A Study of Food Safety Knowledge for Sustainable Foodservice Management of Childcare Centers in South Korea Using Importance-Performance Analysis.

This study aims to evaluate the importance and performance level of knowledge about sanitary management among foodservice employees in childcare centers that were registered at Center for Children's Food Service Management in Chungju city according to their work duration, type of childcare center, and number of enrolled children. The self-administered questionnaire was conducted to examine food safety attributes of sanitary management at 150 childcare centers without qualified dietitians registered at Center for Children's Food Service Management of Chungju city. The questionnaire consisted of 15 questions about perceived importance and performance regarding sanitation management (personal hygiene, ingredient control, temperature control of food, facility, equipment, and utensils sanitation) using IPA (importance−performance analysis). The results show that overall mean scores of the importance and performance of sanitary knowledge were 4.71 and 4.67 out of 5, respectively. 'Checking the center temperature at 75 °C for 1 min in the thickest part of meat (3 times or more check for each serving)' (p = 0.047) and 'Keeping preserved meals (at least 100 g of each menu) for 144 h. with −18 °C or less' (p < 0.001) show significantly lower scores of performance than those of importance. The results of importance and performance for sanitary management according to work duration of foodservice employees show that those who have worked more than 10 years had the highest scores of importance and performance for overall sanitary management among them. For the types of childcare centers, the overall performance scores of national/public employees for sanitary management were lower than those of private or home type (p < 0.001). Additionally, the result showed that the overall importance (p < 0.001) and performance scores (p < 0.001) of employees for sanitary management in centers with <50 children were higher than those in centers with ≥50 children. This result should provide more useful information to develop food safety programs for employees and sustainable foodservice management in childcare centers.

Changes in Eating-Out Frequency according to Sociodemographic Characteristics and Nutrient Intakes among Korean Adults.

BACKGROUND: The quality of out-of-home foods is an increasingly important issue due to increasing popularity of eating out. The objective of this study was to analyze the relationship of eating-out frequency with general characteristics, dietary habits, and nutrient intakes among Korean adults. METHODS: This study collected data from 2010- 2015 KNHANES. The total number of participants was 33,427 Korean adults aged 19 years and older. All statistical analyses were conducted using SAS software version 9.3. RESULTS: Eating-out more frequently was associated with younger, unmarried, employed, urban resident, higher income, higher education, and being male. Regarding dietary behavior, subjects with skipping breakfast and taking snack behavior showed a tendency to eat out more frequently. Meanwhile, energy, carbohydrate, protein, fat, and sodium intake were higher in subjects with ≥ 5/week eating-out frequency than those in subjects with < 5/week eating-out frequency. CONCLUSION: This study provides important insights into the effect of targeted public health education and policies.

Low fruit and vegetable intake is associated with depression among Korean adults in data from the 2014 Korea National Health and Nutrition Examination Survey.

BACKGROUND: Depression is a major mental disorder worldwide. The prevalence of depression among Korean adults was estimated to be 5.6% in 2006 and 6.7% in 2011, and that increased to 10.3% in 2013. Using national data, the present study investigated the association between vegetable and fruit intake and the prevalence of depression among Korean adults. METHODS: This analysis used data from 4349 subjects aged 19 years and older who participated in the Korea National Health and Nutrition Examination Survey (KNHANES, 2014). Depression was assessed using the self-reported Patient Health Questionnaire (PHQ)-9. Food and nutrient intake was assessed using the 24-h recall method. Individual food intake was categorized into 18 food groups. The statistical analyses in this study were performed by adopting stratification, clustering, and sample weight variables using SPSS Ver. 23.0. Cronbach's α was used to determine the internal consistency of the PHQ-9 items. Logistic regression analysis was used to estimate the odds ratios of depression adjusted for several confounders. RESULTS: The depression rate of all subjects was between 8.7 and 4.7% and decreased as vegetable and fruit intake increased. With regard to sex, the depression rate decreased from 6.4 to 2.5% in males and from 11.4 to 6.6% in females as vegetable and fruit intake increased. Thus, the results of this study reveal an inverse association between vegetable and fruit intake and depression. The odds ratios show that vegetable and fruit intake was inversely associated with depression with no adjustment. When the data were adjusted for age, energy intake, obesity, smoking, drinking, stress, eating-out frequency, breakfast, and food security, subjects exhibited significantly lower rates of depression with higher vegetable and fruit intakes. CONCLUSIONS: This is the first study to investigate the association between vegetable and fruit consumption and depression in a Korean population. Additional epidemiological studies are needed to find the underlying reasons for that association.

