Development of Korean Healthy Eating Index for adults using the Korea National Health and Nutrition Examination Survey data / 한국영양학회지

PURPOSE: The current study was conducted in order to develop the Korean Healthy Eating Index (KHEI) for assessing adherence to national dietary guidelines and comprehensive diet quality of healthy Korean adults using the 5th Korea National Health and Nutrition Examination Survey (KNHANES) data. METHODS: The candidate components of KHEI were selected based on literature reviews, dietary guidelines for Korean adults, 2010 Dietary Reference Intakes for Koreans (2010 KDRI), and objectives of HP 2020. The associations between candidate components and risk of obesity, abdominal obesity, and metabolic syndrome were assessed using the 5th KNHANES data. The expert review process was also performed. RESULTS: Diets that meet the food group recommendations per each energy level receive maximum scores for the 9 adequacy components of the index. Scores for amounts between zero and the standard are prorated linearly. For the three moderation components among the total of five, population probability densities were examined when setting the standards for minimum and maximum scores. Maximum scores for the total of 14 components are 100 points and each component has maximum scores of 5 (fruit intakes excluding juice, fruit intake including juice, vegetable intakes excluding Kimchi and pickles, vegetable intake including Kimchi or pickles, ratio of white meat to read meat, whole grains intake, refined grains intake, and percentages of energy intake from carbohydrate) or 10 points (protein foods intake, milk and dairy food intake, having breakfast, sodium intake, percentages of energy intake from empty calorie foods, and percentages of energy intake from fat). The KHEI is a measure of diet quality as specified by the key diet recommendations of the dietary guidelines and 2010 KDRIs. CONCLUSION: The KHEI will be used as a tool for monitoring diet quality of the Korean population and subpopulations, evaluation of nutrition interventions and research.

Development of dietary behavior items available in Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: Given that the indicators related to chronic diseases are important to evaluating goals of the national health policy, the aim of this study was to develop dietary behavior items available in the Korea National Health and Nutrition Examination Survey. METHODS: The dietary behavior items were developed based on the literature reviews, need assessment of the field, expert focus-group interviews, and expert advisory meeting. Questions for each dietary behavior item were developed by reflecting on environmental, personal, and behavior factors of the ecological frame and then revised through expert focus-group interview and expert advisory meeting. The understanding and reliability of the developed questionnaire were assessed by cognitive interview and test-retest reliability. RESULTS: The developed items were sodium and salt intake, added and simple sugar intake, enough time to consume a meal for all ages, caffeine drinks and fresh/healthy food intake for children and adolescents, and limited dietary intake, fresh/healthy food intake for seniors. In most questions except some questions on sodium and salt intake, subjects understood over 70% and consistency of responses based on the kappa values was acceptable. CONCLUSION: Developed dietary behavior items are expected to be useful for evidence-based nutrition policy, interventions and research targeting dietary patterns through investigating and monitoring dietary behavior patterns.

Dietary intake of fats and fatty acids in the Korean population: Korea National Health and Nutrition Examination Survey, 2013

BACKGROUND/OBJECTIVES: The aim of this study was to estimate average total fat and fatty acid intakes as well as identify major food sources using data from the Korea National Health and Nutrition Examination Survey (KNHANES) VI-1 (2013). SUBJECTS/METHODS: Total fat and fatty acid intakes were estimated using 24-hour dietary recall data on 7,048 participants aged > or = 3 years from the KNHANES VI-1 (2013). Data included total fat, 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) levels. Population means and standard errors of the mean were weighted in order to produce national estimates and separated based on sex, age, income, as well as residential region. Major food sources of fat, SFA, MUFA, PUFA, n-3 FA, and n-6 FA were identified based on mean consumption amounts of fat and fatty acids in each food. RESULTS: The mean intake of total fat was 48.0 g while mean intakes of SFA, MUFA, PUFA, n-3 FA, and n-6 FA were 14.4 g, 15.3 g, 11.6 g, 1.6 g, and 10.1 g, respectively. Intakes of MUFA and SFA were each higher than that of PUFA in all age groups. Pork was the major source of total fat, SFA, and MUFA, and soybean oil was the major source of PUFA. Milk and pork were major sources of SFA in subjects aged 3-11 years and > or = 12 years, respectively. Perilla seed oil and soybean oil were main sources of n-3 FA in subjects aged > or = 50 years and aged < 50 years, respectively. CONCLUSIONS: Estimation of mean fatty acid intakes of this study using nationally represented samples of the Korean population could be useful for developing and evaluating national nutritional policies.

