• Korean Journal of Community Nutrition
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• v.8 no.5
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• pp.689-698
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• 2003

The purpose of this study was to evaluate the relationship between the diversity of food intake and nutrient intake among Korean college students participating in a nutrition education class via the internet. The subjects were 796 college students throughout South Korea (278 males, 518 females). A 3 days dietary recall survey was conducted and results were analyzed using the Computer-aided Nutritional Analysis Program. Dietary variety was assessed by DDS (dietary diversity score), MBS (meal balance score), and DVS (dietary variety score). Dietary quality was assessed by NAR (nutrient adequacy ratio), and MAR (mean adequacy ratio). As the DDS, MBS and DVS increased, the NAR and MAR improved. The subjects with a DDS of above 4 or a MBS of above 10 or a DVS of above 11 met two-thirds of the Korean recommended dietary allowance for most nutrients. The DDS, MBS and DVS correlated positively and significantly with the NAR and MAR. Associations between the NAR and high levels of DVS were more positive than those between the NAR and the DDS. Based on these results, the food intake of these subjects was not adequate. Specially, the dietary intake of calcium and iron were not adequate. Therefore, dietary guidelines should be made considering nutritional characteristics so as to improve the intake from all of the major food groups and provide a variety of foods in their diets.

• Korean Journal of Community Nutrition
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• v.4 no.1
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• pp.46-56
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• 1999

A deep understanding of the dietary patterns and nutrient intake is important for assessment of possilbe nutritional risk and for establishing nutrition improvement strategies. This study was conducted toexamine the dietary characteristics of a nutritionally poor elderly group compared to the middle-and highly-nourished group. Elderly participant was recruited from local elderly centers in Suwon city in 1998. Trained dietitians interviewed 119 elderly(35 males, 84 females) aged 60 years and over for collecting dietary data(24-hour recall) and related variables. Male and female subjects were grouped into high, middle, and low according to the mean nutrient adequancy ratio(MAR) tertiles. An analysisof the percentage of RDA(Recommended Daily Allowances of Korea) for each of the 10 nutrients showed that the male low-MAR group consumed below the RDA in all kinds of nutrients, and the female low-MAR group consumed nutrients below the RDA except vitamin C. An evaluation of nutrient density by Index of Nutritonal Quality(INQ) also showed a similar tendency. Thus, the INQ level of the male low-MAR group was significantly lower than the middle-or high-MAR group, especially in protein, vitamin A, thiamin, riboflavin, and phosphorus(p<0.05). Moreover, INQ level of female low-MAR group was significantly lower than that of the high group(p<0.05) in all nutrients. The female low-MAR group's daily food intake were also lower than those of the high-MARgroup in gains, fish, fruits, oil and beverages. The energy distribution from carbohydrates, fats and proteins showed that the male low-MAR group had significantly higher carbohydrate and lower fat proportions compared to each gender high-MAR group, respectively. The male and female low-MAR group had low scores about eating all side dishes. These findings indicate that a moderate increase of the meat/egg/fishes intake was needed by the male low-MAR group for improving nutrition adequacy, and an overall increase of the food quantity and quality was desired for the female low-MAR group. These data could be used for planning a community elderly nutrition program and establishing strategies for tailored guidelines for the individuals.

• Korean Journal of Community Nutrition
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• v.10 no.6
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• pp.880-891
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• 2005

The purpose of this study was to investigate nutrients intakes and nutritional quality of Adults and Elderly People in an island area (Wando). A three-day dietary intakes survey, using a 24 hour recall method was obtained from 187 subjects aged 46 to 84 (mean age 65.3) living in an island area (Wando). Nutient intakes were analyzed using CAN-Pro soft program and compared to Korean RDA. The quality of nutrients was assessed by analyzing nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ). The average daily mean energy intakes were 1869.0 kcal for males and 1943.9 kcal for females, respectively. Daily intakes of protein for males and females were 28.0 and 30.4 g and those of fat were 31.5 and 28.51 g, respectively. Nutrient consumed below $75\%$ of Korean RDA was protein, vitamin A, Ca and Zn in both males and females. Average CPF ratio of males and females were 78.8 : 6.0 : 15.1 and 80.0 : 6.4 13.4, respectively. Energy intake ratio from protein was significantly higher in over 60 years males. Carbohydrate dependency decreased with age. Protein dependency increased with age. Nutrient adequacy ratio (NAR) of energy, protein vitamin A and vitamin E were increased with age in males. The mean adequacy ratio (MAR), an index of overall dietary quality, were not significantly different by age group. Average MAR for males and females was 0.77 and 0.78, respectively. The index of nutritional quality (INQ) showed the tendency to decrease with age. Especially, there were significantly decreases in INQ of all nutrients, except protein, with age. Based on these results, it is evident that people in the island area did not consume enough nutrients. Specially, dietary intake of protein, vitamin A, vitamin E, and Ca were not adequate. (Korean J Community Nutrition 10(6) : $880\∼891$, 2005)

• Journal of Nutrition and Health
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• v.35 no.5
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• pp.531-543
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• 2002