Asthma and Dietary Intake of Fish, Seaweeds, and Fatty Acids in Korean Adults.

The dietary intake of fish and fatty acid may influence the risk of asthma, yet epidemiological research remains controversial and inconclusive. We examined the association between asthma and the dietary intake of fish, seaweeds, and fat in a Korean population, aged 19 to 64 years, using the data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2013-2016 (n = 13,038). The prevalence of doctor-diagnosed asthma and medication prescribed asthma were 2.5% and 1.0%, respectively. The subjects with medication prescribed asthma had significantly lower consumption of seaweeds (p = 0.0110) and lower n3/n6 polyunsaturated fatty acid (PUFA) (p = 0.0275) as compared to subjects without medication prescribed asthma. Multiple logistic regression analysis showed that the odds ratio (OR) (95% confidence interval, CI) of doctor-diagnosed asthma in the highest quartile were 0.63 (0.41-0.97) and 0.66 (0.44-1.00) for fish and seaweeds respectively, compared to the lowest quartile after adjusting confounding factors. Furthermore, there were significant inverse associations between medication prescribed asthma and seaweeds [OR (95% CI) = 0.37 (0.19-0.70)], n-3 PUFA [OR (95% CI) = 0.43 (0.21-0.89)] and n3/n6 [OR (95% CI) = 0.47 (0.22-0.99)] intake after adjusting for confounding factors. These results suggest, that the higher consumption of fish and seaweed and the high ratio of n-3 to n-6 PUFA may be associated with a lower prevalence of asthma.

Kimchi intake and atopic dermatitis in Korean aged 19-49 years: The Korea National Health and Nutrition Examination Survey 2010-2012.

BACKGROUND AND OBJECTIVES: Many studies have reported that fermented foods have favorable effects in preventing and managing atopic dermatitis (AD). Although kimchi, a major fermented food, is an important part of the traditional diet in Korea, only a few studies have investigated the relationship between AD and kimchi. This study aimed to examine the association between the risk of AD and kimchi intake among Korean adults aged 19 to 49 years. METHODS AND STUDY DESIGN: We conducted a population-based, cross-sectional study among a total of 7,222 adults who participated in the 2010-2012 Korea National Health and Nutrition Examination Surveys. We defined AD based on responses to a health interview and assessed kimchi intake using a 24-hour recall method administered by well-trained interviewers. RESULTS: In the multivariable logistic regression analysis, we observed a significantly decreased odds ratio (OR) of having AD according to kimchi consumption after adjustment for confounding factors. In particular, subjects in the third quartile of kimchi consumption (85.0-158 g) had a 32% lower presence of AD than those in the first quartile of kimchi consumption (0-36.0 g) (Odds ratio: 0.68, 95% confidence interval: 0.50-0.92). CONCLUSIONS: We found that consuming 85.0-158 g/day of kimchi was significantly associated with a lower presence of AD. Considering that one serving size of kimchi is 40 g, this corresponds to about 2-4 servings per day. This finding suggests that adequate amount of kimchi intake might have a protective effect against AD.

Relationship Between Plant Food (Fruits, Vegetables, and Kimchi) Consumption and the Prevalence of Rhinitis Among Korean Adults: Based on the 2011 and 2012 Korea National Health and Nutrition Examination Survey Data.

