• Korean Journal of Community Nutrition
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• v.28 no.6
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• pp.480-494
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• 2023

Objectives: This study sought to assess the effectiveness of community-based nutrition counseling on improving nutritional status, managing complex chronic diseases, and enhancing the quality of life for elderly individuals with chronic conditions, particularly in older adults with high levels of food insecurity and multiple chronic illnesses. Methods: Thirty elderly subjects with diabetes and hypertension who were registered at local Senior Welfare Center received individualized nutrition counseling, based on their Nutrition Quotient for the Elderly (NQ-E) index. Over a 16-week period, they received tailored counseling and underwent various health and nutritional assessments. The final analysis included 28 participants after two dropped out. Data analysis was conducted using the SPSS v28.0. Results: The subjects were over 70, with multiple chronic diseases including diabetes and hypertension and predominantly female. After 16 weeks, significant improvements were observed in the subjects' grip strength, and HbA1c levels, as well as in their NQ-E scores, indicating improved dietary balance and diversity. There were no significant improvements in the 'Moderation' subdomain of the NQ-E index, suggesting that this aspect requires further attention in nutritional counseling. The subjects' nutritional risk scores (NSI) were also significantly decreased, indicating less nutritional risk. Lastly, as measured by the SF-36K, the subjects' quality of life showed significant improvement in several domains including physical role performance and social function. Conclusions: This study demonstrates that tailored nutrition counseling, based on the NQ-E index, can improve elderly health, manage chronic diseases, and enhance quality of life. This approach potentially broadens the scope of community nutritionists' roles within an aging society. However, additional research is necessary to evaluate these interventions' long-term effects and sustainability.

• Journal of Nutrition and Health
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• v.53 no.6
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• pp.629-647
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• 2020

Purpose: This study was undertaken to develop a nutrition quotient for elementary school children (NQ-C) for evaluating the overall dietary quality and eating behaviors. Methods: The NQ-C was developed by implementing 3 stages: item generation, item reduction, and validation. Candidate food behavior checklist (FBC) items of the NQ-C were derived from systematic literature reviews, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. For the pilot survey, 260 elementary school students (128 second graders and 132 fifth graders) completed self-administered questionnaires as well as 24-hour dietary intakes, with the help of their parents and survey team staff, if required. Based on the pilot survey results, expert reviews, and priorities of national nutrition policy and recommendations, checklist items were reduced from 41 to 24. A total of 20 items for NQ-C were finally selected from results generated from 1,144 nationwide samples surveyed. Construct validity of the NQ-C was assessed using the confirmatory factor analysis, LInear Structural RELations. Results: Analyses of the exploratory factors of NQ-C identified that 5 dimensions of diet (balance, diversity, moderation, practice and environment) accounted for 46.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-C and 5-factor scores of the subjects were calculated using the obtained weights of the FBC items. Conclusion: Our data indicates that NQ-C is a useful and suitable instrument for assessing nutrition adequacy, dietary quality, and eating behaviors of Korean elementary school children.

• Journal of Nutrition and Health
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• v.51 no.4
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• pp.340-356
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• 2018

Purpose: This study was conducted to develop a nutrition quotient (NQ) to assess overall dietary quality and food behaviors of Korean adults. Methods: The NQ was developed in three steps: item generation, item reduction, and validation. Candidate items of the NQ checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the Korea National Health and Nutrition Examination Survey (2010 ~ 2013) data, and national nutrition policies and recommendations. A total of 368 adults (19 ~ 64 years) participated in a one-day dietary record survey and responded to 43 items in the food behavior checklist. Pearson's correlation coefficients between responses to the checklist items and nutritional intake status of the adults were calculated. Item reduction was performed, and 24 items were selected for a nationwide survey. A total of 1,053 nationwide adult subjects completed the checklist questionnaires. Exploratory and confirmatory factor analyses were performed to develop a final NQ model. Results: The 21 checklist items were used as final items for NQ. Checklist items were composed of four factors: nutrition balance (seven items), food diversity (three items), moderation for the amount of food intake (six items), and dietary behavior (five items). The four-factor structure accounted for 41.8% of the total variance. Indicator tests of the NQ model suggested an adequate model fit (GRI = 0.9693, adjusted GFI = 0.9617, RMR = 0.0054, SRMR = 0.0897, p < 0.05), and item loadings were significant for all subscales. Standardized path coefficients were used as weights of the items. The NQ and four-factor scores were calculated according to the obtained weights of the questionnaire items. Conclusion: NQ for adults would be a useful tool for assessing adult dietary quality and food behavior. Further investigations of adult NQ are needed to reflect changes in their food behavior, environment, and prevalence of chronic diseases.

