• Journal of Nutrition and Health
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• v.56 no.2
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• pp.217-230
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• 2023

Purpose: The purpose of this study was to assess the diet intake status and quality of adults from North Korea who had lived in Seoul and Gyeonggi-do, using the nutrition quotient (NQ) for Korean adults. Methods: A number of 166 adults aged from 20 to 64 years were enrolled as study subjects. A structured questionnaire was used to collect information on their demographic characteristics, food consumption frequency, eating behaviors, and NQ. The NQ score was then used to measure the overall diet quality. The NQ score was composed of four major age-based categories. 'Balance', 'Diversity', 'Moderation', and 'Dietary behavior' were utilized as scores for measurements within each of the four categories. The scores for all four categories were summed up, resulting in the total NQ score. Participants' age groups were stratified by 20's, 30's, 40', and over 50's. A χ² test and generalized linear regression (GLM) model were used to assess a significance for difference of subject distribution in categorical and continuous variables in the food consumption frequency, eating behaviors, and NQ scores. Results: Participants in younger age groups were more likely to report consumption of ramyeon, fast food, sweet and greasy baked products, processed beverage, delivery food, and night snacks than the older age groups. Most importantly, participants in 20's age group were less likely to report the total NQ and moderation score than the 50's age group. Conclusion: In this study, the 20's age group displayed a lower NQ characteristic for an unbalanced diet. Therefore, it is imperative for adults from North Korea to be given individualized diet instructions along with nutritional education programs.

• Journal of Nutrition and Health
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• v.51 no.6
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• pp.526-537
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• 2018

Purpose: The purpose of the study was to identify women's osteoporosis knowledge, concerns about osteoporosis factors, and health behavior as well as to examine the relationship between these variables. Methods: The participants were 394 women in the Jeonbuk area. The data were analyzed using a t-test, ANOVA, Duncan test, and hierarchical regression analysis with SPSS v. 24.0. Results: The score for osteoporosis knowledge was 6.21 points out of a possible 12, the score for concern about osteoporosis factors was 26.50 points out of a possible 40. The score for the health behavior was 57.26 points out of a possible 85. The knowledge showed significant differences according age (p < 0.01), income (p < 0.05), education level (p < 0.01), drinking milk in childhood (p < 0.05), health interest (p < 0.05), and osteoporosis information (p < 0.01). The concern showed significant differences according to age (p < 0.001), income (p < 0.05), health interest (p < 0.001), osteoporosis information (p < 0.001), family history of osteoporosis (p < 0.05), and calcium medications (p < 0.001). The health behavior showed significant differences according to age (p < 0.001), income (p < 0.01), drinking milk in childhood (p < 0.05), health interest (p < 0.001), osteoporosis information (p < 0.01), and calcium medications (p < 0.01). Regression analysis showed that the concern about osteoporosis factors was the most influential variable on health behavior, followed by health interest of the subjects, age, and the osteoporosis knowledge. Conclusion: Therefore, it is necessary to consider educational programs on increasing interest in osteoporosis according to the age and health for improving the health behavior to prevent osteoporosis.

• Journal of Nutrition and Health
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• v.56 no.3
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• pp.247-263
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• 2023

Purpose: This study was conducted to update the Nutrition Quotient for Adolescents (NQ-A), which is used to assess the overall dietary quality and food behavior among Korean adolescents. Methods: The first 30 candidate items of the measurable eating behavior checklist were obtained based on a previous NQ-A checklist, the results of the seventh Korea National Health and Nutrition Examination Survey data, Korea Youth Risk Behavior Survey data, national nutrition policies and dietary guidelines, and literature reviews. A total of 100 middle and high school students residing in Seoul and Gyeonggi Province participated in a pilot study using the 25-item checklist. Factor analysis and frequency analysis were conducted to determine if the checklist items were organized properly and whether the responses to each item were distributed adequately, respectively. As a result, 22 checklist items were selected for the nationwide survey, which was applied to 1,000 adolescent subjects with stratified sampling from 6 metropolitan cities. The construct validity of the updated NQ-A 2021 was assessed using confirmatory factor analysis. Results: Twenty checklist items were determined for the final NQ-A 2021. The items were composed of three factors: balance (8 items), moderation (9 items), and practice (3 items). The standardized path coefficients were used as the weights of items to determine the nutrition quotients. NQ-A 2021 and 3-factor scores were calculated according to the weights of questionnaire items. The weight for each of the 3 factors was determined as follows: balance, 0.15; moderation, 0.30; and practice, 0.55. Conclusion: The updated NQ-A 2021 is a useful instrument for easily and quickly evaluating the dietary qualities and eating behaviors of Korean adolescents.

