• Nutrition Research and Practice
• /
• v.16 no.sup1
• /
• pp.21-36
• /
• 2022

BACKGROUND/OBJECTIVES: The long-term health impacts of dietary sugar have begun to be reported. The committee on the 2020 Dietary Reference Intakes for Koreans for sugar intended to update the scientific evidence on the association of added sugar intake with health outcomes, including mortality. This study evaluated the evidence on the association of dietary sugar with the all-cause and cardiovascular disease mortality from cohort studies. SUBJECTS/METHODS: The PubMed and ScienceDirect databases were searched until July 2021. The search terms were based on multiple combinations of keywords, such as added sugar, beverage, and mortality, included in the title or abstract. Two authors independently assessed the eligibility criteria of study selection and extracted the information from each selected article for this systematic review. RESULTS: The literature search identified 276 articles. Seventeen cohort studies met the inclusion criteria and were included in this systematic review. This study extracted information on the cohort and participants, dietary assessment methods, exposure and its comparison groups, health outcomes, and risk measures. Five articles reported added sugar intake, and 15 articles reported the food sources of the added sugar in the association with mortality. Increased mortality was observed in higher added sugar intake and a lower intake of less than 5% of energy, while higher discrepancies between gender, age groups, and countries were noted. In addition, nutritious sugary foods and beverages did not increase mortality. CONCLUSIONS: A 'U' or 'J' shaped relationship between the added sugar intake and mortality was estimated. The observed discrepancy indicated the need for more evidence to establish the dose-response relationship for Koreans.

• Korean Journal of Community Nutrition
• /
• v.15 no.1
• /
• pp.15-26
• /
• 2010

The purpose of this study was to compare nutrient intakes and blood lipids of middle-aged women according to the obesity index by %Fat. Subjects were assigned to one of the following groups based on percentage of body fat (%Fat): normal weight (18% ~ < 28%), overweight (28% ~ < 33%) and obesity (over 33%). Nutrient intakes were evaluated based on questionnaires of 24 hours recall method and blood lipids were analyzed by blood analyzer. The results were as follows. 1) Nutrient intakes were that carbohydrates and fat intakes in obesity group were higher than normal and overweight group but the difference was not significant, and protein intake rate was similar all groups. The intake rate of calcium was higher in normal group than obesity group (p < 0.05), and obesity group ingested under dietary reference intakes. The intake rate of iron was higher in obesity group than normal group (p < 0.05). 2) TG, TC, VLDL and TC/HDL in obesity group were higher than normal group (p < 0.001). The attack rate of coronary heart disease in obesity group is higher than normal group (p < 0.01), LDL, blood glucose and blood pressure in obesity group were higher than normal group (p < 0.01), and HDL was a little higher in normal group than obesity group, but the difference was not significant. 3) The correlation of anthropometric measurements, blood glucose, blood lipid, and blood pressure had significant results. Weight was associated positive level with blood glucose, blood lipid and blood pressure. Waist and WHR were associated positive level with blood glucose and blood lipid but weren't associated with blood pressure. BMI was associated positive level with blood glucose, blood lipid and blood pressure, %Fat was associated positive level with blood lipid and blood pressure, but wasn't associated with blood glucose. These results suggest that the decrease of waist on blood glucose control is better than decrease of % Fat and BMI, the decrease of %Fat and BMI on blood pressure control is better than decrease of waist, and the decrease of %Fat on blood lipid control is better than waist and BMI. The nutritional education for obesity treatment must perform to analyze the blood and assess the obesity degree by %Fat, waist and BMI before nutritional education, so the obesity treatment will be effectively.

• Environmental Analysis Health and Toxicology
• /
• v.30
• /
• pp.4.1-4.11
• /
• 2015

