Government-Funded Meal Support Program for Low-Income Children through Convenience Stores : Current Status and Nutritional Quality of Available Meal Items in Seoul / 대한지역사회영양학회지

The objectives of this study were to investigate the current status of the Korean government-funded meal support program for low-income children through convenience stores and to evaluate the nutritional quality of the meal items available under the program. The POS data of three convenient stores where children had used their electronic meal cards most often in Seoul during January 2010 and the kinds and amounts of ingredients of the meals items available to the children were obtained from the headquarter of the convenient stores. A total of 5,081 transactions by 693 children included in the POS data was analyzed. In addition, nutritional contents of meal items, which were meal boxes (11 kinds), kimbab (13 kinds), rice balls (27 kinds), inari sushi (1 kind), and sandwiches (26 kinds), were analyzed with Can Pro 3.0. The results showed that children had purchased flavored-milk products most often. Children tended to purchase meal items together with drinks (60.9% of transactions), but some purchased drinks (27.6%) or meal items only (11.5%). Except for meal boxes, none of the meal items satisfied 1/3 of Estimated Energy Requirements of the 9-11 year-old boys per day. The average energy contents of different kinds of meal boxes, kimbabs, rice balls, and sandwiches were 619, 357, 200, and 380 kcal, respectively, and the energy content of a package of Inari sushi was 457 kcal. Vitamin C amount was found to be deficient in all the meal items, compared to 1/3 of Recommended Intake of the 9-11 year-old boys per day. The results of this study could be useful to develop nutritionally appropriate meal items for the convenient stores participating in the government-funded meal support program for children from low-income families.

Predictors of letter knowledge in children growing in poverty / Predictores del conocimiento de las letras en niños que crecen en contextos de pobreza

This study examined the influence of phonological processing abilities on letter knowledge and letter learning in 1st grade children growing in poverty. At the beginning of the school year, 59 first graders were evaluated with tests measuring phonological awareness, phonological memory and rapid naming. Letter knowledge was assessed at the beginning and at the end of the year. All phonological processing abilities predicted letter knowledge at time 1, with phonological awareness producing the largest effect. However, only phonological memory predicted additional letter learning during the school year, once initial letter knowledge was taken into account.

El presente trabajo busca explorar la incidencia de las habilidades de procesamiento fonológico en el conocimiento y aprendizaje de letras en niños hispanohablantes de primer año de nivel socioeconómico (NSE) bajo. Al comenzar el año se evaluó el conocimiento de letras, la conciencia fonológica, la memoria fonológica y la denominación veloz. A fin de año se evaluó el conocimiento de letras. El análisis de la relación entre las medidas administradas se realizó en el grupo total y en un subgrupo con poco conocimiento alfabético. Los resultados sugieren que la conciencia fonológica tendría un papel fundamental en el inicio del aprendizaje, en tanto el aprendizaje adicional en el marco de la enseñanza escolar estaría asociado a las diferencias individuales en memoria fonológica.

Estado nutricional de preescolares asistentes a la junta nacional de jardines infantiles de Chile: evaluación de la concordancia entre indicadores antropométricos de obesidad y obesidad central / Nutritional status of preschool children attending the Chilean national nursery schools council programs (JUNJI): assessment of the agreement among anthropometric indicators of obesity and central obesity

Históricamente, el monitoreo nutricional de los programas de ayuda nutricional infantil ha utilizado indicadores de peso-edad y talla-edad para detectar deficiencias nutricionales. Recientemente, dado el aumento de la obesidad infantil se ha recomendado también incorporar mediciones de peso-talla y de circunferencia de cintura. Sin embargo, en preescolares no está claro cuál es el grado de concordancia existente entre estos indicadores. Los objetivos de este artículo son: reportar el estado nutricional de niños beneficiarios de la Junta Nacional de Jardines Infantiles de Chile y evaluar la concordancia entre medidas antropométricas de obesidad general y obesidad central en este grupo. En 574 niñas y 580 niños entre 3,0 y 5,9 años de edad se midió peso, talla, circunferencia de cintura y de cadera y 5 pliegues. Los puntajes Z se estimaron según los estándares de crecimiento OMS 2006. Se definió obesidad general como Z P/T ó Z IMC/E ≥+ 2DE y obesidad central como circunferencia de cintura ≥ percentil 90 para el sexo y la edad según NHANES III. La prevalencia de obesidad fue cercana al 16 por ciento con ambos indicadores, mientras que la de obesidad central fue 15 por ciento. La concordancia entre indicadores antropométricos de obesidad general y central fue buena (Kappa entre 0,6 y 0,7). En conclusión, en niños beneficiarios de un programa de ayuda social chileno se encontró una alta prevalencia de obesidad y obesidad central. En este grupo, existe una buena concordancia entre indicadores antropométricos de obesidad general y obesidad central, lo que sugiere que no se justificaría la incorporación de mediciones de circunferencia de cintura al monitoreo nutricional del programa.