• Journal of Nutrition and Health
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• v.51 no.1
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• pp.87-102
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• 2018

Purpose: The purpose of this study was to develop a valid instrument for measuring the dietary quality and behaviors of Korean elderly. Methods: The development of the Nutrition Quotient for Elderly (NQ-E) was conducted in three steps: item generation, item reduction, and validation. The 41 items of the NQ-E checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Pearson's correlation was used to determine the level of agreement between the questionnaires and nutrient intake level, and 24 items were selected for a nationwide survey. A total of 1,000 nationwide elderly subjects completed the checklist questionnaire. The construct validity of the NQ-E was assessed using confirmatory factor analysis, LISREL. Results: The nineteen checklist items were used as final items for NQ-E. Checklist items were composed of four-factors: food behavior (6 items), balance (4 items), diversity (6 items), and moderation (3 items). The standardized path coefficients were used as the weights of the items. The NQ-E and four-factor scores were calculated according to the obtained weights of the questionnaire items. Conclusion: NQ-E would be a useful tool for assessing the food behavior and dietary quality of the elderly.

• Journal of Nutrition and Health
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• v.46 no.4
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• pp.332-345
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• 2013

The aim of this study was to evaluate the nutritional status of elementary and middle school students by gender with an emphasis on comparison of nutritional intake between weekday and weekend. Survey construct included one 24-hour diet recall and two diet records, short food frequency questionnaire, and anthropometry. Eating behaviors and nutritional intake were largely different for four groups divided by age and gender: ME, FE, MM, and FM. Frequency of consumption of healthful foods was significantly higher in the ME and FE groups. The highest and lowest scores for frequency of eating with parents were observed in the FE and FM groups, respectively. The amount of consumption of food groups was lower on weekends than on weekdays and this trend was more prominent in elementary schoolers compared with middle schoolers. In terms of food group consumption as well as energy and nutrient intake, the ME group showed the greatest differences between weekday and weekend, followed by FE, MM, and FM, in descending order. A significantly higher amount of potassium, phosphorus, and calcium was consumed on weekdays than on the weekend in the ME and FE groups. The amount of energy and nutrient intake was smallest in the FM group; however, the difference between weekday and weekend was minimal as well. In comparison of the subjects' energy and nutrient intake with their Korean Dietary Reference Intakes values (%KDRI), the MM group showed the most undesirable results for energy, protein, dietary fiber, vitamin A, vitamin $B_1$, vitamin $B_2$, niacin, vitamin $B_6$, calcium, and zinc. Overall, findings indicated that nutritional intake status may differ between weekday and weekend for elementary and middle schoolers by gender, suggesting that youth may benefit from nutritional education programs that stress the impact of gender and weekend effect on their dietary intake.

• Journal of Nutrition and Health
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• v.46 no.3
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• pp.250-260
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• 2013

The purposes of this study were 1) to investigate eating behaviors and patterns in breast cancer patients using a newly developed food frequency questionnaire and 2) to examine perception and use of nutritional information about breast cancer treatment among cancer patients treated with radiation therapy. Sixty breast cancer patients (case group) undergoing radiation therapy in Ajou University Hospital, Suwon, South Korea and 79 healthy women (control group) participated in this study. Mean age of subjects in the control group was $46.00{\pm}7.88$ years and BMI was $23.12{\pm}2.85kg/m^2$, and that of the case group was $50.06{\pm}11.64$ years and $22.32{\pm}3.24kg/m^2$. The results of eating behaviors showed several significant differences between control and case groups. Breast cancer patients ate meals on a more regular basis, on time, and more frequently compared to control subjects. In addition, they preferred more salty or spicy and bland food compared to healthy women. According to answers from the food frequency questionnaire, breast cancer patients consumed significantly lower amounts of boiled white rice, meats and processed food, fish and shellfish, coffee, milk, and cheese, whereas they consumed a significantly large amount of boiled multigrain rice, vegetable, seaweeds, soybean and processed food, and yoghurt compared to healthy women. This study also observed the way in which cancer patients and healthy control subjects obtain information about breast cancer treatment and its reliabilities. Results showed that healthy women did not hesitate to obtain information from mass media, while breast cancer patients would obtain nutritional information from specialists rather than mass media. Results of this survey confirmed that breast cancer patients avoided intake of red meat protein, even though they already recognized the importance of dietary protein intake for recuperation and treatment of the disease. These results could be used for future diet and nutrition guidelines for breast cancer patients.

