• Nutrition Research and Practice
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• v.17 no.2
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• pp.269-283
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• 2023

BACKGROUND/OBJECTIVES: This study aimed to examine the food security status of urban poor adolescents and its association with diet quality. SUBJECTS/METHODS: A cross-sectional survey was conducted among 188 adolescents aged 13-18 yrs living in Kuala Lumpur, Malaysia. Household food insecurity and dietary intake data were collected using the Radimer/Cornell hunger and food insecurity instrument and 2-day 24-h dietary recalls, respectively. Diet quality was determined using the Malaysian Healthy Eating Index (HEI). Weight and height were measured and body mass index-for-age, as well as height-for-age z scores were calculated. RESULTS: The present study revealed that 47.9% of the adolescents experienced household food insecurity, 24.5% experienced individual food insecurity, 18.6% household food security, and 9.0% child hunger. The mean score of diet quality was 56.83 ± 10.09, with a significantly lower HEI score among food insecure adolescents (household food insecure, individual food insecure, and child hunger) than household food secure adolescents (P = 0.001). The differences between food secure and food insecure households were found to be significant for energy (P = 0.001) and nutrients including proteins (P = 0.006), carbohydrates (P = 0.005), dietary fiber (P = 0.001), folate (P < 0.001), and vitamin C (P = 0.006). The multiple linear regression showed that adolescents who experienced food insecurity (β = -0.328; P = 0.003) were found to be significantly associated with poor diet quality (F = 2.726; P < 0.01), wherein 13.3% of the variation in the diet quality was explained by the food security status. CONCLUSIONS: Experiencing food insecurity contributed to poor diet quality among urban poor adolescents. Further longitudinal studies are needed to comprehensively understand this association to improve food insecurity and diet quality among urban poor communities.

• Nutrition Research and Practice
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• v.9 no.5
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• pp.511-516
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• 2015

BACKGROUND/OBJECTIVES: This study aims to determine contribution of meal frequency, self-efficacy for healthy eating, and availability of healthy foods towards diet quality of adolescents in Kuala Lumpur, Malaysia. SUBJECTS/METHODS: This study was conducted among 373 adolescents aged from 13 to 16 years old. Diet quality of the respondents was assessed using the Healthy Eating Index for Malaysians. Meal frequency, self-efficacy for healthy eating, and availability of healthy foods were assessed through the Eating Behaviours Questionnaire (EBQ), self-efficacy for healthy eating scale, and availability of healthy foods scale, respectively. RESULTS: The majority of the respondents (80.7%) were at risk of poor diet quality. Males ($mean=34.2{\pm}8.2%$) had poorer diet quality than females ($mean=39.9{\pm}9.0%$) (t = -5.941, P < 0.05). Malay respondents ($mean=36.9{\pm}8.7%$) had poorer diet quality than Indian respondents ($mean=41.3{\pm}10.0%$) (F = 2.762, P < 0.05). Age (r = 0.123, P < 0.05), self-efficacy for healthy eating (r = 0.129, P < 0.05), and availability of healthy foods (r = 0.159, P < 0.05) were positively correlated with the diet quality of the respondents. However, meal frequency was not correlated with the diet quality of the respondents. Multiple linear regression analysis showed that being a male, being a Malay, low self-efficacy for healthy eating, and low availability of healthy foods contributed significantly towards poor diet quality among respondents. CONCLUSIONS: In short, sex, ethnicity, self-efficacy for healthy eating, and availability of healthy foods were associated with diet quality among adolescents. Health practitioners should take into consideration of differences in sex and ethnicity during implementation of nutrition-related intervention programs. Self-efficacy for healthy eating and availability of healthy foods should be included as important components in improving diet quality of adolescents.

• Nutrition Research and Practice
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• v.1 no.2
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• pp.84-88
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• 2007

The purpose of this study was to identify dietary patterns among children and adolescents in Korea and to examine their associations with obesity and some blood profiles. One day food consumption data measured by 24-hour recalls on 2704 subjects aged 1 to 19 were used from 2001 Korea National Health and Nutrition Survey. The data of blood profiles available in the ages of 10 or older was also used. After categorizing each food consumed into 29 food or food groups, five dietary patterns were derived through a factor analysis and subjects were classified into three major dietary patterns via a cluster analysis using the factor scores. Three dietary patterns were identified as 'traditional diet' (25.6%), 'westernized-fast food' (6.2%), and 'mixed diet' (68.2%). The 'traditional diet' pattern had a higher percentage in boys. Both the 'traditional diet' and the 'westernized-fast food' had higher proportions of adolescents (12-19 y) than younger children, while the 'mixed diet' had a higher percentage of preschool children (1-5 y). Obesity rate analyzed within each age group showed no differences among 3 dietary pattern clusters. Blood pressure and all plasma profiles were not different among dietary patterns when adjusted with age and gender. Conclusively, children and adolescents in Korea had three distinct dietary patterns, which were associated with gender and age. These patterns could be useful to plan nutrition interventions for teenager health promotion.

