• Korean Journal of Community Nutrition
• /
• v.28 no.4
• /
• pp.282-292
• /
• 2023

Objectives: Bone health in early adulthood, as individuals approach peak bone mass, plays a critical role in preventing osteoporosis later in life. This study aimed to investigate the associations between lifestyle and dietary factors, anthropometric measurements, and urinary bone resorption markers in young adults. Methods: A cross-sectional study was conducted with 100 healthy Korean adults (50 men and 50 women) in their 20s and early 30s. Bone mineral density (BMD), anthropometric measurements, dietary intake (24-hour recall), and urinary bone resorption indicators (deoxypyridinoline and N-terminal telopeptide of type I collagen) were analyzed. Variables were compared between the osteopenia and osteoporosis groups (OSTEO group: 30% men and 60% women) and the healthy control group. Results: Men in the OSTEO group were significantly taller than those in the control group (P < 0.05). Women in the OSTEO group had significantly lower body weight and body composition (muscle and body fat) than those in the normal group (P < 0.01). Men in the OSTEO group had a significantly higher intake of animal calcium (Ca) than those in the normal group (P < 0.05). Women in the OSTEO group had significantly higher dietary fiber, vitamin A, Ca, plant Ca, and potassium intake than did those in the normal group (P < 0.05). There were no significant differences in caffeinated beverage consumption, eating habits, or urinary bone resorption indicators between the OSTEO and control groups of either sex. Conclusions: In our study of young South Korean adults, we observed low bone density levels, with particularly low BMD in taller men and underweight women. We found a higher nutrient intake in the OSTEO group, indicating the possibility of reverse causality, a phenomenon often found in cross-sectional studies. Therefore, there is a need to further elucidate dietary factors related to osteoporosis in young adults through prospective cohort studies involving a larger population.

• Korean Journal of Community Nutrition
• /
• v.29 no.1
• /
• pp.34-50
• /
• 2024

Objectives: Transformation through a sustainable food system to provide healthy diets is essential for enhancing both human and planetary health. This study aimed to explain about sustainable diets and illustrate appropriate measurement of adherence to sustainable diets using a pre-existing index. Methods: For literature review, we used PubMed and Google Scholar databases by combining the search terms "development," "validation," "sustainable diet," "sustainable diet index," "planetary healthy diet," "EAT-Lancet diet," and "EAT-Lancet reference diet." For data presentation, we used data from National Health and Nutrition Examination Survey, 2017-2018, among adults aged 20 years and older (n = 3,920). Sustainable Diet Index-US (SDI-US), comprising four sub-indices corresponding to four dimensions of sustainable diets (nutritional quality, environmental impacts, affordability, and sociocultural practices), was calculated using data from 24-hour dietary recall interview, food expenditures, and food choices. A higher SDI-US score indicated greater adherence to sustainable diets (range: 4-20). This study also presented SDI-US scores according to the sociodemographic status. All analyses accounted for a complex survey design. Results: Of 148 papers, 16 were reviewed. Adherence to sustainable diets fell into 3 categories: EAT-Lancet reference diet-based (n = 8), Food and Agriculture Organization (FAO) definition-based (n = 4), and no specific guidelines but including the sustainability concept (n = 4). Importantly, FAO definition emphasizes on equal importance of four dimensions of diet (nutrition and health, economic, social and cultural, and environmental). The mean SDI-US score was 13 out of 20 points, and was higher in older, female, and highly educated adults than in their counterparts. Conclusions: This study highlighted that sustainable diets should be assessed using a multidimensional approach because of their complex nature. Currently, SDI can be a good option for operationalizing multidimensional sustainable diets. It is necessary to develop a Korean version of SDI through additional data collection, including environmental impact of food, food price, food budget, and use of ready-made products.

• Korean Journal of Community Nutrition
• /
• v.29 no.1
• /
• pp.51-64
• /
• 2024

