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http://dx.doi.org/10.4163/jnh.2020.53.6.629

Development of nutrition quotient for elementary school children to evaluate dietary quality and eating behaviors  

Lee, Jung-Sug (Department of Food & Nutrition, Kookmin University)
Hwang, Ji-Yun (Department of Foodservice Management and Nutrition, Sangmyung University)
Kwon, Sehyug (Department of Statistics, Hannam University)
Chung, Hae-Rang (Nutrition for the Future Inc.)
Kwak, Tong-Kyung (Department of Food & Nutrition, Yonsei University)
Kang, Myung-Hee (Department of Food & Nutrition, Hannam University)
Choi, Young-Sun (Department of Food & Nutrition, Daegu University)
Kim, Hye-Young (Department of Food & Nutrition, Yongin University)
Publication Information
Journal of Nutrition and Health / v.53, no.6, 2020 , pp. 629-647 More about this Journal
Abstract
Purpose: This study was undertaken to develop a nutrition quotient for elementary school children (NQ-C) for evaluating the overall dietary quality and eating behaviors. Methods: The NQ-C was developed by implementing 3 stages: item generation, item reduction, and validation. Candidate food behavior checklist (FBC) items of the NQ-C were derived from systematic literature reviews, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. For the pilot survey, 260 elementary school students (128 second graders and 132 fifth graders) completed self-administered questionnaires as well as 24-hour dietary intakes, with the help of their parents and survey team staff, if required. Based on the pilot survey results, expert reviews, and priorities of national nutrition policy and recommendations, checklist items were reduced from 41 to 24. A total of 20 items for NQ-C were finally selected from results generated from 1,144 nationwide samples surveyed. Construct validity of the NQ-C was assessed using the confirmatory factor analysis, LInear Structural RELations. Results: Analyses of the exploratory factors of NQ-C identified that 5 dimensions of diet (balance, diversity, moderation, practice and environment) accounted for 46.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-C and 5-factor scores of the subjects were calculated using the obtained weights of the FBC items. Conclusion: Our data indicates that NQ-C is a useful and suitable instrument for assessing nutrition adequacy, dietary quality, and eating behaviors of Korean elementary school children.
Keywords
nutritive quality; child; eating behavior; checklist;
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Times Cited By KSCI : 17  (Citation Analysis)
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1 Oh SM, Yu YL, Choi HI, Kim KY. Implementation and evaluation of nutrition education programs focusing on increasing vegetables, fruits, and dairy foods consumption for preschool children. Korean J Community Nutr 2012; 17(5): 517-529.   DOI
2 Joreskog KG, Sorbom D. LISREL 8: structural equation modeling with the SIMPLIS command language. Chicago (IL): Scientific Software International; 1993.
3 Marshall S, Burrows T, Collins CE. Systematic review of diet quality indices and their associations with health-related outcomes in children and adolescents. J Hum Nutr Diet 2014; 27(6): 577-598.   DOI
4 Choi Y, You Y, Go KA, Tserendejid Z, You HJ, Lee JE, et al. The prevalence of obesity and the level of adherence to the Korean dietary action guides in Korean preschool children. Nutr Res Pract 2013; 7(3): 207-215.   DOI
5 Lee AR, Yu YL, Kim HJ, Kim KA, Kim KY. Status of dietary life related knowledge, self-efficacy, food preference and dietary behavior of preschoolers in Kyunggi area. Korean J Community Nutr 2016; 21(3): 274-283.   DOI
6 De Cosmi V, Scaglioni S, Agostoni C. Early taste experiences and later food choices. Nutrients 2017; 9(2): 107.   DOI
7 Kang MH, Lee JS, Kim HY, Kwon S, Choi YS, Chung HR, et al. Selecting items of a food behavior checklist for the development of nutrition quotient (NQ) for children. Korean J Nutr 2012; 45(4): 372-389.   DOI