The aim of the current study was to analyze the relationship between plant food (fruits, vegetables, and kimchi) and the prevalence of rhinitis among Korean adults using data from the 2011 and 2012 Korea National Health and Nutrition Examination Survey. A total of 7494 subjects aged from 19 to 64 years participated in a rhinitis morbidity survey, health behavior interview, and 24-h dietary recall test. Individuals with energy intakes less than 500 kcal or more than 5000 kcal were excluded. The results showed that kimchi intake was inversely associated with the prevalence of rhinitis. The prevalence of rhinitis decreased with increasing kimchi consumption. The quintile 4 (range of kimchi intake: 108.0-180.0 g) groups, compared with the reference of quintile 1 (0-23.7 g), showed a decrease of 18.9% (odds ratio [OR] = 0.811, 95% confidence interval [CI] = 0.672-0.979) in Model 4. In conclusion, consumption of kimchi lowers the risk of rhinitis, suggesting that its use should be encouraged among the Korean population.

Analysis of Kimchi, vegetable and fruit consumption trends among Korean adults: data from the Korea National Health and Nutrition Examination Survey (1998-2012).

BACKGROUND/OBJECTIVES: The purpose of this study is to analyze daily kimchi, vegetable and fruit consumption by general characteristics and vegetable and fruit consumption from 1998 to 2012 by the Korean population based on the data of the KNHANES (Korea National Health and Nutrition Examination Survey). SUBJECTS/METHODS: This study is based on the 1998-2012 KNHNES. Analysis data on 54,700 subjects aged 19 years and older were obtained from health behavior interviews and the 24-hour dietary recall method. RESULTS: Daily kimchi consumption and portion size of kimchi decreased significantly from 1998 to 2012 (adjusted P for trend < 0.0001). Meanwhile, daily consumption of both non-salted vegetable and fruit with and without kimchi did not significantly change between 1998 and 2012. Reduced consumption of kimchi, non-salted vegetable, and fruit was observed for both genders as well as daily meal episodes and cooking locations. Male and female subjects with insufficient non-salted vegetable and fruit intake were increased 1.4 times and 1.3 times, respectively, in 2012 than 1998. All subjects consumed at least 400 g/day of non-salted vegetable, fruit, and kimchi in each survey year, although they consumed insufficient amounts (< 400 g/day) of non-salted vegetable and fruit without kimchi. CONCLUSIONS: Since Koreans generally consume high amounts of fermented vegetables, including kimchi, total vegetables and fruit. Consumption of these foods by the Korean adult population reached 400 g, which is the recommended intake of the WCRF/AICR. Based on this result, it is necessary to promote consumption of kimchi in the Korean population and research the development of low sodium kimchi in the future.

Dietary factors associated with high serum ferritin levels in postmenopausal women with the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010-2012.

BACKGROUND/OBJECTIVES: Serum ferritin levels are significantly increased after menopause and greatly affect women's health. The aim of this study was to investigate the dietary and non-dietary factors associated with high ferritin levels in postmenopausal women. SUBJECTS/METHODS: Among adult women in 2010-2012, qualified postmenopausal women (n = 3880) were separated into quartiles of serum ferritin. The variable differences among the quartiles of ferritin were determined using either procsurvey chi-square test (χ(2)-test) among categorical variables, or GLM (Generalized Linear Model) among continuous variables. The odds ratio for high ferritin in relation to dietary factors was also determined using procsurvery logistic analysis. RESULTS: Age, obesity, drinking habit, and blood glucose levels were found to be significant indicators of high serum ferritin level after adjusting for all confounding factors. Among the food groups, grain, milk, vegetable, and seaweed intakes were significantly associated with high ferritin levels, but after adjusting for all confounding factors, only grains and vegetables remained significant factors. Among the nutrient groups, calcium, vitamin A, and vitamin C intake were significant factors, but after adjustment, none of the nutrient groups analyzed were associated with a high risk of ferritin. CONCLUSION: Age, obesity, drinking habit, and glucose levels, as well as inadequate intakes of grains and vegetables, were found to be significantly associated with high serum ferritin levels in postmenopausal Korean women.

Attitudes and preferences of consumers toward food allergy labeling practices by diagnosis of food allergies.