Objectives: This survey was designed to conduct the first nationwide dietary exposure assessment on hazardous substances including the intakes of functional food and herbal medicine. In this paper, we introduced the survey design and the results of the dietary exposure status and internal exposure levels of lead (Pb), cadmium (Cd), and mercury (Hg). Methods: We selected 4867 subjects of all ages throughout Korea. We conducted a food survey, dietary survey, biomonitoring, and health survey. Results: Pb and Cd were the highest (median value) in the seaweed ($94.2{\mu}g/kg$ for Pb; $594{\mu}g/kg$ for Cd), and Hg was the highest in the fish ($46.4{\mu}g/kg$). The dietary exposure level (median value) of Pb was $0.14{\mu}g/kg$ body weight (bw)/d, $0.18{\mu}g/kg$ bw/d for Cd, and $0.07{\mu}g/kg$ bw/d for Hg. Those with a blood Pb level of less than $5.00{\mu}g/dL$ (US Centers for Disease Control and Prevention, reference value for those 1 to 5 years of age) were 99.0% of all the subjects. Those with a blood Cd level with less than $0.30{\mu}g/L$ (German Federal Environmental Agency, reference value for non-smoking children) were 24.5%. For those with a blood Hg level with less than $5.00{\mu}g/L$ (human biomonitoring I, references value for children and adults, German Federal Environmental Agency) was 81.0 % of all the subjects. Conclusions: The main dietary exposure of heavy metals occurs through food consumed in a large quantity and high frequency. The blood Hg level and dietary exposure level of Hg were both higher than those in the European Union.

• The Korean Journal of Community Living Science
• /
• v.28 no.1
• /
• pp.5-16
• /
• 2017

This study was conducted to compare the nutritional status, nutrient intakes, and chronic disease risks of Chinese elderly people. MNA (Mini Nutritional Assessment) developed for elderly people was used to determine their nutritional status. In this study, participants consisted of 148 urban residents aged 65 years and over residing in three cities in Shandong Province, China. Participants were 67 (45.3%) men and 81 (54.7%) women, and average age was 72.8 years. According to MNA score, 77.7% of participants were 'well nourished', 22.3% were 'at risk of malnutrition', and 2% were 'malnourished'. Nutritional status was divided into two groups by MNA score as 'well nourished' and 'malnourished', which was formed with the combination of 'at risk of malnutrition' and 'malnourished'. Compared with the well nourished group, the malnourished group was older, and physical status indicators such as weight, BMI (Body Mass Index), and calf circumference of the malnourished group were much smaller. The malnourished group had higher prevalence rates of heart disease and stomach disorders while the well nourished group had a higher rate of hypertension. There was no significant difference between the malnourished group and well nourished group in nutritional intake below Chinese DRIs (Dietary Reference Intakes) among elder males. A higher proportion of elder females showed insufficient intakes of energy, protein, vitamin A, vitamin E, and zinc in the malnourished group compared to the well nourished group. The INQ (Index of Nutrition Quality) of calcium, magnesium, zinc, iodine, and most vitamins was less than 1 in both the malnourished and well nourished groups.

• Korean Journal of Community Nutrition
• /
• v.15 no.4
• /
• pp.485-497
• /
• 2010

The purpose of this study was to investigate effects of the developed nutrition education program focused on individual daily energy requirements and food exchange units using Food Exchange System for diabetes mellitus at a community health center. Developed the nutrition education program, four weeks' nutrition education including provided twice individual meal as diet therapy (2 hour/lesson/week, 4 week), was provided to 20 diabetic elderly (12 male, 8 female, 50-75 yrs): 1st lesson "Introduction: management of diabetes mellitus", 2nd lesson "6 Food groups and sources of 6 food groups", 3rd lesson "Individual daily energy requirements and food exchange units", and 4th lesson "Food choice for diabetes mellitus". For effects' analysis of the developed program, we assessed the changes in anthropometric characteristics; biochemical characteristics and nutrient intakes using 24 hr recall method. Effects of the developed nutrition education program were as follows: weight was significantly decreased, blood urea nitrogen (BUN) and glycosylated hemoglobin (HbA1c) were significantly decreased, and distribution of subjects in BUN and HbA1c was significantly changed. In protein : fat : carbohydrate (PFC) ratio, it was significantly changed from 15.98 : 16.30 : 66.69 to 17.51 : 18.94 : 64.10. In evaluation of nutrient intakes by Dietary Reference Intakes for Koreans (KDRI), protein, fiber, fat, vitamin E, niacin, folic acid, calcium and zinc were shown significantly positive changes in distribution of subjects according to intake level. The index of nutrition quality (INQ), nutrition adequacy ratio (NAR) and mean nutrition adequacy ratio (MAR) were significantly increased. In conclusion, the developed 4 weeks' nutrition education program focused on individual daily energy requirements and food exchange units using Food Exchange System for diabetes mellitus at community health center may improve the symptom of diabetes mellitus.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.28 no.3
• /
• pp.722-731
• /
• 1999

