, visual loss, and skin diseases after the accident. They mentioned that their worries about economic hardship and worsened health status since the accident induced mental problems, such as depression about their children. Regarding eating habits, participants reported less intakes of fishes and meats and relatively more intakes of vegetables and kimchi due to the lack of household incomes after the accident. Although the participants had been used to collecting or catching fish or shellfish for their consumption previously, they mainly purchased these foods from local markets after the accident. Changes of eating habits induced by the accident included drinking boiled water and having steamed or fried seafood rather than raw seafood. Changes of food intakes occurred less frequently in older adults due to their long-term fixed eating habits, although they felt uncomfortable for having raw fish. The findings of this study clearly present that the exposure of hazardous substances by the oil spill accident had a significant impact on changes in eating habits besides economic, physical, and mental problems among the residents in Taean. Continuous health and nutrition monitoring and support are needed.

Development of Food Security Measures for Korean National Health and Nutrition Examination Survey

Given that household food security issues have become the concern of the Korean society, this study aimed to develop food security measures for the Korean population. Based on the literature reviews on previously developed food security measures, the 18-item US household food security survey module (US HFSSM) was adapted. The developed food security measures was assessed by qualitative validity method. It was evaluated and modified by face validity by expert focus groups belong to university, public health center, and government agencies and by cognitive interview by 40 subjects with low household income who live in an urban community and are participants in welfare programs of local districts. Then, it was reviewed and revised by the National Institute of the Korean Language and the advisory committee for nutrition survey of Korean National Health and Nutrition Examination Survey (KNHANES). The results showed that the developed questionnaire items were well adapted by expert focus groups and general subjects, showing the feasibility of measuring food security with the developed measures although there were discrepancies in some expressions of questionnaire items between experts focus groups and general subjects. The study to assess reliability and quantitative validity of the developed food security measures should be further needed to examine its application for KNHANES.

Validation of Food Security Measures for the Korean National Health and Nutrition Examination Survey / 대한지역사회영양학회지

The objective of this study was to assess the reliability and validity of food security measures, which was developed based on the US household food security survey module (US HFSSM) with content validity in the Korean population. The reliability and validity were assessed by internal consistency, construct validity and criterion-related validity. The study included 446 households. Among those, 46.2% were households with children. The proportion of food insecure households was 33.3%. Among those, 35.4% and 64.6% households were food insecure with hunger and without hunger, respectively. The Cronbach's alpha coefficients were 0.84 and the infit value by the Rasch model analysis ranged from 0.68 to 1.43. The scale item response curves by food insecurity severity explained well the nature and characteristics of food security, indicating the highest proportion of "yes" for the items on diet quality, followed by those with diet quantity. The result of criterion-related validity showed that food insecurity status was significantly related in a dose-response manner with the household income level, food expenditure, subjective health state, subjects' educational level. Household food security status was also related to dietary diversity regarding protein foods, fruits and fruit juice, and milk and dairy product. These findings suggest that the food security instrument is reliable and valid and would be used to assess food security status in the Korean population.

Associations of Household Food Insecurity with Socioeconomic Measures, Health Status and Nutrient Intake in Low Income Elderly

This study examined household food insecurity and the associations of food insecurity with socioeconomic conditions, food behaviors, and nutrient intakes among 458 older adults (mean age = 73.2 +/- 4.5) from 5 clusters of low-income areas in Seoul, Korea. Using an adapted version of the USDA short form household food insecurity scale, 63.4% of the households were food insecure (40.7% for food insecure without hunger and 22.7% for food insecure with hunger). The proportion of household was lower on the items measured more severe level of food insecurity. Food insecurity was linearly and negatively associated with food expenditure, food secured period and the degree of nutrition management skills, health status and depression. Food secure older adults had more of energy and other nutrients from animal resources (riboflavin and animal protein, fat and calcium), but less of carbohydrates than those from the food insecure households. These results suggest household food insecurity measures used in this study was valid as well as food insecurity was prevalent and an important indicator of nutrition well-being among low income elderly persons.

Nutritional Status and Related Factors of the Elderly in Longevity Areas: III. Relation among Self-rated Health, Health-related Behaviors, and Nutrient Intake in Rural Elderly

The study aimed to identify major factors related to global self-rated health of the community-dwelling elderly people in rural areas. Interviews were conducted with 433 persons over 65 years of age. The socio-economic characteristics, chronic disease status, measures of functional and mental health, life satisfaction, health-related behaviors including smoking, drinking, exercise, social activity, dietary habit, and food intakes were analyzed to determine their influence on self-rated health index. Data on food intake were obtained through the 24-hour recall method. The self-rated health of rural elderly was poor or very poor as reported by 42.6% and 52.4% of the men and women, respectively. Poor self-rated health was found to be related to elderly aged 65~74, female, absence of work, more chronic diseases, dependence on Instrumental Activity Daily Living (IADL), higher mental unhealthy days, lower current life satisfaction, less social activity, lower dietary habit scores, lower intake of total food, fruit, eggs, fishes and shell fishes, vitamin C (%RDA), and Nutrient Adequacy Ratio (NAR). The results of the multiple regression analysis showed that poor self-rated health index is significantly associated with more chronic diseases, mental unhealthy days, gastrointestinal disease, musculoskeletal disease, less social activity, and lower intake of fruits. The results also suggested that improving the nutritional status and functional ability, and reducing the burden of chronic diseases are beneficial to the self-rated health index of the elderly.

Nutritional Status and Related Factors of Residents Aged Over 50 in Longevity Areas: II. Effect of Dietary Factors on Bone Ultrasound Measurements in Aged Men

This study was conducted to examine dietary factors affecting bone status in the rural aged men. Quantitative ultrasound measurements (QUS) of bone, that may reflect certain architectural aspects of bone, have been shown to be associated with bone mineral density and fracture. Information of diet and anthropometry was collected in 164 aged men. Dietary intake data were obtained by 24-hour recall method. Measurements of the speed of sound (SOS, m/s), at distal radius, mid-tibia, phalanx, were performed using Omnisense 7000S analyzer (Sunlight Ltd., Tel Aviv, Israel). T-scores for bone SOS measurements at distal radius, mid-tibia and phalanx were 0.60, 0.03 and -0.42 respectively. The prevalence of osteopenia by use of the WHO criteria was 17.7% at the mid-tibia and 25.3% of the subjects at the distal radius. Age were negative association with bone SOS at three sites. Osteopenia group of radius were significantly lower in total foods and vegetable intakes than normal group. After adjusted for age, vegetable intakes were significantly and positively related to bone SOS at the radius. The bone SOS of the tibia were significantly and positively related to vegetable protein, iron, folate and vegetable intakes, but negatively related to fat intakes. Multiple regression analysis showed that bone SOS of tibia was positively associated with folate intakes. Vegetable intakes were positively associated with the bone SOS at three sites. These results indicate that the consumption of vegetables, sources of folate, may have a effect on bone status of men.