To assess the dietary therapy compliance of non-insulin-dependent diabetes mellitus (NIDDM) patients living in Daegu, we evaluated diet adequacy levels by index of nutritional quality (INQ), nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and dietary variety score (DVS) with food exchange system and Korean recommended dietary allowances (KRDA). One day dietary intake was measured by 24 hour recall method for 229 subjects over 20 years of age. Average daily energy intake was 1444 kcal. The relative ratio of carbohydrate, protein and fat in terms of energy intake was 69.4：14.5：16.0. The nutrient adequacy ratio (NAR) for Vitamin A, B$_2$, calcium were lower than 0.5 and MAR was 0.65. It appeared that the consumption of each food group as compared to prescribed food exchange unit was insufficient, in the order of dairy group (10.2 $\pm$ 25.2%), fruits group (58.2 $\pm$ 71.2%) and oils & fats group (42.9 $\pm$ 42.0%). The dietary variety score (DVS) was evaluated as an useful tool for diabetes' meal management when we accept minimum intake as 0.3 of food exchange unit. We found significant correlation between food groups and anthropometric indices: cereals group and % total body fat (r = 0.251, p < 0.01), meat group and waist circumference (r = 0.241, p < 0.01), vegetables group and WHR(r = 0.139, p < 0.05), and oils poop and WHR(r = 0.165, p < 0.05). from these results, we concluded that overall status of dietary intake of NIDDM patients in Daegu area was insufficient not only in quality but also in quantity. It is suggested that nutrition education for NIDDM patients should stress on balanced food consumption to meet proscribed amount by six food group to improve the inadequacy of dietary status.

• Nutritional Sciences
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• v.7 no.2
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• pp.92-97
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• 2004

Despite the universal recommendation to eat a variety of foods, we still do not know whether and to what extent the variety affects dietary quality. This study was performed to evaluate the dietary variety scores as tools for assessing the dietary quality of Korean young adults. The 1-day dietary intake data were collected from 144 male and 214 female college students (>18 years) using the 24-hour recall method Relative nutrient intake compared to Korean Recommended Dietary Allowance (KRDA) as the nutrient adequacy ratio (NAR), were computed Also, the mean adequacy ratio (MAR) was calculated. Dietary variety score (DVS) was determined by counting the number of food items consumed daily, and the dietary diversity score (DDS) by counting the number of food groups consumed daily. Results showed that DVS, DDS and MAR were significantly correlated to each other. The MAR score significantly increased as DDS increased in both men and women. When different DVS (20$\leqDVS\leq$ 30) was evaluated for its sensitivity, specificity, measured prevalence, true prevalence, and positive and negative predictive values towards MAR, DVS 21 was revealed to be optimal dietary variety score as a cutoff point to differentiate Korean young adults with or without an adequate and balanced diet. Nutrient intakes of subjects who had DVS<21 were significantly lower than those of subjects with DVS$\qeq$ 21. These results indicate that the dietary variety score appeared to be an effective tool for evaluating the adequacy of diet in Korean young adults.

• Journal of the Korean Dietetic Association
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• v.18 no.1
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• pp.16-29
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• 2012

The purpose of this study was to investigate the changes in nutritional status of gastrectomy patients. The anthropometric and biochemical data were measured at pre-operation, at discharge, 1 month after discharge, and 3 months after discharge. Nutrient intake levels, nutrients adequacy ratio (NAR), mean adequacy ratio (MAR), and the proportion of patients with intake levels inferior to those of dietary reference intakes (DRIs) were analyzed at discharge, 1 month after discharge, and 3 months after discharge. Finally, the data on 23 patients (15 male and 8 female) were collected and used for statistical analysis. Fifteen patients underwent subtotal gastrectomy, and 8 patients underwent total gastrectomy. Compared to pre-operation, body weight and body mass index of subjects significantly decreased at discharge, 1 month after discharge, and 3 months after discharge (P<0.001). Serum albumin (P<0.001), total lympocyte count (P<0.001), total cholesterol (P<0.001), hemoglobin (P<0.001), hematocrit (P<0.001), and mean corpuscular hemoglobin concentration (P<0.05) were significantly different between pre-operation, at discharge, 1 month after discharge, and 3 months after discharge. The proportions of patients with lower nutrient intake levels than DRIs were substantial. MAR at discharge, 1 month after discharge, and 3 months after discharge were 0.70, 0.80 and 0.91, respectively. Especially, the NARs of folate, niacin, vitamin $B_2$, vitamin C, and zinc were all low. Considering the various nutritional problems of gastrectomy patients, systematic medical nutrition therapy is needed after gastrectomy.