• Nutrition Research and Practice
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• v.5 no.4
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• pp.322-328
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• 2011

The aim of this study was to use the Healthy Eating Index-2005 (HEI-2005) to assess diet quality and determine the relationship between the HEI-2005 and the energy and nutrient intakes of adolescents. A cross-sectional study was conducted on 1,104 healthy adolescents, mean age of $15.8{\pm}1.24$ years. Dietary intake was measured with the 24-hour dietary recall method, and dietary quality was assessed by means of the HEI-2005. Diet quality scores ranged from 23.7 to 77.5. The mean score was found to be $51.5{\pm}9.07$ according to the HEI-2005. There were no differences according to gender, 42.8% had a poor diet and 57.2% had a diet that needs improvement. No subjects had a "good diet". Lower mean subgroup scores were found for whole grains, total vegetables, total fruits, dairy products, and meat and beans. Fruits and vegetables scores were significantly high in girls, whereas sodium, oil, and meat and beans scores were significantly high in boys. Total HEI-2005 scores were increasingly associated with parental education level when age and gender were adjusted. There was a negative correlation between HEI-2005 scores and age, total energy intake, and fat intake. Positive correlation was only observed in the HEI-2005 scores for protein and dietary fibre intakes. Consequently, the overall diet quality and nutritional habits of Turkish adolescents need modification and improvement. In the family, measures should be initiated by the government, including advertisements and campaigns.

• Korean Journal of Community Nutrition
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• v.3 no.5
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• pp.679-684
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• 1998

This study was conducted to investigate the determinants of obesity during adolescnece. A total of 726 adolescents living in rural areas in Korea had been observed for four years from 1992 to 1996 regarding their diet, sexual maturity, blood profile and physical growth. Stepwise multiple regression analysis was used to identify priorities fo the importance between the factors influencing obesity. The average nutrient intake over the three year period was higher than that of the Korean Recommended Dietary Allowances. The prevalence of obesity for the subjects based on BMI was 9.5%. Results of the stepwise multiple regression analysis showed that blood components and sexual maturity were more significant factors for determining the obesity than the dietary factors. The result may suggest that to understand obesity in children it is necessary to develop on analytical model for the children rather than using the existing analytical model developed mostly for adult patients of obesity. The model should include a wide range of variables such as diet, sexual maturity and changes in blood.

• Journal of Nutrition and Health
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• v.34 no.4
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• pp.433-439
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• 2001

Intakes and excretions of calcium and phosphorus were determined for 8 female adolescents(aged 16.3$\pm$0.5y; body mass index 20.4$\pm$1.3kg/$m^2$; body fat 33.3$\pm$2.5%; bone mineral density of lumbar spine in L2-L4; 0.96$\pm$0.08g/$\textrm{cm}^2$) when they consumed diets basal and high in calcium for 6 days each. All subjects consumed a basal Ca diet containing 800mg, Korean RDA level of the subjects, and a high Ca diet containing 1200mg, RDA plus 2 SDs of calcium intake. The diets provided 58% of energy intake as carbohydrate, 25% as fat, and 17% as protein. Food, urine, and fecal composites were collected during the last 3 days of each feeding period. Fecal excretion of calcium was significantly greater on the high Ca than on the basal Ca diet. Hence, apparent absorption rate was significantly lowered from 40.9% on the basal Ca diet to 33.1% on the high Ca diet. There was no significant difference in calcium retention between the two diet periods but it tended to be greater on the high Ca diet. However, excretions and retention of phosphorus did not show any significant difference even though intake was significantly increased from 1,253mg on the basal Ca diet to 1,583mg on the high Ca diet. The results indicate that higher calcium intake than the Korean RDA level is recommended for adolescents to meet peak bone mineral accretion and attain a desirable level of calcium retention. (Korean J Nutrition 34(4) : 433~439, 2001)

• Journal of Nutrition and Health
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• v.55 no.3
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• pp.406-417
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• 2022

Purpose: The incidence of chronic diseases is increasing and the age of onset is decreasing in South Korea. Healthy eating habits to prevent chronic diseases are established in adolescence. This study verified the identified factors and dynamics that affect diet self-assessment for sustainable adolescent health and the prevention of chronic diseases. Methods: Data were collected from 492 middle and high school students in South Korea from June to July 2018, and the participants answered a questionnaire on dietary safety management competency for sustainable health. Results: The healthy dietary self-assessment scores of overweight/obese adolescents and adolescents who perceived their health as normal were significantly lower than those of other groups. Factor analysis verified the validity of the items that comprised each study area before a multiple regression analysis was used to investigate the factors affecting healthy dietary self-assessment. Sweet and salty diets, anxiety, food and nutrition knowledge, weight management knowledge, stress management, exercise, basic eating habits, and healthy eating habits significantly affected healthy dietary assessment among adolescents. A higher perception of one's health indicated a higher healthy dietary self-assessment, dietary safety knowledge, and health management practice scores (p < 0.01). Factors like healthy dietary self-assessment, food and nutrition knowledge, and weight management knowledge appear to have a significant correlation with other identified factors, except overeating. The adolescents' awareness, knowledge, and dietary safety practices influenced healthy dietary self-assessment, which can prevent chronic diseases and achieve sustainable health. Conclusion: This study illustrated how the adolescents' awareness, knowledge, and practices of dietary safety influenced their healthy diet self-assessment. The results indicate that diet-based health management competency education relative to the adolescents' self-perception and weight levels should be implemented.