8 Kim HY, Kwon S, Lee JS, Choi YS, Chung HR, Kwak TK, et al. Development of a nutrition quotient (NQ) equation modeling for children and the evaluation of its construct validity. Korean J Nutr 2012; 45(4): 390-399.   DOI
9 Cheng G, Duan R, Kranz S, Libuda L, Zhang L. Development of a dietary index to assess overall diet quality for Chinese school-aged children: the Chinese children dietary index. J Acad Nutr Diet 2016; 116(4): 608-617.   DOI
10 Altavilla C, Caballero-Perez P. An update of the KIDMED questionnaire, a Mediterranean diet quality index in children and adolescents. Public Health Nutr 2019; 22(14): 2543-2547.   DOI
11 Toffano RB, Hillesheim E, Mathias MG, Coelho-Landell CA, Salomao RG, Almada MO, et al. Validation of the Brazilian healthy eating index-revised using biomarkers in children and adolescents. Nutrients 2018; 10(2): 154.   DOI
12 Ronca DB, Blume CA, Cureau FV, Camey SA, Leotti VB, Drehmer M, et al. Diet quality index for Brazilian adolescents: the ERICA study. Eur J Nutr 2020; 59(2): 539-556.   DOI
13 Lee SJ, Kim Y. Evaluation of the diet and nutritional states of elementary and middle school students in the Daegu area by using nutrition quotient for children. J Nutr Health 2013; 46(5): 440-446.   DOI
14 Ministry for Health, Welfare and Family Affairs. Dietary guidelines for Korean children. Seoul: Ministry for Health, Welfare and Family Affairs; 2011.
15 Serra-Majem L, Ribas L, Ngo J, Ortega RM, Garcia A, Perez-Rodrigo C, et al. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean diet quality index in children and adolescents. Public Health Nutr 2004; 7(7): 931-935.   DOI
16 Feskanich D, Rockett HR, Colditz GA. Modifying the healthy eating index to assess diet quality in children and adolescents. J Am Diet Assoc 2004; 104(9): 1375-1383.   DOI
17 Hurley KM, Oberlander SE, Merry BC, Wrobleski MM, Klassen AC, Black MM. The healthy eating index and youth healthy eating index are unique, nonredundant measures of diet quality among low-income, African American adolescents. J Nutr 2009; 139(2): 359-364.   DOI
18 Branscum P, Sharma M, Kaye G, Succop P. An evaluation of the validity and reliability of a food behavior checklist modified for children. J Nutr Educ Behav 2010; 42(5): 349-352.   DOI
19 Yoo JS, Choi YS. Evaluation of items for the food behavior checklist and nutrition quotient score on children in rural areas of Gyeongbuk. J Nutr Health 2013; 46(5): 427-429.   DOI
20 Kim WK, Kang MH, Kim SH. Survey on nutritional status and dietary behaviors of middle school students in Korea using the nutrient quotient (NQ) of children for dietary education. J Korean Soc Food Sci Nutr 2019; 48(4): 456-468.   DOI
21 Lee JS, Kang MH, Kwak TK, Chung HR, Kwon S, Kim HY, et al. Development of nutrition quotient for Korean preschoolers (NQ-P): item selection and validation of factor structure. J Nutr Health 2016; 49(5): 378-394.   DOI
22 Korea Disease Control and Prevention Agency. Korea National Health and Nutrition Examination Survey. Primitive Data Download [Internet]. Cheongju: Korea Disease Control and Prevention Agency; c2020 [cited 2020 Mar 14]. Available from: https://knhanes.cdc.go.kr/knhanes/index.do.
23 Boo MN, Cho SK, Park K. Evaluation of dietary behavior and nutritional status of elementary school students in Jeju using nutrition quotient. J Nutr Health 2015; 48(4): 335-345.   DOI
24 Bae JM, Kang MH. Age difference in association between obesity and nutrition quotient scores of preschoolers and school children. J Nutr Health 2016; 49(6): 447-458.   DOI
25 Jung YH, Kim JH. Evaluation of nutrition quotient and related factors in preschool children. Korean J Community Nutr 2016; 21(1): 1-11.   DOI
26 Kim HY, Lee JS, Hwang JY, Kwon S, Chung HR, Kwak TK, et al. Development of NQ-A, nutrition quotient for Korean adolescents, to assess dietary quality and food behavior. J Nutr Health 2017; 50(2): 142-157   DOI