Development of a fatty acids database using the Korea National Health and Nutrition Examination Survey data / 한국영양학회지

PURPOSE: The objective of this study was to develop a fatty acid database (DB) for estimation of intake levels of fatty acids in the Korean population, using data from the Korea National Health and Nutrition Survey (KNHANES). METHODS: Analytical values of fatty acids in foods were collected from food composition tables of national institutions (National Fisheries Research & Development Institute, Rural Development Administration), Japan Ministry of Education, Culture, Sports, Science and Technology, US Department of Agriculture, and journal articles that previously reported analytical fatty acid content of some Korean foods. The coverage of fatty acids was C14:0, C16:0, C18:0, C18:1, C18:2 n-6, C18:3 n-3, C20:5 n-3 (EPA), C22:6 n-3 (DHA), SFA, MUFA, and PUFA (n-3, n-6, n-9). The fatty acids DB covered a total of 5,144 food items used in the KNHANES nutrition survey. The food items were preferentially filled with analytical values of the collected data source. An analytical value for each food item was selected based on the priority criteria and the quality evaluation of data sources. Missing values were replaced with calculated or imputed values using the analytical values of similar food items from the data source. RESULTS: A total of 1,545 analytical values, 2,589 calculated values, and 1,010 imputed values were included in the fatty acid DB. The developed fatty acid DB was applied to 2,112 food items available for 2011 KNHANES data. Mean intake levels of total fatty acids and saturated fatty acids were 40.3 g/day and 13.2 g/day, respectively. The estimation of total fatty acid intake was 84.3% (men 83.2%, women 86.0%) of daily total fat intake. CONCLUSION: This newly developed fatty acid DB would be helpful in determining the association of fatty acids intake and related health concerns in the Korean population.

Nutritional roles and health effects of eggs / 한국영양학회지

PURPOSE: The aim of this study is to examine the effects of egg consumption and suggest proper guidelines for consumption of eggs by determining the relationship between eggs and cholesterol. METHODS: Literature review was conducted on the relationship between nutritional, functional properties of eggs and serum cholesterol, as well as cardiovascular disease. RESULTS: Eggs, which are a good protein food with complete amino acid composition, contain vitamin A, riboflavin, vitamin B1(2), folic acid, vitamin D, vitamin E, vitamin K, calcium, iron, choline, selenium, beta-carotene, lutein, zeaxanthin, etc. However the egg yolk has a high cholesterol content, which is associated with chronic diseases, including heart disease and hypertension. As a result, its intake is subject to regulation. Outbreak of heart disease by yolk intake can show different results depending on the characteristics of the subjects, amount of egg intake, and the implications of other foods eaten. It is difficult to determine whether eggs are beneficial, as they are the main supplying source for other major nutritive elements as well. Several research studies insist that when cholesterol intake increases by 100 mg, the level of serum cholesterol increases by 2.2~4.5 mg/dL and when serum cholesterol increases by 1%, the risk of heart disease increases by 2%. This indicates that a large intake of eggs can increase the risk of heart disease. Although the cholesterol of egg yolk and serum cholesterol are correlated, it is insufficient to conclude that only cholesterol and not other components are related to heart disease. In fact, other components in egg such as various unsaturated fatty acids and phospholipids could be related as well. Rather than concluding egg as a 'good' or 'bad' food according to its cholesterol content, it is important to define egg as a part of dietary patterns. CONCLUSION: Generalizing an indiscriminate and uniform amount of egg intake for all seems inadequate. However, patients with diabetes or heart disease should pay particular attention to the amount of egg intake. As for the norm, eating egg with vegetables as a substitute for other animal products seems beneficial.