• Journal of Nutrition and Health
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• v.30 no.7
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• pp.854-869
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• 1997

This study was conducted to evaluation the quality of meals served in elementary school based on nutrient contents and food diversity . A questionnaire was mailed to school foodservice dietitians requesting one week menus for April and October . Menus served in 388 schools from each province and from major cities in Korea were analyzed. Mean nutrient contents per meal of persons served, and food expenses per meal. Mean percentages of energy from fat was 20.2% , and was significantly l different by foodservice system. When nutrient contents were converted to amount per 1, 000kcal, all were higher than that calculated from RDA except calcium, iron, and Vitamin A. Most of these were not significantly different according to area, foodservice system, the number of persons served, and food expense per meal. Compared to 1/3 of RDA for children , many meals provided lower amounts of energy, Vit A, VitB2, and Ca. More than half of the meals provided less iron than 1/3 RDA for 10-12 years girls. Using the highest values of RDA for the elementary school age group as evaluation, criteria nutrient adequacy ratios(NAR) were lowest for Ca(0.61), Vit A(0.57), and iron(0.77). The mean adequacy ratio(MAR) was 0.86. Mean numbers of food items and dishes per meal were 15.3 and 5.1 , respectively. 66.3% of the meals provided three food groups of grain, meat, and vegetable. Except for the number of different food items served per meal, the aspect of food diversity was similar to that of nutrient contents. There was significant positive correlation between mean number of different food items served per meal and nutrient content . In summary , schools in small cities and rural areas than those in large cities, schools adapting commissary or joint management than those or density. Also the more food groups served per meal, the higher the nutrient content per meal . In summary , schools in small cities and rural areas than those in large cities, schools adapting commissary or joint management than those adapting conventional foodservice system, schools serving smaller number of persons, and schools with higher food expenses provided higher energy contents and food diversity.

• Journal of the Korean Society of Food Science and Nutrition
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• v.28 no.6
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• pp.1380-1390
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• 1999

To assess the food intake and diet quality of preschool children in Pusan, dietary survey was conducted with 176 subjects using 24hr recall method. Diet quality was assessed by food group pattern, dietary diversity score(DDS), dietary variety score(DVS), and dietary frequency score(DFS). The total number of food items consumed was 307. The foods consumed most frequently were rice, Korean cabbage kimchi, milk and green onion. When investigating the consumption pattern of major six food groups, 38.1% of subjects consumed all six groups. Food group was missed in order of fruit(41.5%), sweet(19.9%), dairy(16.5), vegetable(4.5%) and meat(1.7%). The mean values of DDS, DVS, and DFS were 5.16, 13.82, and 16.07 re spectively. Persons who had higher DDSs also had higher DVSs(p<0.001). DDS, DVS and DFS correlated positively with NAR(nutrient adequacy ratio) and MAR(mean adequacy ratio) significantly. Associations between the NAR of most nutrients and MAR with DVS and DFS were higher than those between the NAR of most nutrients and MAR with DDS. People with DDS of above 6 or DVS of above 16 or DFS of above 21 met two thirds of recommended dietary allowance for nutrients. Based on the result of the food group intake, the food intake of subjects was not adequate, especially the fruit and dairy groups. When assessing the dietary quality of subjects using DDS, DVS and DFS, many people appeared not to have a desirable food intake.

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

• Journal of Nutrition and Health
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• v.37 no.10
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• pp.908-916
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• 2004

Due to the common dietary practice of preparing foods in various ways using the same food item, in addition to rather a large number of food items that average Koreans consume, it is difficult to accurately assess the nutritional adequacy. In an effort to identify a reliable means of assessing the nutritional adequacy of Korean adults, we analyzed the association between the scores of dietary diversity (DDS) and dietary variety (DVS), and the quality of nutrient intake as assessed by Nutrient Adequacy Ratio (NAR) and Mean Adequacy Ratio (MAR). A three day-dietary record was obtained from each of 324 inhabitants, aged 40 to 69 years (mean :t SD,52.4 $\pm$ 8.7), of a rural area (Ansung) and a mid-sized city (Ansan) of Korea. These individuals were randomly selected among the participants of the Korean Health and Genome Study. The number of consumed foods and food groups were assesses by DDS (scored 1 to 5) and DVS (ranked 30 $\leq$,31 - 40, 41 - 50, 51 - 60, and 60 <) over three-day period, respectively. As DDS/DVS increased, mean daily food intakes tended to increase, and NARIMAR was improved. Thus, DDS and DVS were significantly correlated with the quality of nutrient intake. Over 95% of the subjects scored less than 2 in DDS for the first one-day period, whilst over 62% recorded 4 during the full three-day period (p < .0001). The mean number of consumed food items increased from 24.9 to 44.4 as a function of days of the record period (p < .0001). We also analyzed the association of DDS and DVS with MAR, using regression analysis, controlling age and sex as covariates. For DDS, the adjusted coefficient determination (adj $R^2$) values were 8.7%,15.8%,23.3% of MAR, also increasing as a function of the record duration, whereas they were 27.3%, 33.3%, 37.6% for DVS, respectively, demonstrating that NAR/MAR has a better correlation with DVS than DDS. Our data show that DDS, and DVS in particular, are useful parameters for evaluating nutrient intake in the Korean population. Our data also support that one day-dietary records are by no means adequate for accurately describing a wide variety of food choices offered for average Koreans, and that dietary assessment at least for 3 days or longer should be obtained for a reliable evaluation of dietary quality using DDS or DVS.