Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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Development of evaluation items for accessing practice and compliance with dietary guidelines among Korean adults

성인 대상 한국인을 위한 식생활지침 실천 및 순응도 평가 항목 개발

  • Min-Ah Kim (Department of Foodservice Management and Nutrition, Graduate School, Sangmyung University) ;
  • Sung-Min Yook (Department of Foodservice Management and Nutrition, Graduate School, Sangmyung University) ;
  • Jieun Oh (College of Science and Industry Convergence, Ewha Womans University) ;
  • Jimin Lim (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Hye Ji Seo (Department of Nutritional Science and Food Management, Ewha Womans University) ;
  • Young-Suk Lim (Department of Food and Nutrition, Yongin University) ;
  • Ji Soo Oh (Department of Food and Nutrition, Yongin University) ;
  • Hye-Young Kim (Department of Food and Nutrition, Yongin University) ;
  • Ji-Yun Hwang (Major of Foodservice Management and Nutrition, Sangmyung University)
  • 김민아 (상명대학교 일반대학원 외식영양학전공) ;
  • 육성민 (상명대학교 일반대학원 외식영양학전공) ;
  • 오지은 (이화여자대학교 신산업융합대학) ;
  • 임지민 (이화여자대학교 식품영양학과) ;
  • 서혜지 (이화여자대학교 식품영양학과) ;
  • 임영숙 (용인대학교 식품영양학과 ) ;
  • 오지수 (용인대학교 식품영양학과 ) ;
  • 김혜영(A) (용인대학교 식품영양학과 ) ;
  • 황지윤 (상명대학교 식품영양학전공)
  • Received : 2024.03.19
  • Accepted : 2024.04.08
  • Published : 2024.04.30
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Abstract

Purpose: With the 2021 revision of dietary guidelines in Korean emphasizing environmentally sustainable dietary practices, this study attempted to develop an evaluation tool to comprehensively evaluate the degree of practice and compliance with food and nutrient intake, dietary habits, and dietary culture guidelines based on the revised dietary guidelines. Methods: The candidate evaluation items were collected by reviewing 934 literature reviews on domestic and foreign dietary evaluations. Fifty-nine candidate items were derived by selecting the items corresponding to dietary guidelines. The content validity ratio (CVR) cutoff point evaluation was conducted with 11 experts to delete 11 items that did not meet the CVR standard. Fifty-five pilot survey candidate items were selected through revision and additional process according to expert opinion. Seventy final candidate items were selected by adding 15 questions for validity verification and reference. A pilot survey was conducted online and offline on 332 adults aged 19-64 in Seoul and the metropolitan area, and exploratory factor analysis was used to verify the construct validity of the evaluation items. Through exploratory factor analysis, the Kaiser-Meyer-Olkin, Bartlett's sphericity test, variance explained, and Cronbach's alpha criteria were confirmed in each process. Results: Exploratory factor analyses derived three criteria: food and nutrient intakes (11 items), eating behaviors (9 items), and dietary culture (14 items), consisting of 34 evaluation items. Conclusion: The present scale was validated and can be used for comprehensive evaluations of the dietary guidelines for Korean adults in a simple way.

본 연구에서 개정된 한국인을 위한 식생활 지침을 기반으로 식품 및 영양소 섭취, 식생활 습관, 환경을 고려한 식생활 문화를 평가할 수 있는 항목을 개발하였다. 예비 문항을 확보하기 위하여 국내·외 평가도구 및 최신 문헌을 조사하여 항목을 조사하였고, 전문가 11명 대상 타당도 평가를 통해 70개의 항목을 선정하였다. 선정된 후보 항목 평가를 위해 서울·수도권 지역 중심으로 성인 332명을 대상으로 온·오프라인 조사를 시행하였고, 하루 총 에너지 섭취가 500 kcal 미만 또는 5,000 kcal 이상으로 섭취한 대상자 2명을 제외한 330명의 조사 자료를 활용하여 수렴타당도 분석 및 탐색적 요인분석을 진행하였다. 분석 결과 최종 선정된 문항은 총 34개로 식품 및 영양소 섭취 영역 11개, 식생활 습관 영역 9개, 식생활 문화 영역 14개로 구성되었다. 본 연구에서 개발한 평가 항목은 2021년 개정된 식생활지침을 기반으로 영역별로 성인의 전반적인 식사의 질과 지속가능한 식생활을 동시에 평가하는 데 용이하다는 점에서 건강한 식생활 개선을 위한 평가 도구로써 활용이 기대된다.