Body Image, Risk of Disturbed Eating Attitudes and Weight Control of Female Junior High School Students by the Body Mass Index in Seoul / 대한지역사회영양학회지

OBJECTIVES: In this study, perception of body image, eating attitudes and weight control were examined by the degree of obesity using Body Mass Index (BMI). METHODS: Out of 420 questionnaires distributed to the female middle school students (aged 12-16 years), 407 were returned (97% response rate) and 395 were analyzed (94% analysis rate). Female students were divided into two groups based on the BMI percentile using the 2007 Korean National Growth Charts. (1) normal weight (5 th percentile < or = BMI < 85th percentile) (2) obese (85th percentile < or = BMI) by 2007 Korean National Growth Charts. Satisfaction of self-body shape, risk of disturbed eating attitudes (Eating Attitude Test : EAT-26), and weight control behaviors were examined. RESULTS: Distribution of the subjects by BMI was 74.5% of normal and 25.5% of obese. There were significant differences between self-perceived current body image and self-perceived ideal body image. The dissatisfaction of body image was higher in obese than in normal groups (p < 0.001). 51.4% of female students were unsatisfied with their body image, while 2.6% were very satisfied. Among the students unsatisfied with their body image, 150 (52.1%) were of normal weight and 48 (49.4%) were obese. EAT-26 total scores were significantly higher in the obese group (16.42 +/- 8.23) compared with normal group (13.72 +/- 8.10) (p < 0.01). Attempted to weight control were significantly different by the BMI (p < 0.001). CONCLUSIONS: This study concludes that there was desire to become thinner than current status in female students, even those with normal BMI. Many female students were dissatisfied with their body image and attempted to lose weight. It is harmful to their health and nutritional status if they choose undesirable methods. These findings suggested that there are needs to encourage female students for maintaining healthy weight. A higher score of EAT-26 was associated with dissatisfaction of selfbody image and this may lead to unhealthy behaviors in obese female students.

Nutritional Management by Dietitian at Elderly Nursing Homes in Gyeonggi-do

The purpose of the study was to examine the current status of nutritional management at elderly nursing homes. A survey was performed of 83 nursing homes from January 5, 2011 to January 21, 2011 via mail. A total of 34 nursing homes responded to the survey and 149 elderly subjects were analyzed according to the presence of a dietitian. Among the 34 nursing homes, 70.6% had a dietitian on duty. All of the facilities with a dietitian had the dietitian making the meal plan, whereas 70% of the facilities without dietitian served meals planned by a non-professional person. Overall, however, a low proportion of nursing homes implemented dietetic treatments for residents with diseases. For the nutritional assessment of these residents, a mini nutritional assessment (MNA) was performed. MNA scores were significantly associated with body mass index (BMI), mid-arm circumference (MAC), calf circumference (CC), ingestion problems, and weight loss during the last 3 months (P<0.001). Among the elderly studied, 5.4% were malnourished, and 36.9% were at risk for malnutrition by MNA score. The results of this survey show that the current management of nutrition at nursing homes is insufficient because the elderly who needed dietetic treatment did not receive proper care. Dietetic management is the most important service in all nursing homes. Therefore, to improve the nutritional status of elderly residents in nursing homes, systematic nutrition management by nutrition experts should be implemented.