The purpose of this study is to analyze the factors associated with health and diet by nutritional status. The subjects were the children aged 2 to 6. Physicians and nurses measured children's anthropometries and examined their blood and urine. Interviewers questioned children's food habits to their mothers. 24 hour recall was done for children with their mother. The nutritional status was classified to 'underweight', 'normal weight' and 'overweight' by weight for height(median±1 S.D.) of the reference population. The number of subjects in each group(under, normal, over) was 25, 130 and 49. Factors including anthropometry and hemoglobin concentration were not significantly dif ferent by the nutritional status. The birth weight of children was correlated positively to mothers' BMI. Z scores of weight for height were related to the birth weight positively by the analysis of variance. The children of the underweight group used nutritional supplements more frequently than those of normal and overweight group. The nutrient intakes of normal weight group were higher than those of low and overweight group. Particularly, the intakes of energy, carbohydrate and calcium were significantly high among the groups. In terms of number of foods, food groups and dishes consumed per day, the children of the normal weight group ate more diversely than other groups but the differences were not significant. In conclusion, the children of normal weight group had similar characteristics with other groups but had more desirable dietary intakes than other groups in this study. Because the diet of children may be different by the nutritional status, nutrition education for children should be conducted according to the characteristics of each group's diet.

• Journal of Nutrition and Health
• /
• v.56 no.6
• /
• pp.730-741
• /
• 2023

Purpose: The 2020 Dietary Reference Intakes for Koreans (KDRIs) serves as a foundation for daily nutrient and energy recommendations aiming to enhance public health and prevent chronic diseases. They act as guidelines for maintaining proper nutrition and overall health. Using KDRIs is crucial for promoting healthier lifestyles and making informed dietary choices. Thus, this study explores the influence of a nutrition education program, based on the 2020 KDRIs, on the nutrition knowledge and dietary habits of undergraduates in Gyeongsangnam-do and Gyeonggi-do. Methods: The nutrition education program, designed with diverse instructional materials, was executed across a wide range of universities. The education group (n = 75) engaged in the program for a 6-week instructional period, while the control group (n = 53) underwent the survey without participating in the education program. Nutrition Quotient (NQ) and knowledge assessments were administered to both groups immediately before and after the instructional period. Results: Within the education group, the nutrition education program positively impacted responses to NQ practice items, including knowledge of nutrition, daily intake, and portion sizes (p < 0.05). In contrast, there were no significant differences between the before and after responses of the control group for most survey items. Post-program evaluations showed significantly higher self-assessment scores and increased satisfaction levels (p < 0.05), with the satisfaction rate for the education program using the 2020 KDRIs reaching 99.2%. Conclusion: This study has demonstrated the positive impact of an effective nutrition education program. However, there is a need for the continuous development and implementation of nutrition education programs to sustain these outcomes and further enhance the nutritional education experience.

• Korean Journal of Community Nutrition
• /
• v.15 no.3
• /
• pp.329-341
• /
• 2010

The purpose of this study was to examine vegetable & fruit (V/F) intakes, beliefs and self-efficacy regarding V/F consumption, nutrition knowledge and eating behavior of elementary students. A survey was conducted to the 4th graders (n = 234) at two elementary schools in Guri, Kyunggi-do. About one-fourth of subjects were overweight or obese. Subjects had 4.2 servings of V/F a day, consuming 340.2 g of V/F. Girls consumed significantly more amounts of vegetables than boys (p < 0.05). Girls were more favorable regarding V/F consumption (p < 0.01), and believed more strongly on advantages of having V/F such as “good for skin” constipation prevention (p < 0.001) and cancer prevention (p < 0.05). Boys felt more strongly in disadvantages or barriers of eating V/F, including mother's cooking time constraints (p < 0.01), lack of past experience of eating V/F, and family members' disliking of V/F (p < 0.05). Girls felt more confident in eating V/F (p < 0.05) than boys; they also felt more confident in specific items of "eating fruits/salads instead of cookies/chips for snack" and "eating fruit juice/vegetable juice instead of soda"(p < 0.01). Subjects showed low level of nutrition knowledge, especially in items such as balanced meals, recommended servings of V/F and vitamin deficiency. Compared to boys, girls had more desirable eating behavior such as eating adequate amount of meals (p < 0.001), having a variety of foods, eating fruits daily, and having fatty foods less frequently (p < 0.05). Intakes of Ca and K were quite below the recommended level, while the intakes of protein, Na and vitamin A intake were much above the Dietary Reference Intakes (DRI) for 9-11 old children. Nutrient intakes expressed as %DRI was higher in girls for vitamin A (p < 0.01), energy and riboflavin (p < 0.05). High V/F consumption group (${\geq}5$ servings of V/F a day) compared to the counterparts showed higher self-efficacy and had better eating behaviors. Nutrition education for children should focus on increasing consumption of V/F, by helping them to increase self-efficacy for eating V/F and to recognize the benefits and reduce the barriers of eating V/F, especially in boys. It is also needed to provide nutrition information for balanced meals or increasing V/F consumption, and help the children to adopt desirable eating behavior.