BACKGROUND/OBJECTIVES: The objective of this study was to investigate food allergens and prevalence rates of food allergies, followed by comparison of consumer attitudes and preferences regarding food allergy labeling by diagnosis of food allergies. SUBJECTS/METHODS: A total of 543 individuals living in Seoul and Gyeonggi area participated in the survey from October 15 to 22 in 2013. RESULTS: The results show that the prevalence of doctor-diagnosed food allergies was 17.5%, whereas 6.4% of respondents self-reported food allergies. The most common allergens of doctor-diagnosed and self-reported food allergy respondents were peaches (30.3%) and eggs (33.3%), respectively, followed by peanuts, cow's milk, and crab. Regarding consumer attitudes toward food labeling, checking food allergens as an item was only significantly different between allergic and non-allergic respondents among all five items (P < 0.001). All respondents reported that all six items (bold font, font color, box frame, warning statement, front label, and addition of potential allergens) were necessary for an improved food allergen labeling system. PLSR analysis determined that the doctor-diagnosed group and checking of food allergens were positively correlated, whereas the non-allergy group was more concerned with checking product brands. CONCLUSIONS: An effective food labeling system is very important for health protection of allergic consumers. Additionally, government agencies must develop policies regarding prevalence of food allergies in Korea. Based on this information, the food industry and government agencies should provide clear and accurate food labeling practices for consumers.

Trends in nutrient intakes and consumption while eating-out among Korean adults based on Korea National Health and Nutrition Examination Survey (1998-2012) data.

BACKGROUND/OBJECTIVES: Eating-out among Korean people has become an important part of modern lifestyle due to tremendous growth of the food service industry and various social and economic changes. This study examined trends in meal patterns and meal sources while eating-out among Korean adults aged 19 years and older. SUBJECTS/METHODS: Data were from the 1998-2012 KNHNES (Korea National Health and Nutrition Examination Survey) by the 24-hour dietary recall method. This study included 55,718 adults aged 19 years and older. For analysis of eating-out frequency, data were categorized by source of meals and serving place. RESULTS: Average frequency of meals consumed away from home increased from 1998 to 2012, although it remained lower than that of meals at home. In addition, male, unmarried, employed, higher educated, and high income individuals more frequently consumed meals away from home. Moreover, sodium intake while eating-out significantly increased from 2,370 mg in 1998 to 2,935 mg in 2012. Lastly, percentage contributions of daily total protein intake, fat intake, and sodium intake from eating-out increased to more than half (53-55%) in 2012 compared with 47-48% in 1998. CONCLUSIONS: As eating-out has grown in popularity, greater recognition of public health and nutritional education aimed at promoting healthy food choices is needed. In addition to developing consumer education for overall healthier eating patterns, individuals who are younger, unmarried, higher educated, and males are especially at risk and require attention.

How do the work environment and work safety differ between the dry and wet kitchen foodservice facilities?

In order to create a worker-friendly environment for institutional foodservice, facilities operating with a dry kitchen system have been recommended. This study was designed to compare the work safety and work environment of foodservice between wet and dry kitchen systems. Data were obtained using questionnaires with a target group of 303 staff at 57 foodservice operations. Dry kitchen facilities were constructed after 2006, which had a higher construction cost and more finishing floors with anti-slip tiles, and in which employees more wore non-slip footwear than wet kitchen (76.7%). The kitchen temperature and muscular pain were the most frequently reported employees' discomfort factors in the two systems, and, in the wet kitchen, "noise of kitchen" was also frequently reported as a discomfort. Dietitian and employees rated the less slippery and slip related incidents in dry kitchens than those of wet kitchen. Fryer area, ware-washing area, and plate waste table were the slippery areas and the causes were different between the functional areas. The risk for current leakage was rated significantly higher in wet kitchens by dietitians. In addition, the ware-washing area was found to be where employees felt the highest risk of electrical shock. Muscular pain (72.2%), arthritis (39.1%), hard-of-hearing (46.6%) and psychological stress (47.0%) were experienced by employees more than once a month, particularly in the wet kitchen. In conclusion, the dry kitchen system was found to be more efficient for food and work safety because of its superior design and well managed practices.