Nutritional Assessment and Management in Long-term Care Insurance's Home Visit Care Service / 대한지역사회영양학회지

The purpose of the study was to examine nutritional management and nutritional care demands of home-visit care service and the nutritional status of serviced elderly. The survey was carried out from 5th to 21st of January, 2011 among 37 In-Home Service institutions. The number of elderly surveyed by 143 care helpers was 281. Analysis was performed for 203 subjects (male: 44, female: 159). The age distribution was from 50 to 99 years. The grading by long-term care insuranceshowed 18,2% on level 1 and 2, and 81.8% on level 3. For the disease treatment, the proportion of implementing diet treatment turned out to be very low. The proportion of subjects living with their children was 45.3%, and living alone was 29.1%. The proportion of home-visit care among types of In-Home Service was 70%. Subjects who needed additional necessary diet management service turned out to be 40.9%. Diet management was the most necessary services from all levels. MNA (specifiy MNA) scores were significantly (p < 0.001) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), intake problems, and weight loss during the last 3 months. For studied elderly, 45.3% were malnourished, and 46.8% were at the risk of malnutrition by MNA score. Based on the result of this survey, the nutritional care was not systematic on the In-Home Service. Prevention and management of the disease was much better than the treatment to improve the quality of life. We conclude that nutrition management is necessary for the elderly. To improve nutritional status of elderly in home care services, systematic nutrition management should be implemented.

Macromineral intake in non-alcoholic beverages for children and adolescents: Using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV, 2007-2009)

The aims of this study were to estimate daily intake of macrominerals from beverages, liquid teas, and liquid coffees and to evaluate their potential health risks for Korean children and adolescents (1-to 19 years old). Assessment of dietary intake was conducted using the actual level of sodium, calcium, phosphorus, potassium, and magnesium in non-alcoholic beverages and (207 beverages, 19 liquid teas, and 24 liquid coffees) the food consumption amount drawn from "The Fourth Korea National Health and Nutrition Examination Survey (2007-2009)". To estimate the dietary intake of non-alcoholic beverages, 6,082 children and adolescents (Scenario I) were compared with 1,704 non-alcoholic beverage consumption subjects among them (Scenario II). Calculation of the estimated daily intake of macrominerals was based on point estimates and probabilistic estimates. The values of probabilistic macromineral intake, which is a Monte-Carlo approach considering probabilistic density functions of variables, were presented using the probabilistic model. The level of safety for macrominerals was evaluated by comparison with population nutrient intake goal (Goal, 2.0 g/day) for sodium, tolerable upper intake level (UL) for calcium (2,500 mg/day) and phosphorus (3,000-3,500 mg/day) set by the Korean Nutrition Society (Dietary Reference Intakes for Koreans, KDRI). For total children and adolescents (Scenario I), mean daily intake of sodium, calcium, phosphorus, potassium, and magnesium estimated by probabilistic estimates using Monte Carlo simulation was, respectively, 7.93, 10.92, 6.73, 23.41, and 1.11, and 95th percentile daily intake of those was, respectively, 28.02, 44.86, 27.43, 98.14, and 3.87 mg/day. For consumers-only (Scenario II), mean daily intake of sodium, calcium, phosphorus, potassium, and magnesium estimated by probabilistic estimates using Monte Carlo simulation was, respectively, 19.10, 25.77, 15.83, 56.56, and 2.86 mg/day, and 95th percentile daily intake of those was, respectively, 62.67, 101.95, 62.09, 227.92, and 8.67 mg/day. For Scenarios I.II, sodium, calcium, and phosphorus did not have a mean an 95th percentile intake that met or exceeded the 5% of Goal and UL.

The effects of food safety education on adolescents' hand hygiene behavior: an analysis of stages of change

The hand hygiene behavior of 400 middle school students (grades 1-3) in Seoul and Gyeonggi-Do was studied to determine how stages of change were affected by food safety education, focusing on hand hygiene and general food safety. Subjects were 51.3% male and 44.3% of study subjects were first graders of middle school. Approximately 40% of subjects were at the stage of action, 42.7% were at the stage of contemplation, and 16.4% were at pre-contemplation. The most important factor that influenced proper hand washing was self efficacy (P < 0.001). Proper hand washing was also correlated significantly with positive belief (P < 0.01) and stages of change (P < 0.01). After food safety education by high-school mentors, middle-school students who were in the stages of pre-contemplation (11.1%) and contemplation (88.9%) showed significant progression toward the action stage (P < 0.001). Proper hand washing (P < 0.01) and food safety knowledge (P < 0.05) were also significantly increased after educational intervention.