Historically, the anthropometric assessment of nutritional welfare programs has been targeted to assess nutritional deficiencies based on weight-to-age and height-to-age indicators. Recently, given the increase on childhood obesity, it has been also recommended the measurement of indicators of obesity (i.e. weight-to-height) and central obesity (i.e. waist circumference). However, the agreement of these indicators in preschool children is unclear. The aims of this study were: 1) assess the nutritional status of children attending the Chilean National Nursery Schools Council Program (JUNJI); 2) assess the agreement between general and central obesity anthropometric measurements in these children. In 574 girls and 580 boys, 3.0 to 5.9 years old, we measured: weight, height, waist and hip circumference, and five skinfolds. We used the WHO 2006 growth standards to estimate Z-scores. We defined general obesity as WHZ or BAZ= 2, and central obesity as waist circumference ≥ 90 percentile of NHANES III. The participants were on average slightly shorter but considerably heavier and obese than the reference populations. Prevalence of general obesity was close to 16 percent with both indicators while prevalence of central obesity reached 15 percent. There was good agreement among general obesity indicators and central obesity indicators (Kappa = 0.6-0.7). In summary, we found a high prevalence of obesity and central obesity among Chilean preschool children beneficiaries of a welfare program. At this age, there was a good agreement among general obesity indicators and central obesity indicators. These results suggest that waist circumferences measurements should not be incorporated to the program.

Appropriate Size and Dish Combination of Nutritional-Balanced Lunch Boxes Delivered to Children Under the Government-Funded Meal Service Program in Korea / 대한지역사회영양학회지

The purpose of this study was to propose the appropriate sizes and dish combination for nutritional-balanced lunch boxes delivered to children under the government-funded meal service program in Korea. The study was based on the 3 : 1 : 2 Meal Box Magic, a nutrition education method developed in Japan. A total of 290 lunch menus, comprising of 10 day menus from 29 organizations having delivered lunch boxes to children during summer vacation of 2008, were analyzed and used as the base data for lunch box combination. Dishes of the menus were classified into 6 groups: Rice group, Protein side dish group (including meat, fish, egg, and bean dishes), Vegetable side dish group, Kimchi group (including kimchi and jangajji), Soup, stew group, and the other group. Nutrient analysis was conducted for 100 ml of these dishes by CAN Pro 3.0 utilizing volume and weight conversion data used for analysis of the Korea Health and Nutrition Examination Survey and those from the Nutrient Composition of Food for Consumers. All the possible combinations of 5 dishes, comprising of 3 dishes from Rice group, Protein side dish group, and Kimchi group, respectively, and 2 dishes from Vegetable side dish group, were made using the frequently served dishes from the respective dish group. Nutrient analysis of each combination was conducted based on the assumption that a lunch box was 600 ml and filled up to 80% by dishes using the volume ratio of 3 : 1 : 1.5 : 0.5 for Rice group : Protein side dish group : Vegetable side dish group : Kimchi group. The mean and standard deviation of energy and nutrients of all combinations calculated by weighting the serving frequency of each dish selected for the combinations were 621 +/- 81 kcal for Energy, 22.1 +/- 5.0 g for Protein, 120 +/- 45 mg for Calcium, 4.1 +/- 1.1 mg for Iron, 201 +/- 130microgram RE for Vitamin A, 0.34 +/- 0.10 mg for Thiamin, 0.27 +/- 0.10 mg for Riboflavin, and 24.3 +/- 9.6 mg for Vitamin C. The energy percentages from Carbohydrate, Protein and Fat were 66%, 14% and 20%. The analysis results met the nutrition standard of lunch boxes for male elementary students in grades 4 through 6 under the government-funded meal service program regarding calories, nutrients except calcium and riboflavin, and macronutrient distribution ranges. Accordingly appropriate box sizes were suggested for different age and sex groups to meet the respective nutrition standards. In addition, milk or dairy products were suggested to accompany lunch boxes to supplement calcium and riboflavin intake. The method of selecting box sizes and making dish combination suggested in this study could be useful for the organizations preparing lunch boxes under the government-funded children's meal service program where nutrition professionals are not available.