Keywords

Acknowledgement

This research was supported by a grant (PJ017088) from Rural Development Administration in 2022.

References

  1. Statistics Korea. Population structure by age group [Internet]. Daejeon: Statistics Korea; 2024 [cited 2024 March 4]. Available from: https://kosis.kr/visual/populationKorea/PopulationDashBoardDetail.do?statJipyoId=3739&vStatJipyoId=5901&listId=A_02&areaId=&areaNm=. 
  2. Korea Centers for Disease Control and Prevention (KCDC). The 8th National Health Statistics: National Health and Nutrition Survey (2019-2020). Cheongju: KCDC; 2020. 
  3. Ministry of Health and Welfare (KR); The Korean Nutrition Society. Application of Dietary Reference Intakes for Koreans 2020. Sejong: Ministry of Health and Welfare; 2021. 
  4. Kim IS, Yu HH, Han HS. Effects of nutrition knowledge, dietary attitude, dietary habits and life style on the health of college students in the Chungnam Area. Korean J Community Nutr 2002; 7(1): 45-57. 
  5. Emilien C, Hollis JH. A brief review of salient factors influencing adult eating behaviour. Nutr Res Rev 2017; 30(2): 233-246.
  6. Kim Y. Dietary safety management awareness and competency for healthcare among adults in Daegu and Gyeongbuk areas. Korean J Community Nutr 2020; 25(2): 112-125.
  7. Oh SY. Analysis of methods in dietary quality assessment. Proceedings of the Korean Society of Community Nutrition (KSCN) Conference; 2020 June 5; Seoul, Korea. Seoul: KSCN; 2000. p.362-367. 
  8. Lee HJ, Lee KH. Evaluation of diet quality according to self-rated health status of Korean middle-aged women: based on 2008~2009 Korean National Health and Nutrition Examination Survey. J Korean Soc Food Sci Nutr 2013; 42(9): 1395-1404. 
  9. Lee OH, Kim JK, Lee HS, Choue RW. Nutritional status, quality of diet and quality of life in postmenopausal women with mild climacteric symptoms based on food group intake patterns. Korean J Community Nutr 2012; 17(1): 69-80.
  10. Kim MH, Bae YJ. Evaluation of diet quality of children and adolescents based on nutrient and food group intake and diet quality index-international (DQI-I). Korean J Community Nutr 2010; 15(1): 1-14. 
  11. Kim WY, Cho MS, Lee HS. Development and validation of mini dietary assessment index for Koreans. Korean J Nutr 2003; 36(1): 83-92. 
  12. Park YS, Han JL, Lee JW, Cho HS, Koo J, Kim HJ, et al. The development of a simple evaluation questionnaire for screening the overweight-type dietary pattern in 30 to 49 year old adults. Korean J Community Nut 2002; 7(4): 495-505. 
  13. Korea Health Industry Development Institute (KHIDI). Diet-related health risk appraisal (D-HRA) [Internet]. Cheongju: KHIDI; 2013 [cited 2024 May 1]. Available from: https://www.khidi.or.kr/dhra. 
  14. Shim JE, Paik HY, Lee SY, Moon HK, Kim YO. Comparative analysis and evaluation of dietary intake of Koreans by age groups: (4) the Korean diet quality index. Korean J Nutr 2002; 35(5): 558-570. 
  15. Yook SM, Park S, Moon HK, Kim K, Shim JE, Hwang JY. Development of Korean healthy eating index for adults using the Korea National Health and Nutrition Examination Survey data. J Nutr Health 2015; 48(5): 419-428.
  16. Lee JS, Kim HY, Hwang JY, Kwon S, Chung HR, Kwak TK, et al. Development of nutrition quotient for Korean adults: item selection and validation of factor structure. J Nutr Health 2018; 51(4): 340-356.
  17. Yook SM, Lim YS, Lee JS, Kim KN, Hwang HJ, Kwon S, et al. Revision of nutrition quotient for Korean adults: NQ-2021. J Nutr Health 2022; 55(2): 278-295.
  18. Ministry of Food and Drug Safety (KR). Nutrition quotient program [Internet]. Cheongju: Ministry of Food and Drug Safety; 2021 [cited 2024 March 4]. Available from: https://various.foodsafetykorea.go.kr/nq/adult_survey.html. 
