• Journal of Nutrition and Health
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• 제42권4호
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• pp.374-385
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• 2009

This study aims to develop an index of food security in order to assess food security status in Korea and to evaluate reliability and validity of the index. The index of food security was developed based on the US Household Food Security Survey Module (US-HFSS). After the US-HFSS was translated and back-translated, it was evaluated and modified by a focus interview for experts. The developed Korean Household Food Security Survey Module (K-HFSS) was tested by cognitive interviews and a pretest for general community population to assess its application for Korean population. For the reliability and validity of K-HFSS, the survey was conducted with 300 adults aged 40 years or more living in a rural community and 212 infants and toddlers living in an urban community. The reliability was assessed by Cronbach' alpha and the validity was evaluated by content validity, construct validity, and criterion-related validity. The questionnaire items of K-HFSS were partly modified, accounting for Korean social and cultural backgrounds and adapted by general community population. The reliability was relatively high, showing Cronbach' alpha coefficients ranged from 0.80 (for adults) to 0.87 (for infants and toddlers). The content and construct validities were all acceptable. The result of criterion-related validity showed that food security status was significantly related to the household income level. In conclusion, the K-HFSS would be used as a reliable and valid instrument to assess food security status in parts of the Korean population.

• Journal of Nutrition and Health
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• 제44권6호
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• pp.551-561
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• 2011

Given that household food security issues have become the concern of the Korean society, this study aimed to develop food security measures for the Korean population. Based on the literature reviews on previously developed food security measures, the 18-item US household food security survey module (US HFSSM) was adapted. The developed food security measures was assessed by qualitative validity method. It was evaluated and modified by face validity by expert focus groups belong to university, public health center, and government agencies and by cognitive interview by 40 subjects with low household income who live in an urban community and are participants in welfare programs of local districts. Then, it was reviewed and revised by the National Institute of the Korean Language and the advisory committee for nutrition survey of Korean National Health and Nutrition Examination Survey (KNHANES). The results showed that the developed questionnaire items were well adapted by expert focus groups and general subjects, showing the feasibility of measuring food security with the developed measures although there were discrepancies in some expressions of questionnaire items between experts focus groups and general subjects. The study to assess reliability and quantitative validity of the developed food security measures should be further needed to examine its application for KNHANES.

• Nutrition Research and Practice
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• 제16권1호
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• pp.94-105
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• 2022

BACKGROUND/OBJECTIVES: The purpose of this study was to investigate the association between socioeconomic status and chewing discomfort and identify the role of food insecurity in the association's causal pathway in a representative sample of Korean elders. MATERIALS/METHODS: We conducted cross-sectional analyses of the Korea National Health and Nutrition Examination Survey (2013-2015) data for elders aged ≥ 65 years. Socioeconomic status indicators used included household income and education level. Chewing discomfort was assessed according to the self-reported presence of chewing problems. Food security was surveyed using a questionnaire based on the US Household Food Security Survey Module. RESULTS: The odds ratios of chewing discomfort in the 1st and 2nd income quartiles were 1.55 (95% confidence interval [CI], 1.15-2.10) and 1.40 (95% CI, 1.03-1.90), respectively, compared to participants in the highest income quartile. Participants with the lowest education level were 1.89 (95% CI, 1.30-2.75) times more likely to have chewing discomfort than those without chewing discomfort. After including food security in the final model, the logistic coefficients were attenuated in the income and education quartiles. CONCLUSIONS: Low socioeconomic status was associated with chewing discomfort. In addition, the results confirm that food insecurity can mediate the association between socioeconomic inequalities and chewing discomfort among the elderly.

• 대한지역사회영양학회지
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• 제16권6호
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• pp.771-781
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• 2011

The objective of this study was to assess the reliability and validity of food security measures, which was developed based on the US household food security survey module (US HFSSM) with content validity in the Korean population. The reliability and validity were assessed by internal consistency, construct validity and criterion-related validity. The study included 446 households. Among those, 46.2% were households with children. The proportion of food insecure households was 33.3%. Among those, 35.4% and 64.6% households were food insecure with hunger and without hunger, respectively. The Cronbach's alpha coefficients were 0.84 and the infit value by the Rasch model analysis ranged from 0.68 to 1.43. The scale item response curves by food insecurity severity explained well the nature and characteristics of food security, indicating the highest proportion of "yes" for the items on diet quality, followed by those with diet quantity. The result of criterion-related validity showed that food insecurity status was significantly related in a dose-response manner with the household income level, food expenditure, subjective health state, subjects' educational level. Household food security status was also related to dietary diversity regarding protein foods, fruits and fruit juice, and milk and dairy product. These findings suggest that the food security instrument is reliable and valid and would be used to assess food security status in the Korean population.

• 대한영양사협회학술지
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• 제21권4호
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• pp.308-319
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• 2015

The purpose of this study was to assess risk factors associated with food insecurity in the Korean elderly aged over 65 years using data from the Korea National Health & Nutrition Examination Survey 2013 (KNHANES VI). A total of 1,200 subjects were analyzed among the participants of the KNHANES 2013 by using SPSS statistics complex samples (ver. 21.0). Food insecurity was measured by using the modified US Household Food Security/Hunger Survey Module. Thirteen percent of subjects lived in food insecure households. There were differences in the prevalence of food insecurity according to sex, educational level, income level, and household structure. Mean age of the food insecurity group was significantly higher than that of the food security group. The results of logistic regression analysis showed that food insecurity was significantly associated with alcohol intake (OR: 1.82), prevalence of melancholy (OR: 2.07) and suicidal thoughts (OR: 2.67), and intake deficiency of energy (OR: 1.60), calcium (OR: 1.97), iron (OR: 1.97), potassium (OR: 1.96), riboflavin (OR: 1.76), and niacin (OR: 1.64), while not with smoking, physical activity, chronic diseases including obesity, anemia, diabetes, and osteoarthritis, and deficiency of protein, vitamin A, thiamin and vitamin C. These findings suggest that food insecurity is strongly related to mental health and certain nutrient intakes. Prospective research is needed to establish the effects of food insecurity on chronic diseases.

• 보건행정학회지
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• 제32권2호
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• pp.216-227
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• 2022

Background: Food insecurity may contribute to mental health indicators such as stress, anxiety, or depression. We investigated whether food insecurity was associated with mental health indicators and health-related quality of life (HRQoL) in a representative sample of the Korean population. Methods: This study enrolled 12,987 adults without a history of medically serious disease from the 2012, 2013, and 2015 Korea National Health and Nutrition Examination Survey. Household food security status was categorized as "food security," "mild food insecurity," and "moderate/severe food insecurity." The association between mental health and HRQoL was evaluated using a multivariate logistic regression model with food security as the reference group. Results: The adjusted odds ratio of adverse mental health or low HRQoL increased significantly in mild or moderate/severe food insecurity compared to food security. In the moderate/severe food insecurity group, it was 1.98% (95% confidence interval [CI], 1.31-2.99) higher for perceived stress, 3.58% (95% CI, 2.44-5.26) higher for depression symptoms, 4.16% (95% CI, 2.68-6.45) higher for suicidal ideation, and 2.81% (95% CI, 1.91-4.15) higher for quality of life. Conclusion: Food insecurity was strongly associated with negative mental health status and poor HRQoL. There is a need for a dietary support program that provides psychosocial support to those experiencing food insecurity.