• Nutrition Research and Practice
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• v.16 no.2
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• pp.272-283
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• 2022

BACKGROUND/OBJECTIVES: Most child and adolescent food literacy measurement tools focus on nutrition and food safety. However, the importance of aspects related to the food system such as food distribution and food waste and their effects on environmental sustainability is growing. We therefore developed and validated a two-dimensional tool for children (8-12 years old) and adolescents (13-18 years old) that can comprehensively measure food literacy. The association of food literacy with diet quality and self-reported health was assessed. SUBJECTS/METHODS: First, we developed a food literacy conceptual framework that contains food system and literacy dimensions through a literature review, focus group interviews, and expert review. After a face validity study, we conducted the main survey (n = 200) to validate the questionnaire. Construct validity and reliability were assessed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Cronbach's alpha. RESULTS: As a result of the Delphi study, content validity was confirmed for the remaining 30 items after two items were excluded (content validity ratio = 0.86). Eleven items were excluded from the EFA results, while the CFA results indicated appropriate fit indices for the proposed model (comparative fit index = 0.904, root mean square error of approximation = 0.068). The final food literacy questionnaire consisted of 19 questions and comprised 5 factors: production, distribution, selection, preparation and cooking, and intake. Food literacy was positively associated with diet quality, as assessed by the Nutrition Quotient score, in both children and adolescents and with self-reported health in adolescents.

• Nutrition Research and Practice
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• v.7 no.4
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• pp.330-335
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• 2013

Data are limited on the association between dietary patterns and screen time among Korean adolescents. The present study identified dietary patterns of 691 adolescents, aged 13-18 years, who had participated in the Third Korean National Health and Nutrition Examination Survey (KNHANES III) and analyzed their associations with screen time. Screen time was defined as the time spent watching TV, using a computer, or playing video games was calculated as a sum of all these times. Dietary patterns and their factor scores were derived from a food frequency questionnaire using the factor analysis method. To analyze the association between dietary patterns and screen time, we conducted multiple linear regression analysis. We also performed multiple logistic regression analysis to estimate odds ratios (OR) of excessive screen time (2 hours or longer per day) and 95% confidence intervals (CI). We identified 2 dietary patterns labeled "the Korean healthy dietary pattern" and "the Western diet and fast foods pattern". The former included mixed grains, legumes, potatoes, red meat, eggs, fish, dairy products, fruits, vegetables, seaweeds, and mushrooms, whereas the latter included noodles, bread, red meat, poultry, fast foods, snack, and soft drinks. After controlling for potential confounding factors, factor scores for the Korean healthy dietary pattern were inversely associated (P-value for trend < 0.01) and those for the Western diet and fast foods pattern were positively associated with the screen time (P-value for trend < 0.01). Adolescents in the top tertile of the scores for the Korean healthy dietary pattern had a multivariable-adjusted OR [95% CI] of 0.44 (0.25-0.75) for excessive screen time compared with those in the lowest tertile. On the basis of these findings, adolescents who have excessive screen time may need to be encouraged to consume a more healthy diet.

• Journal of Korean Home Economics Education Association
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• v.23 no.3
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• pp.37-51
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• 2011

The contents of 'Nutrition and Diet for Adolescents' in the 12 technology and home economics middle school 1st grade textbooks are analyzed based on the elaboration theory. The elaboration theory is the lecture strategy with 7 essential elements, proposed by Reigeluth. The elaboration strategies shown in 'Nutrition of Adolescents' and 'Diet for Adolescents' are all the same in 12 books, the conceptual elaboration, and the process elaboration, respectively. On the other hand, the elaboration strategies shown in 'Diet and Dietary Habit for Adolescents Nutrition Issues' and 'Proper Eating Habit and Nutrition Issues' are different depend upon the textbooks, all 3 conceptual, theoretical, and process elaborations strategies are shown. The element of pro study is presented by study objective, opening the thinking, and looking back. The summarizer is presented in all 11 but 1 textbooks by various activities and data. On the other hand, the element of analogy has the lowest implementation rate, only 3 among the 12 textbooks implement the analogy. The cognitive-strategy activator and learner control are shown in all 12 textbooks, mostly by data. Implementation of more activities and more analogies might be helpful to the students' participation and understanding the contents of 'Nutrition and Diet for Adolescents'.