Exposure Assessment for Pesticide Residues in Vegetables using Korea National Health and Nutrition Examination Survey Data for Seoulites

The characteristics of pesticide residues were examined in 18,069 samples from 91 vegetable commodities collected in Seoul from 2007 to 2009, and the vegetable dietary intakes of Seoulites were estimated using the Korea National Health and Nutrition examination survey data from 2008. The hazard index was calculated using vegetable pesticide residues and dietary vegetable intake by Seoulites. Detection rates for pesticide residues in vegetables were 11.2 % in 2007, 8.6 % in 2008, and 12.0 % in 2009. Excess rate of Maximum Residue Limits tended to decline from 4.6 % in 2007, to 2.8 % in 2008, and 2.1 % in 2009. Daily vegetable intake for Seoulites was 288.12 +/- 214.8 g, and vegetable intake by males was more than that of females (p < 0.001). The hazard index was the highest at 2.76 x 10(-2) in 2007, and the lowest at 1.69 x 10(-2) in 2009. The risks caused by multiple pesticides in vegetables were very low and vegetable intake was safe considering the hazard index values.

Comparison of Growth from First to Sixth Grade Based on the Obesity Index of Sixth Grade Students at an Elementary School in Seoul

This study was conducted to identify differences in growth based on the obesity index in sixth grade. Heights and weights of 141 students from first to sixth grades were collected from school records. Other information was gathered by survey, and the weight length index (WLI) was calculated. Subjects were classified into three groups: underweight (n = 57, UG), normal (n = 53, NG), and obese (n = 31, OG) using the WLI. Differences in weight, height, and growth velocity were compared among the three groups from the first to sixth grades. With regard to growth, the past physical status of the three groups was maintained. More than 50% of the OG was in the overweight range when they were in the third to fifth grades. Approximately 60% of NG was in the normal weight range between the first and fifth grades. More than 70% of UG was in the underweight range when they were in the first to fifth grades (p < 0.001). Growth velocity was faster in OG than that in NG and UG (p < 0.001). The annual growth rate of children was the highest when they moved from the third to the fourth grade (p < 0.001). The results indicate that general balanced diet education should be implemented in lower grades, because physical growth formed in lower grades tended to be maintained in senior grades. It would be better to educate students about diet to prevent obesity before the fifth grade when a major change in body structure has occurred.

Evaluation of the Health Status and Dietary Intakes of the Elderly in Rural Areas by Dental Status

In Korea, there has been a rapid increase in the number and proportion of elderly people, especially in rural areas, due to improvements in the standard of living and medical technology. One of the main health problems for the elderly people is dental health, which can cause nutritional and health problems. Thus, in this study, the dental health status and health status in relation to nutritional intake were analyzed. A total of 155 rural-dwelling elderly people (68 males, 87 females) over the ages of 65 participated in this study. The subjects were classified into three groups; the no denture no teeth group, denture user group, and natural teeth group. The dietary intake, biochemical health status, and anthropometry were evaluated. Can-pro 3.0 was used to assess dietary intakes and the SPSS 12.0 program was used for statistical analysis. The results showed that the natural teeth group had better nutritional and dietary intake status than the no denture no teeth group. The dietary assessment showed that there were differences in food intakes among the groups, which depended on their dental health status. In conclusion, dietary management is required for the elderly since each group has a different ability to chew food depending on their dental health status. In addition, the elderly will need different therapeutic diets because of the high prevalence of chronic degenerative diseases.