• Journal of Nutrition and Health
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• v.55 no.2
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• pp.278-295
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• 2022

Purpose: This study was undertaken to revise and update the Nutrition Quotient (NQ) for Korean adults, a tool used to evaluate dietary quality and behavior. Methods: The first 31 items of the measurable food behavior checklist were adopted based on considerations of the previous NQ checklist, recent literature reviews, national nutrition policies, and recommendations. A pilot survey was conducted on 100 adults aged 19 to 64 residing in Seoul and Gyeonggi Province from March to April 2021 using a provisional 26- item checklist. Pilot survey data were analyzed using factor analysis and frequency analysis to determine whether checklist items were well organized and responses to questions were well distributed, respectively. As a result, the number of items on the food behavior checklist was reduced to 23 for the nationwide survey, which was administered to 1,000 adults (470 men and 530 women) aged 19 to 64 from May to August 2021. The construct validity of the developed NQ (NQ-2021) was assessed using confirmatory factor analysis, linear structural relations. Results: Eighteen items in 3 categories, that is, balance (8 items), moderation (6 items), and practice (4 items), were finally included in NQ-2021 food behavior checklist. 'Balance' items addressed the intake frequencies of essential foods, 'moderation' items the frequencies of unhealthy food intakes or behaviors, and 'practice' items addressed eating behaviors. Items and categories were weighted using standardized path coefficients to calculate NQ-2021 scores. Conclusion: The updated NQ-2021 appears to be suitable for easily and quickly assessing the diet qualities and behaviors of Korean adults.

• Journal of the Korea Society of Computer and Information
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• v.21 no.8
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• pp.95-103
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• 2016

Food habit forming the basis for a lifetime of food and nutrient intake is established in early childhood and has an effect to the child's growth, sociality, and obesity. A variety of nutrition screening tools exists for assessing the health and nutrition status of children such as the Growth Curve, for determining if growth is appropriate. Body mass index(BMI) as a more reliable index of overweight to prevent childhood obesity, and Nutrition Quotient(NQ) and eating behaviors questionnaire for young children and parents to estimate their nutrient intake adequate or not. Such tools are mainly used by health practitioners, such as doctor and dietitian to provide nutrition intervention services to children at risk, especially and are not easy to use for general parents, who need assessment at any time and at any place. We propose Growth Assistance System for infants and children, which is possible to assess their physical condition, nutritional status, and eating behavior integrated. To be convenient and portable, it is implemented over the smartphone as an application. The system offers the growth charts, the BMI curves, NQ and eating behavior questionnaire to take a monitoring and the functionalities operate well. We hereby expect this system support the normal growth and development of infants and young children. And also support for the health practitioner (dietitians and nutritionists) to take a role in providing nutrition counseling and education to children needing nutrition services.

• Journal of the Korean Dietetic Association
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• v.23 no.3
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• pp.263-273
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• 2017