Current Status of Meal Box Service Management for Children from Low-income Families During Summer Vacation / 대한지역사회영양학회지

The purpose of this study was to investigate the current status of foodservice management in organizations delivering meal boxes for low-income children during summer vacation. A survey was conducted with persons in charge of meal box production and service of these organizations via mail. Out of 114 questionnaires distributed nationwide, 100 were analyzed (87.8% analysis rate). Over half (53%) of the organizations delivered meal boxes consisting of rice and side dishes while the rest delivered side dishes only. About 81% of the organizations received KRW 3,000 per meal from their local governments and the rest received KRW 3,500. Only 28% of organizations had employed a dietitian. Over one-third (38%) of the respondents were unaware of the official nutritional standard of the foodservice program for low-income children during vacation. Most of the organizations (94%) had menu planned in advance. The average percentage of food cost was 84.1%. Over 40% of the organizations did not keep food samples for sanitation test (43%) and did not take any measures for keeping food temperature during delivery (45%). The organizations delivering rice and side dishes were more likely to be located in cities rather than rural areas and received higher reimbursement rate. The organizations receiving reimbursement of KRW 3,500 or hiring a dietitian were more likely to use standardized recipes, keep food samples for sanitation test, or take measures for keeping food temperature during delivery compared to the counterparts. Respondents reported that increasing reimbursement rate was the most necessary for improving the quality of meal box. This study results showed that the meal box delivery service for low-income children was not properly managed during the vacation, with regards to menu planning and food production. It is recommended that reimbursement rate for meal boxes should be adjusted depending on meal box types and local conditions.

Meal skipping children in low-income families and community practice implications

We examined dietary habits, food intakes, health status, and school and community life of meal skipping children, and investigated factors predicting meal skipping of children. A sample was composed of 944 children in low-income families who were provided with public meal service. The sample was obtained from the Survey of Meal Service for Poor Children conducted by the Korea Institute for Health and Social Affairs in 2007. Meal skipping was significantly associated with a lower nutrition and health status, and poor school performance of children, as hypothesized. The school age of child, family structure, region, job of caretaker, concern about diet, and the child's visit to welfare center significantly predicted frequency of meal skipping. We suggested a few implications for community practice to reduce meal skipping of children.

Health status of children in low socioeconomic conditions / 소아과

PURPOSE: The purpose of this study was to investigate the health status and nutritional condition of children living in a low-income community through anthropometric, laboratory evaluation. METHODS: A community-based survey identified children below 15 years living in a low-income community. Their weight, height, visual acuity, hearing level and dental status were measured. Blood sample were obtained on June and July, 2004. Hemoglobin, serum cholesterol, Hepatitis B antigen/antibody, AST and ALT were measured. RESULTS: A total of 285 students(M:F=141:144) aged 6 to 14 years were included in this study. The heights and weights in some grades were smaller than controls. The prevalence of obesity was 10.6 percent in males and 10.7 percent in females. The prevalence of abnormal visual acuity, hearing impairments and dental carries were 20.5 percent, 0.3 percent and 69.4 percent. The prevalence of anemia was 10.1 percent. Serum total cholesterol was over 200 mg/dL in 7 percent. They complained of abdominal pain(22.1 percent) and headache(17.1 percent). Hyperthyroidism, cataract, neurofibromatosis, severe atopic dermatitis, ventricular septal defect, strabismus and inguinal hernia were newly diagnosed. CONCLUSION: Mean heights and weights of children in the low-income community were smaller than controls. The prevalence of abnormal visual acuity, hearing impairment and dental carries were higher than in the 2003 national health survey. Additional research is needed to evaluate the health status of the low-income community.