Objectives: This study examined the association between ultra-processed food (UPF) consumption and chronic diseases in elderly Koreans. Methods: Data from the 2019-2021 Korea National Health and Nutrition Examination Survey were analyzed. Dietary intake and UPF consumption were assessed using the NOVA food classification based on 24-hour recall data from 3,790 participants (aged 65+ years). Participants were divided into 4 groups based on the quartile of energy intake from UPFs. Regions were classified as urban or rural. Multivariable logistic regression was employed to estimate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) after controlling for potential confounders. Results: Among the participants, 71.3% resided in urban and 28.7% in rural areas. Compared to the urban elderly, rural participants tended to be older, have lower education and income levels, be more likely to live in single-person households, and have a higher smoking rate (P < 0.05). Urban elderly consumed more UPFs daily (146.1 g) compared to rural residents (126.6 g; P < 0.05). "Sugar-sweetened beverages" were the most consumed category in both regions. "Sweetened milk and its products" and "traditional sauces" were prominent in urban areas, while rural elderly consumed more "traditional sauces" and "distilled alcoholic beverages." Rural areas also had a higher carbohydrate-to-calorie ratio than urban areas. Compared to the lowest quartile of UPF intake, the highest quartile was significantly associated with impaired fasting glucose only in rural areas (AOR, 1.48; 95% CI, 1.00-2.19; P for trend = 0.0014). No significant associations were observed for diabetes in either urban or rural areas. Conclusions: This study suggests that high intake of UPFs is associated with increased odds of impaired fasting glucose in rural elderly. Further research is needed to elucidate the specific negative health effects of UPFs in different populations, and targeted efforts should promote healthy diets in both urban and rural areas.

• Journal of Nutrition and Health
• /
• v.57 no.2
• /
• pp.261-274
• /
• 2024

Purpose: Recently, high-protein diets have become highly popular, and the market for protein products has steadily increased in Korea together with the development of various types of such products. However, there is limited information on the consumption of protein supplements (PS) or protein-fortified foods (PF). Thus, this study aimed to evaluate the use of PS/PF among young adults in Jeju. Methods: A total of 350 adults (140 men and 210 women) aged 19-39 years voluntarily participated in this study from June 2022 to May 2023. PS/PF use was measured using a questionnaire. Dietary intake was assessed using a 24-hour dietary recall. Results: Approximately 31.4% of the participants (n = 110) had consumed PS/PF for more than 2 weeks during the past year and 71.8% of them (n = 79) were still consuming these products (PS/PF consumers). The PS/PF consumers tended to be male and physically active (p < 0.05 for all). The most frequent reason for PS/PF use was muscle gain (59.5%), followed by protein supplementation (19.0%) and body fat loss (13.9%), and the most frequent type of PS/PF consumed was powders (70.6%), followed by drinks (17.7%) and bars (8.8%). The PS/PF consumers tended to consume a high-protein low-carbohydrate diet compared to the non-consumers. The prevalence of consuming dietary protein less than the estimated average requirement (EAR) was significantly lower in PS/PF consumers (13.9%) compared to non-consumers (25.4%; p = 0.0316). Conclusion: These findings indicate that the necessity of protein supplementation should be determined based on the current dietary protein intake and individual requirements. The study also provides the basic information for establishing guidelines for appropriate protein intake.

• Korean Journal of Community Nutrition
• /
• v.29 no.2
• /
• pp.144-155
• /
• 2024

Objectives: This study evaluated dietary intake and food sources of essential fatty acids in Korean adolescents. Methods: This study was comprised of 3,932 adolescents (9-18 years) who participated in the 2016-2021 Korea National Health and Nutrition Examination Surveys. Dietary intake and food sources of essential fatty acids, including alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and linoleic acid (LA) were evaluated using data obtained from one-day 24-hour dietary recall. The proportions of adolescents consuming ALA, EPA + DHA, and LA above or below the adequate intake (AI) of the 2020 Dietary Reference Intakes for Koreans were calculated. All statistical analyses accounted for the complex sampling design effect and appropriate sample weights. Results: The mean intakes of ALA, EPA, DHA, and LA among Korean adolescents were 1.29 g/day, 69.6 mg/day, 166.0 mg/day, and 11.1 g/day, respectively. Boys had higher intakes of all essential fatty acids compared to girls. By age group, adolescents aged 15-18 years showed lower intakes of EPA and DHA compared to adolescents in younger age groups. The 9-11-year-old adolescents had lower intakes of ALA and LA than older adolescents. The proportions of adolescents who consumed more than AI were 35.7% for ALA, 30.4% for EPA + DHA, and 41.5% for LA. Adherence to the AI for ALA did not differ by sex or age group, although boys showed a lower adherence to the AI for EPA + DHA than girls. Major food sources for ALA and LA were plant-based oils, mayonnaise, pork, and eggs. Mackerel was the most significant contributor to EPA and DHA intake (EPA, 22.6%; DHA, 22.2%), followed by laver, squid, and anchovy. Conclusions: The proportion of Korean adolescents who consumed EPA + DHA more than AI was low. Our findings highlight that nutrition education emphasizing an intake of essential fatty acids from healthy food sources is needed among Korean adolescents.