Numerous studies have investigated quantifying dietary intake according to the weight status of children and adolescents. However, studies on differences in quality among diets remain scarce. This study compared diet quality by weight status and examined correlations between quality of diet and obesity in children and adolescents. Two hundred fourteen children and adolescents aged between 9 and 18 years participated in this study (Normal weight n=104, Obesity n=110). The data related to food intake were investigated by dietary records, Diet Quality Index-International (DQI-I), and Nutrition Quotient (NQ) and then compared with Dietary Reference Intakes for Korean (KDRIs). In DQI-I, moderation factor (control of unhealthy foods) score was 21.7 in the normal weight group and 19.5 in the obesity group. The normal weight group showed a higher score for moderation factor than the obesity group (P<0.001). Compared with KDRIs, vitamin $B_6$, folate, vitamin C, vitamin E, calcium, potassium, and zinc intakes were insufficient in both groups. Multiple logistic regression analysis revealed that DQI-I moderation was negatively associated with obesity (OR=0.77, 95% CI 0.69-0.87) after adjustment for age, gender, income, and total energy intake. Our results suggest that children and adolescents require nutritional education to understand the importance of vitamin and mineral consumption. Especially, education for children and adolescents with obesity needs to emphasize moderation of nutrient intake that can cause diseases with hyper-ingestion such as sodium and high calorie-low nutrition foods.

• Journal of the Korean Dietetic Association
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• v.27 no.4
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• pp.248-262
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• 2021

This study examined the effect of the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet of the Korean multi-domain dementia prevention program on the cognitive functions of the elderly with dementia risk factors. We developed the program including nutrition, exercise, cognitive training, vascular disease prevention, and motivation. One- hundred and fifty-three participants aged 60~79 years with at least 1 dementia risk factor were randomly assigned in a 1:1:1 ratio to the facility-based intervention (FMI), home-based intervention (HMI), and the control group. The nutrition education program consisted of 10 classes over 24 weeks: the FMI received 7 group sessions and three 1:1 sessions, the HMI received 4 group sessions and three 1:1 sessions with 3 homework sessions. The Nutrition Quotient for Elderly (NQ-E) and the Mini Nutritional Assessment (MNA) were used to evaluate nutritional status. The Repeatable Battery for the Assessment Neuropsychological Status (RBANS), Korean Mini-Mental State Examination (K-MMSE), and the Cognitive Complaint Interview (CCI) were used to evaluate cognitive functions. A total of 136 people completed the program with an 11.1% dropout rate. The NQ-E (P=0.009) and RBANS (P=0.001) scores significantly increased in the FMI (N=45) and HMI (N=49) groups compared to the control group (N=42) after the study. The changes in the score of MNA and CCI did not differ significantly between groups. In conclusion, the nutritional intervention which focused on the MIND diet as a part of a multi-domain intervention program had a positive effect on the improvement of healthy eating habits and cognitive function scores in the high-risk dementia group.

• Journal of Nutrition and Health
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• v.52 no.6
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• pp.604-617
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• 2019

Purpose: To investigate the effect of eating behavior on nutritional status according to temperament type. Methods: One thousand one hundred three preschool children aged 2 to 6 years in Gyeongsan, Gyeongsangbuk-do from April to June 2018 were surveyed about their eating behavior and nutritional status using DBT (Dietary Behavior Test) and NQ (Nutrition Quotient) which are proven tests. The dietary behaviors of the children were classified into four categories: approach avoidance, sensory sensitivity, hyperactivity, and irregularity. NQ scores were divided into five categories: balance, diversity, moderation, regularity, and practice. Results: The mean of the children's age was 3.42 ± 1.4 (596 boys and 507 girls). The percentage distribution of the NQ grade was as follows: 5.5% (highest), 12.5% (high), 47.1% (medium), 22.2% (low), and 12.6% (lowest). The risk group of approach avoidance and sensory sensitivity had significantly (p < 0.001) lower scores than the normal group in balance factor (51.9 ± 12.0 vs. 57.8 ± 15.9 in approach avoidance type, 52.6 ± 17.6 vs. 57.7 ± 15.9 in sensory sensitivity type) and diversity factor (32.5 ± 24.4 vs. 50.1 ± 22.4 in approach avoidance type, and 32.5 ± 24.0 vs. 50.7 ± 22.2 in sensory sensitivity type). The scores of the hyperactivity risk group were significantly lower in moderation factor (78.2 ± 12.1 vs. 81.2 ± 11.9), and those of the irregular risk group were significantly lower in variety (35.9 ± 24.5 vs. 48.8 ± 23.2), regularity (57.6 ± 37.1 vs. 66.1 ± 17.6), and practice (57.1 ± 19.4 vs. 65.1 ± 22.5) factors than the normal group (p < 0.001). Especially, the risk group of approach avoidance and sensitivity type had significantly (p < 0.001) lower intakes of whole grain, fruit, bean and bean products, vegetables, and Kimchi. Conclusion: This present study suggested that the eating behavior based on temperament of demanding preschool children affected food choice resulting in food consumption diversity of children. Therefore, it is important to provide customized nutrition education programs based on temperament type.