  19. Patterson RE, Haines PS, Popkin BM. Diet quality index: capturing a multidimensional behavior. J Am Diet Assoc 1994; 94(1): 57-64.
  20. Haines PS, Siega-Riz AM, Popkin BM. The diet quality index revised: a measurement instrument for populations. J Am Diet Assoc 1999; 99(6): 697-704.
  21. Kim S, Haines PS, Siega-Riz AM, Popkin BM. The diet quality index-international (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States. J Nutr 2003; 133(11): 3476-3484.
  22. Kennedy ET, Ohls J, Carlson S, Fleming K. The healthy eating index: design and applications. J Am Diet Assoc 1995; 95(10): 1103-1108.
  23. Guenther PM, Reedy J, Krebs-Smith SM. Development of the healthy eating index-2005. J Am Diet Assoc 2008; 108(11): 1896-1901.
  24. Guenther PM, Casavale KO, Reedy J, Kirkpatrick SI, Hiza HA, Kuczynski KJ, et al. Update of the healthy eating index: HEI-2010. J Acad Nutr Diet 2013; 113(4): 569-580.
  25. Krebs-Smith SM, Pannucci TE, Subar AF, Kirkpatrick SI, Lerman JL, Tooze JA, et al. Update of the healthy eating index: HEI-2015. J Acad Nutr Diet 2018; 118(9): 1591-1602.
  26. Ministry of Health and Welfare (KR). Dietary guidelines for Korean 2021 [Internet]. Sejong: Ministry of Health and Welfare; 2021 [cited 2023 December 8]. Available from: http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=365279. 
  27. Ministry of Health and Welfare (KR); Ministry of Agriculture, Food and Rural Affairs (KR); Ministry of Food and Drug Safety (KR). (2016.4.7.) Government, establishment of the "Public Dietary Guidelines" for healthy eating, press release [Internet]. Sejong: Ministry of Health and Welfare; 2016 [cited 2023 December 8]. Available from: https://www.mohw.go.kr/board.es?mid=a10503010100&bid=0027&tag=&act=view&list_no=330959&cg_code=. 
  28. Korea Disease Control and Prevention Agency (KDCA). The 9th (2022-2024) National Health and Nutrition Examination Survey (food life/physical activity) [Internet]. Cheongju: KDCA; 2024 [cited 2024 April 3]. Available from: Available from: https://knhanes.kdca.go.kr/knhanes/sub04/sub04_01_02.do?classType=2. 
  29. Seoul Metropolitan Government. 2020 Seoul food statistics survey report [Internet]. Seoul: Seoul Metropolitan Government; 2020 [cited 2024 April 3]. Available from: https://fsi.seoul.go.kr/front/bbs/bbsView.do?currPage=1&listSize=10&searchType=all&searchValu=&bbsCode=1020&bbsSeq=15. 
  30. Korea Disease Control and Prevention Agency (KDCA). Korean Genome and Epidemiology Study (KoGES): lifestyle survey [Internet]. Cheongju: KDCA; 2022 [cited 2024 April 3]. Available from: https://www.kdca.go.kr/contents.es?mid=a40504100100.  https://www.kdca.go.kr/contents.es?mid=a40504100100
  31. Centers for Disease Control and Prevention (CDC). NHANES 2019-2020 questionnaire instruments [Internet]. Atlanta (GA): CDC; 2019 [cited 2024 April 3]. Available from: https://wwwn.cdc.gov/nchs/nhanes/continuousnhanes/questionnaires.aspx?BeginYear=2019. 
  32. Centers for Disease Control and Prevention (CDC). 2022 NHIS survey implementation materials [Internet]. Atlanta (GA): CDC; 2022 [cited 2024 April 3]. Available from: https://www.cdc.gov/nchs/nhis/2022nhis.htm. 
  33. Lawshe CH. A quantitative approach to content validity. Person Psychol 1975; 28(4): 563-575.
  34. Kaiser HF. An index of factorial simplicity. Psychometrika 1974; 39: 31-36. 
  35. Korea Health Industry Development Institute (KHIDI). Development of standard guide for digital-based customized dietary management service [Internet]. Cheongju: KHIDI; 2021 [cited 2024 March 10]. Available from: https://www.khidi.or.kr/board/view?linkId=48870684&menuId=MENU00085. 
  36. Seoul Metropolitan Government. SMG Guidelines for a Sustainable Diet: a Practical Guide to the Seoul Mirae Bapsang. Seoul: Seoul Metropolitan Government; 2023.