• Korean Journal of Community Nutrition
• /
• v.5 no.2
• /
• pp.297-306
• /
• 2000

In order to examine the relationship between the number of different foods consumed and nutrient intake, one-day food consumption were surveyed by 24-hour recall from a sample of 287 individuals(20-49 years) living in Daejon City. The number of consumed food items did not include seasonings except red pepper power, sugar, oil, and soybean paste when used in large amounts(DVS). The number, including all seasonings except salt and vinegar(DVSS), was also counted. Of the total subjects, 43.6%(DVS) or 39.0%(DVSS) consumed 18-23 daily different foods with an average of 20.2 or 22.9, respectively. As the DVS increased, daily intakes of total foods and most food groups were elevated. Cereals however were not changed and eggs were decreased with increasing DVS. Energy and nutrient intakes and their mean adequacy ratio(MAR) and index of nutritional quality(INQ) also show positive correlations with DVS. MAR equal to or greater than($\geq$) 0.75 was taken as a cut-off point for nutritional adequacy. In that case, the mean INQ was shown to be $\geq$1. MRI(10) for energy and 9 nutrients and MAR(3) for Ca, vitamin A, and riboflavin were estimated. Form a regression analysis, when MAR(10) was 0.75, the DVS and DVSS were assumed to be 19.6 and 22.2, respectively. And when MAR(3) was 0.75, the DVS and DVSS were assumed to be 31.6 and 34.6, respectively. However the subjects whose MAR(3) was 0.75(0.7-0.8) 23.8(DVS) or 26.6(DVSS) different foods in average, and their mean intakes of energy and all nutrients, except vitamin A, were ranged at 85-100% of the RDA. Of the 74 subjects who consumed DVS$\geq$24, 24 to 42 numbers took 〈75% RDA of Fe, Ca, riboflavin, and vitamin A. And five of 7 who consumed DVS$\geq$32 took $\geq$125%RDA of protein, which showed concerns of overnutrition in case of DVS$\geq$32. Form the above results it could be suggested that a daily intake of 24-32(or 28) of DVS or 27-35(or 31) of DVSS was recommendable for an optimal nutritional of all nutrients if the variety of food groups and sufficient intake of vitamin A and calcium were emphasized together.

• International Journal of Human Ecology
• /
• v.4 no.2
• /
• pp.27-37
• /
• 2003

Although the idea that obese people consume higher calorie diets is widely accepted, many dietary surveys have shown that obese people do NOT consume larger amounts of energy. We had an opportunity to study the relationship between calorie intake and obesity in Korea from the data contained in the '98 National Health and Nutrition Examination Survey of Korea. The survey was executed nationwide for two months - from Nov. 1 to Dec.30 in 1998. The survey included 10,876 (aged >10 years) subjects of whom 9,771 underwent health examinations. Surveyors visited each household and checked health status, measured anthropometry and blood pressures, collected blood and urine samples, and interviewed from the health questionnaires. Well-trained dietitians evaluated the food consumption of 11,525 subjects over the age of 1 year with the 24-hour recall method. The number of subjects from whom a complete health examination and food consumption information was obtained was 8,004. Subjects were classified by BMI (< 20, 20-22, 22-24, 24-26, 26-28, 28 $\leq$) and into newly diagnosed patients with DM (FBS $\geq$ 126 mg/㎗), hypertension (SBP $\geq$ 140 mmHg or DBP $\geq$ 90 mmHg) and hyperlipidemia (Total cholesterol $\geq$ 220 mg/㎗ or TG $\geq$ 200 mg/㎗). Our main results were as following：1) their average energy intake was 2,029.6 $\pm$ 908.5 ㎉ and BMI is 22.6 $\pm$ 3.4 kg/$m^2$；2) a comparison of nutrient intakes by BMI level did not show a significant difference of energy intake even though BMI increased (BMI, < 20： 1,999 ㎉ ∼ 28 $\leq$： 2,028 ㎉)；and 3) Even in newly diagnosed patients with diabetes, hypertension or hyperlipidemia, their energy consumption was not significantly increased as BMI increased (from BMI 20). There are several possible explanations for these results：1) Reduced physical activity caused the weight of obese people to increase even with the same energy intake；2) people underreported their energy consumption；or, people intentionally reduced their energy consumption due to self-image regarding their obesity. We might also hypothesize that there is a metabolic problem conceiving obese people, because calorie intake was not higher in obese people than in non-obese people in Korea. Further research is necessary for re-evaluating these current conclusions.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.24 no.6
• /
• pp.892-900
• /
• 1995

Dietary data of 538 middle school students have been analysed to identify the contribution of specific foods to absolute intake and between-person-variance in nutrient consumption. The 24-hour-dietary-recall method had been used to collect the data required. Contribution of specific foods, in terms of ranking order for both absolute intake and between-person-variance have been observed. Ranking order of food for absolute intake was given based on the percen of contribution whereas the ranking order of foods for between-person-variance was given based on the percent of contribution whereas the ranking order of foods for between-person-variance was given based on a coefficient fo variation. As a result, for most of the nutrients(except cholesterol), the ranking order of foods for the between-person-variance was quite different from that of absolute intake. The results indicate that to identify between-person-variance of nutrient intake in an epidemiology study, foods with a high ranking in between-person-variance should be included in developing the food frequency questionnaires rather than foods which showed a high ranking in absolute intake.