• Korean Journal of Community Nutrition
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• v.28 no.1
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• pp.11-23
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• 2023

Objectives: This study aimed to determine the nutritional status of residents, to examine the perception and needs of community nutrition care service, and to compare and analyze the results of females and males living in Daejeon, Korea. Methods: The subjects were 592 adults and elderly (278 men and 314 women) residents of Daejeon. The dietary quality was assessed using the nutrition quotient (NQ), and data of the perception and needs for community nutrition care service were obtained by a questionnaire survey. Descriptive analysis was applied to analyze the demographic characteristics, perception and needs of the respondents, and independent t-test and chi-square test were performed to analyze and compare the differences between female and male participants. Results: A nutritional status that required monitoring was established in 78.9% of the respondents in this study. The balance factor (29.1 points) was much lower than the national average. In the diversity factor, the NQ score of the female group was 47.6 points, which was 8 points lower than that of males; the NQ grade was 43.9%, showing a significant difference between females and males (P < 0.001). The respondents answered that those who needed community nutrition care services were residents experiencing health care difficulties. Additionally, dietitians (35.6%) were pointed out as the most suitable service providers. The most important factor of community nutrition care service operation was securing the budget (47.0%). Conclusions: The results of the present study show that Daejeon residents need overall nutrition support, and a demand for community nutrition care services exists. Our findings provide basic data and can serve as a foundation for the development and establishment of a community nutrition care service model.

• Journal of Nutrition and Health
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• v.53 no.1
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• pp.68-82
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• 2020

Purpose: This study evaluated the dietary quality and nutritional status of elderly people using the Nutrition Quotient for Elderly (NQ-E). Methods: The participants were 204 elderly people over 65 years of age (38 men and, 166 women) in Seoul. The dietary information was analyzed using a questionnaire of NQ-E, which consisted of 19 checklist items, and 24-recall test data. The NQ-E scores and its four factors, including 'balance', 'moderation', 'diversity', and 'dietary behavior' factors, were calculated according to general characteristics of the subjects. The subjects were divided into the 'monitoring needed group' (62 > NQ-E score) and the 'good group' (62 ≤ NQ-E score) according to their NQ-E score. Results: The mean NQ-E score of the total subjects was 61.9, which was within the mediumhigh grade. The scores of balance, moderation, and dietary behavior factors were within the medium-high grade, while the score of the diversity factor was within the medium-low grade. The NQ-E score was 54.8 in the monitoring needed group and 69.3 in the good group. For the score of the diversity factor, the elderly living alone had a significantly lower score than the score for the elderly living with a spouse. The female subjects showed significantly higher scores of moderation and dietary behavior factors than did the male subjects. The daily intakes of vitamin A, thiamin, riboflavin, vitamin C and calcium in the monitoring needed group were significantly lower than those in the good group. The nutrient adequacy ratios (NAR) of vitamin A, thiamin, riboflavin, vitamin C and calcium in the monitoring needed group were significantly lower compared to the scores of the good group. The indexes of nutritional quality (INQ) of vitamin A, thiamin, riboflavin, vitamin C, calcium and potassium were less than 1 for all the subjects. The monitoring needed group had a significantly lower consumption of total foods, vegetables and mushrooms than the good group. As a result, the nutritional status of the monitoring needed group was significantly lower than that of the good group. Conclusion: The results of this study show that NQ-E would be a useful tool for assessing the dietary quality of the elderly. In conclusion, a focused-nutrition education program and a useful guideline are needed for promoting the health and nutritional status in elderly people.