Comparing School Lunch Program Served at Dining Room with Program at Classroom for Sanitation and Contentment at One Middle School / 대한지역사회영양학회지

School lunch programs at middle schools have increased in quantity. However, the quality of them is in fact not enough to reach the satisfactory standard, especially in the aspect of environment of school meals. It is true that there seems to be little attention to the environment. In this study, degree of satisfaction about school lunch program was surveyed for students in one middle school. Focus of survey was sanitary condition about the dining room and classroom where they have lunch. First, in order to investigate the degree of satisfaction about their dining place, questionnaire was sent out to the students at one middle school in Seoul. Questionnaire was made with reference to previous research. Second, for the study on environmental sanitation, dropping bacteria (general bacteria) is measured in three parts of dining place (entrance, serving table, dining table). Petriplate film was exposed to the responsible places for 15 minutes and then cultivated at the temperature of 32degrees C for 48 hours before counting the number of bacteria formed. For the statistical analysis, SPSS 12.0 was used. The results of the study show that students had more satisfaction in dining room service than in classroom service. Important factors for the meal program such as "taste of food", "amount of food per student", "state of keeping warm", "appearance of food", "diversity of menu", and "kindliness of feeding staff" had more points in dining room than in classroom. For the environmental and sanitary aspect, the result of dropping bacteria (general bacteria) in dining room and classroom showed that table (5.00) and fooddistribution corner (8.67) of dining room were cleaner than those of classroom (P < 0.05). Making a good environment for school feeding will have a positive effect on the improvement of satisfaction and sanitation of school feeding. There should be expansion of dining room service for the students.

Nutrients and Dish Intake by Fasting Blood Glucose Level

The nutrient intake and association between dish group intake and blood glucose and serum lipid level (TG, cholesterol, LDL and HDL) was analyzed among 3 groups: 452 subjects in normal blood glucose group (NG: fasting blood glucose or = 140 mg/dL) and 101 subjects in diabetic group (DG: fasting blood glucose > or = 126 mg/dL and 2 hours postprandial blood glucose > or = 140 mg/dL). The data were obtained from the 2005 National Health and Nutrition Survey of Korea. The 811 subjects were adults aged 40~64 without dietary treatment. In nutrients intake, IFG was the highest and DG the lowest in both quantity and quality. DG, especially, had the lowest intake in carbohydrates, fiber, proteins, Ca, P, K, vitamins B1 and C, and consumed the highest amount of alcohol. In macronutrients distribution ratio, the DG diet showed a lower energy intake from carbohydrates but higher from fat than the NG diet, while IFG showed a higher energy intake from carbohydrates and lower intake from fat in supper out of 3 meals and snacks. IFG preferred salt-fermented foods and DG preferred soups, braised foods and kimchi compared to other groups. NG preferred multi-grain cooked rice and both IFG and DG preferred plain white cooked rice. Regarding the association between dish group intake and blood glucose, cooked rice, soups, salt-fermented foods and kimchi were significantly related to blood glucose. In blood lipids, steamed-foods, beverages and fruits were inversely related to the risk of developing type 2 diabetes, whereas cooked rice, stews, saltfer- mented foods, seasoned-fermented foods and seasoned vegetables were directly proportional to the risk of developing type 2 diabetes and related diseases. Therefore, it is beneficial to avoid rich, salty and fatty foods and heavy alcohol consumption for controlling blood glucose and blood lipids, while steamed foods, foods rich in fiber (like multigrain rice) as a staple, and fruits and teas are recommended for preventing or managing type 2 diabetes risks.

Assessment of Nutrient Intake for Middle Aged with and without Metabolic Syndrome Using 2005 and 2007 Korean National Health and Nutrition Survey