• Journal of Nutrition and Health
• /
• v.33 no.2
• /
• pp.193-201
• /
• 2000

This study was conducted to investigate the effectiveness of nutrition counseling on the dietary intake and nutritional status cancer patients undergoing radiotherapy treatment. The study was conducted over 6 week period and included 104 patients : 66 received nutrition counseling as the variable group of 42 male and 24 female and 38 patients received no counseling as the control group of 19 male and 19 female. Nutrition counseling was accompanied with the radiation therapy and adminstered via counseling session and distribution of printed material during radiation therapy for 6 weeks. Nutrition counseling aimed at maintaining a balanced diet and preventing weight loss of subjects, guideline used for energy and protein intake were 35kcal/kg IBW and 1.5-2.0g/kg IBW, respectively. Over the course of the study, the counseling group increased significantly in comparison to the control group's energy intake, evidenced by the counseling group's initial mean daily energy intake of 1932.0kcal, and 4 and 6 week mean energy intake values of 2046.6kcal, 2066kcal, respectively. But mean energy values of control group was 1614.3kcal at 4 week. Th energy intake per weight values and protein intake per weight values for initial, 4 and 6 week intervals for counseling group were 33.2kcal/kg, 33.7kcal/kg, 34.0kcal/kg, and 1.48g/kg, 1.58g/kg, 1.59g/kg, respectively. Based on results, nutrition counseling had positive effects on both the variety of diet and energy intake of the variable group, mostly due to an increase in dairy product and egg consumption. In addition, the percentage of counseling group patients who consumed all 5 food group increased from 48.5% to 54.5%. Sufficient energy intake and protein consumption seem to be important factors in weight loss prevention, evidenced by weight gain by subjects in the counseling group who had 36.1kcal/kg/day mean energy intake and 1.77g/kg/day mean protein intake after 4 weeks. Counseling group subjects experiencing weight loss had lower intake and 1.77g/kg/day mean protein intake after 3 weeks. Counseling group subjects experiencing weight loss had lower intakes of 29.3kcal/kg/day for energy and 1.33g/kg/day for protein during the same period. Another significant factor in weight loss prevention of the counseling group could be the variety of diet. The dietary variety scores(DVS) of both counseling and control groups differed significantly : the counseling group had a mean score of 34 while the control group of patients. At the end of the study, the mean percentage of subjects within each group having a DDS 5 was higher in the counseling group (54.5% v.s. 24.0%). In this study, nutrition counseling for cancer patients undergoing radiation therapy proved to be effective in preventing weight loss, a major complication during radiotherapy. Nutrition counseling not only increased protein and energy intake, but also had desirable effects on variety or diversity of diet.

• Journal of Nutrition and Health
• /
• v.51 no.1
• /
• pp.73-86
• /
• 2018

Purpose: The aim of this study was to design optimized food intake patterns that meet the nutritional recommendations with minimal changes from the current food intake patterns among Korean adults using linear programming. Methods: Data of a one day 24-hour dietary recall from the 2010 ~ 2014 Korea National Health and Nutrition Survey were used to quantify the food items that Korean adults usually consumed. These food items were categorized into seven groups and 24 subgroups. The mean intakes and intake distributions of the food groups and the food subgroups were calculated for eight age (19 ~ 29, 30 ~ 49, 50 ~ 64, and over 65 years old) and gender (male and female) groups. A linear programming model was constructed to minimize the difference between the optimized and mean intakes of the food subgroups while meeting the Dietary Reference Intakes for Koreans (KDRIs) for energy and 13 nutrients, and not exceeding the typical quantities of each food subgroup consumed by the respective age and gender groups. Results: The optimized food intake patterns, which were a set of quantities of 24 food subgroups, were obtained mathematically for eight age and gender groups. Overall, major modifications of current diet were required to increase the intake of vegetables and milk/dairy products and decrease the Kimchi intake. The optimized intake of seasonings, including salt, was calculated to be 0 g for all the age and gender groups. Conclusion: The optimized food intake patterns designed using linear programming in this study lack feasibility because they suggest a seasoning consumption of 0 g. Modification of intake goal for sodium is needed to obtain optimized food intake patterns with improved feasibility.