• Journal of Nutrition and Health
• /
• v.40 no.sup
• /
• pp.9-21
• /
• 2007

This study aimed to assess the total sugar intake for Korean and to identify major food sources contributing to those food components. Korean adults aged over 20 years old from the Korean National Health and Nutrition Examination Survey (KNHANES) 2001 and 2002 were selected. The data were analyzed to obtain nationally and seasonally representative information on the health and nutritional status of the Korean. Forty food groups were used in identifying food sources of total sugar and energy intake. Total sugar contents of foods in the KNHANES data sets were estimated by food code matching technique with Release 18 of the USDA National Nutrient Database for Standard Reference. Sample weighted means, standard errors, and population percentages were calculated using SAS and SUDAAN. The mean total sugar intake of the Korean was 60.3g in 2001, 40.9g in spring 2002, 45.7g in summer 2002, and 52.1g in fall 2002, which were 30-44% of intake of US people. Fresh fruit was identified as the most significant food source for total sugar intake in Korean population in all age groups and all seasons. The next major food sources following fresh fruits were candy/jelly/syrup/honey, coffee/coffee caream, vegetables, Kimchi, soft drinks, milk, fruit juice, cookie/cracker/cake, and vegetable juice/grain juice, which showed similar results through the seasons. While carbonated soft drink was the most significant food sources for total sugar or added sugar intakes for US people. The total sugar intakes were significantly higher in women, higher educational level, and residing in metropolitan area. As intake of total sugar increased, intakes of protein, fiber, calcium, phosphorus, iron, Vit A, B1, B2, C, niacin showed significantly increased, while high intakes of added sugars showed low intakes of some micronutrients in the US people. Percentages of people who consumed nutrients below EAR were less in higher total sugar intake group than in lower intake group. From these results, we can conclude that the food consumption habits including the total sugar intake of Korean people seems relatively good so far. More reliable database of total sugar and added sugar composition tables in public domain should be established in the future, and also more researches about total sugar and added sugar for Koreans should be continued.

• Korean Journal of Community Nutrition
• /
• v.17 no.6
• /
• pp.689-706
• /
• 2012

The purpose of this study was to evaluate effects of a nutrition education focused on Food Exchange System for the higher grades elementary children. Nutrition education lessons (40 min/lesson, 4 times), '5 major nutrients and functions', '6 food groups', 'daily needed energy and food exchange units', 'good choice of snacks and balanced exercise' were provided to elementary students (5th grade students). This research was based on the data from two groups of elementary school children in the 'education' group (n = 31) and 'non-education' group (n = 31). We assessed the changes in dietary attitude, food habit and nutrition knowledge using questionnaire and nutrient intake using 24hr recall method by nutrition education using the developed pamphlet. After education, there was a significant difference in the dietary attitude score only in attitude of 'balanced meal' (p < 0.001) in the education group compared to the non-education group. In food habit, there were significant positive changes in the type of breakfast and in the priority of choosing snack in the educated group. In nutrition knowledge, there were significant increases in scores of 'function of carbohydrate' (p < 0.05), 'function of fat' (p < 0.01), 'function of vitamin' (p < 0.01), 'foods of carbohydrate' (p < 0.01), and 'foods of vitamin' (p < 0.01) in the educated group. After education, carbohydrate: protein: fat (CPF) ratio was significantly different between the two groups (education group, 59 : 16 : 26 vs. non-education group, 63 : 15 : 23). In evaluation of nutrient intake by Dietary Reference Intakes for Koreans (KDRIs), there were significant positive effects in energy (p < 0.05), thiamin (p < 0.05), riboflavin (p < 0.05), vitamin C (p < 0.05), phosphorus (p < 0.01), Fe (p < 0.01) and zinc (p < 0.01) in the education group compared to the non-education group. In conclusion, the developed 4 times' nutritional education pamphlet focused on individual daily energy requirements and food exchange units using food exchange system for higher grades' elementary student may positively change nutrition knowledge and dietary intakes.