The prevalence rate of metabolic syndrome has increased rapidly among the middle-aged and seems to be affected by socioeconomic factors, lifestyles and dietary habits. This research tries to find out the difference in dietary intake between middle-aged with and without metabolic syndrome. Using Korean National Health and Nutrition Survey (KNHANES) in 2005 and 2007, this study investigated 2,382 people (normal: 1,575, disease: 807) in 2005 and 1152 people (normal: 747, disease: 405) in 2007 (between the age of 40 and 64). Analysis was performed to discover the difference in nutrient intakes between people with and without metabolic syndrome. Also differences among people with various socioeconomic factors (such as age, education level, and income level), which can affect nutrient intake, were analyzed. In the nutrient intake people with metabolic syndrome has lower intake in most of nutrients than those of normal group, except carbohydrate. In 2007, normal group had higher intake in most nutrients, except for carbohydrate, sodium, potassium and vitamin A. Carbohydrate: protein: fat (C: P: F) ratio for syndrome group showed higher rate for carbohydrate, than normal group, in 2005, and 2007. Overall, the higher age and income level, the more carbohydrate intake rate is increase in syndrome group. The Quality of each nutrient intake was assessed using NAR (Nutrient adequacy ratio) and MAR (Mean adequacy ratio). According to the MAR, there was significant difference in 2005, 0.83 for normal group and 0.81 for syndrome group but there wasn't any in 2007 (0.81 for normal group, 0.82 for syndrome group). By NAR, in 2005, all nutrient except phosphorus, iron, vitamin A for Normal group higher then those of syndrome group (p < 0.05). In 2007 intake of syndrome group were higher then those normal group in most of nutrient by NAR. For age, education and income, MAR for normal group is higher then that of metabolic syndrome. In conclusion, Quality of nutrient intake in normal group is better then in metabolic syndrome group. Therefore, it is necessary to monitor dietary of intake people with metabolic syndrome, and necessary measures should be taken.

Dishes Contributing to Sodium Intake of Elderly Living in Rural Areas / 대한지역사회영양학회지

Sodium is a necessary element for the body. Excessive intake of sodium is known as one of the risk factors for chronic diseases. Recently, increasing numbers of people in Korea are suffering from chronic diseases. Major causes of deaths were chronic degenerative disease with the rising aging population. Especially, the population of rural areas is growing older fast. In rural areas, it is known that under nutrition and high sodium intake were major nutritional problems. For sodium intake, there were some studies about contributing food items. They were not enough to show diets relate to sodium intakes. Thus, this study analyzed dishes contributing to sodium intakes of elderly living in rural areas. Dietary intakes using "the 24hour recall method" were used. For the analysis for sodium intakes, "Can-pro3.0" was used. Ranking of dishes by contributions of sodium intakes were Korean cabbage, kimchi (19.6%), seasoned soybean paste (5.3%), soybean paste (4.6%), soybean paste soup dried radish leaves (3.5%), hot pork and kimchi stew (3.4%) in order. Ranking of dish groups by sodium intakes was kimchies (28.3%), soup and hot soups (22.8%), stews and casseroles (9.7%), seasonings (8.2%),and seasoned vegetables (6.0%) in order. One-dish meals among cooked rice, wheat noodles among noodle and mandu, soups using the soybean paste, stews using soybean paste and kimchi, salted fish among grilled foods, stir-fried anchovy among stir-fried foods, seasoned spinach, and Korean cabbage kimchi contributed to sodium intakes. As the nutrition deficiency of the elderly living in rural areas could be a problem, and excessive sodium intakes is threatening to their health, it is needed for the senior citizens to have adequate knowledge for diets containing less sodium. And recipes for healthy food and nutrition education based on their diets are needed.

Reliability of Nutritional Screening Using DETERMINE Checklist for Elderly in Korean Rural Areas by Season / 대한지역사회영양학회지

It is very important to screen the elderly for nutritional risk, because nutritional status is a critical factor to maintain their health. Some nutrition checklists used in Korea for the elderly are from other countries. Reliability of those checklist in Korea is not studied enough. This survey was done for the elderly over 65-years-old who live in Hongcheon, An-dong, Dam-yang and Yeon-gi in Korea (subject; summer: 146, winter: 145) to study the reliability of DETERMINE checklist which is adopted widely in Korea. Using the score of DETERMINE checklist, the elderly were divided as high, middle and low risk groups. For nutritional assessment for those elderly, dietary assessment using 24 recall, anthropometry, biochemical assessment and health condition were used. Results for the checklist showed that percentage below EAR for energy intake and protein intake in winter were higher in the high risk group than other groups. The intakes of phosphorus and iron and most vitamins were below the DRI. The percentage of subjects with intake below DRI was highest in the high risk group. Sensitivity, specificity, and positive predictive values using the DETERMINE were calculated using 6 point as a cut-off point. Subjects were divided into two groups by MAR (MAR< 0.75:undernutrition, MAR< 0.75 : normal). Sensitivity recorded 49.4% and 34.3%, specificity did 61.9% and 65.4 and Positive predictive value did 62.1% and 46.0% each for summer and winter. Results of screening using DETERMINE Checklist were not matched with dietary assessment but not with anthropometric and biochemical measurement. In conclusion DETERMINE 'Checklist' is shown be a good screening tool for finding out risk groups for dietary intake in the elderly, It needs to verify reliability and validity through large-scale survey.

Dietary Intake Assessment by the Number of Chronic Diseases and the Season for Elderly Living in Rural Area

Korea's aging population has been remarkably increased. They want to have not only extension of life expectancy but also improving quality of life. To maintain the quality of life, it is essential to have good nutrition. However, nutritional status of elderly in Korea has problems qualitatively and quantitatively. Risk factors for poor nutrition are advanced age, woman, living alone and low economic status. Another risk factor in rural area is season because seasonal changes can affect food intake of elderly. Thus this study surveyed the health status and dietary intakes of elderly by season in rural area. In this study, the elderly were grouped as group 1 {elderly who have one risk factor for chronic diseases (obesity, hypertension, dyslipidemia, diabetes)} and group 2 (elderly who have more than 2 risk factors). Can-Pro 3.0 was used for dietary data analysis and SPSS 12.0 program was used for statistical analysis. Obesity had the highest percentage 62%, followed by hypertension 59.5%, dyslipidemia 21.5% and diabetes 11.6%. Obesity, hypertension, and dyslipidemia were high in winter and WHR, diabetes and anemia were high in summer. Mean intakes of energy and nutrients were less than RI. Nutrients which were changed most by season were vitamin A and Vitamin C. Intakes of calcium and folic acid were less than recommended in summer. The ratio of CPF for carbohydrate was higher and fat was lower than recommended. In conclusion, the nutrient intake of Group 2 was better in quality but Group 1 was better in quantity. Nutrient intakes were poor in summer. In rural area, more careful nutritional assesment and management are needed for aged population, especially in summer.

Comparison of Dietary Patterns by Sex and Urbanization in Different Economic Status / 대한지역사회영양학회지

The purpose of this study is to find differences in dietary patterns through menu analysis by economic status. The data was obtained from the 1998 and 2001 National Health and Nutrition Survey of Korea. The main variables were economic status, sex, and area by urbanization. The economic status was classified into low, middle, high, and top classes using a poverty line based on the 1998 and 2001 minimum standard cost of living. The areas were divided into metropolis, small city, and rural areas. The dishes of 3 meals were classified into 29 categories by cooking method. The most frequent pattern was "rice + soup + kimchi". The frequency of this Korean basic dietary pattern was the lowest in the top income class and metropolis areas, while the highest in the low income class and rural areas. The frequency of Korean recommended dietary pattern, that is, "rice + soup or stew + kimchi + side dish" was the highest in the top income class. The metropolis group preferred side dishes using meat and a cooking method that saved time, but the rural group preferred side dishes using vegetables and cooking methods that take a longer time. In comparison of dietary pattern between male and female by economic status, the higher economic status, the male's dietary patterns showed more side dishes than those of female. But the main side dish was kimchi in male low class. onsequently, the major dietary pattern in Korea is rice-style, though the western pattern is increasing in the top income class, especially in metropolis areas. Therefore, to make a better dietary pattern, we should develop and spread low-priced recipes of various side dishes and teach financial skills such as ability to make a food budget for lower income classes. Also, we should emphasize the importance of the balance between meat and vegetables and traditional diet and western diet for the top income class, especially in the metropolis areas.