• 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.

• Journal of Nutrition and Health
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• v.51 no.2
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• pp.177-185
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• 2018

Purpose: This study analyzed the perception and importance of country-of-origin labeling at restaurants in 500 college students in Jeju surveyed from April 15 to May 5, 2016 with the aim of providing basic data. A total of 465 questionnaires out of 500 were used as base data for this study. Methods: The data were analyzed using descriptive analysis, ${\chi}^2-test$, and t-test using the SPSS Win program (version 21.0). Results: Regarding food safety-related dietary behaviors, average score was 3.65 points (out of 5), and 'put the food in a refrigerator or freezer immediately (4.07)' showed the highest score, whereas 'cool rapidly hot food prior to putting it in the refrigerator (3.08)' showed the lowest score. Regarding the awareness of country-of-origin labeling at restaurants, 67.5% of subjects were aware of it. With regard to dietary behavior of food safety, the high group showed a higher score than the low group (p < 0.001). Regarding reliability of the system, 4.9% of subjects indicated 'very reliable' and 45.4% 'somewhat reliable'. For perception of subject's country-of-origin labeling, the average score was 3.77 (out of 5). Regarding checking country-of-origin labeling at restaurants, 68.0% of subjects checked country-of-origin labeling, and the high group in the safety-related dietary behavior score ranking showed a higher rate (79.3%) than the low group (57.1%) (p < 0.001). With regard to importance by item, 'honest country-of-origin labeling of restaurants' showed the highest score at 4.27 (out of 5). Conclusion: It is necessary to provide continuing education for college students in order to enhance their perception of country-of-origin labeling at restaurants. Moreover, a systematic and appropriate support and control system by the government and local government needs to be developed in order to improve country-of-origin labeling at restaurants.

• Journal of Nutrition and Health
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• v.47 no.5
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• pp.351-363
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• 2014

Purpose: The aim of this study was to develop a reliable measurement tool to assess the urban food environment, particularly focusing on food stores in Korea. Methods: The items for the measurement tool were selected through systematic literature reviews and adjusted to the Korean food environment. A total of 25 food stores in an urban area were recruited for the pilot test to evaluate the time required for completion of the survey, ease of response, willingness to participate, difficulties in conducting the survey, and appropriateness, and 34 food stores were recruited for assessment of the reliability of the tool using percent agreement and kappa value. Results: The measurement tool is composed of questions regarding food store characteristics, accessibility, and food availability. On average, 26 minutes was required to survey a single food store, and the subjects and interviewers answered that the process was not difficult for the survey. The percent agreement for the inter-rater and test-retest reliability ranged from 93.9~98.8% and 91.9~97.9, respectively. The kappa values ranged from 0.78 to 0.97, which was very high. Percent agreement and kappa value of food with healthy option were lower than those of the general food in the inter-rater reliability (p = 0.0027, p = 0.0095 respectively) as well as in the test-retest reliability (p = 0.0081, p = 0.0290, respectively), although they were still high enough (86.4~98.0% for percent agreement, 0.64~0.96 for kappa value). Conclusion: The newly developed measurement tool for assessment of food store environment appears to be feasible and reliable; therefore, it can be applied to research on the association between food environment and dietary behaviors as well as health outcomes.

• Korean Journal of Community Nutrition
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• v.28 no.1
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• pp.38-47
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• 2023

Objectives: This study examined the association between the experience of disease management education and the use of nutrition labels according to the sociodemographic characteristics and health behaviors of people diagnosed with hypertension and diabetes living in the community. Methods: Among the participants from the Community Health Survey (2018), 74,283 individuals diagnosed with hypertension or diabetes were included in the study population. According to gender, this study evaluated nutrition label use by the experience of disease management education, individual sociodemographic characteristics, and health behavior. Finally, using multiple logistic regression analysis, the association between disease management education and nutrition labels was calculated using the odds ratio (OR) and 95% confidence interval (CI). Results: Males (24.5%) experienced more disease management education than females (22.6%). In addition, younger age, higher education level, and higher equalized personal income experienced more disease management education (P < 0.001). The educational experience rate was higher in the male subjects who did not smoke or were involved in high-risk alcohol consumption (P < 0.001). In addition, the rate of disease management education experience was significantly higher for both men and women who exercised by walking (P < 0.001). The use of nutrition labels was higher in females (9.9%) than males (5.8%), and both males and females were significantly higher in young age, high education, high income, and professional and office positions (P < 0.001). The utilization rate of nutrition labels was high in non-smoking male subjects and high-risk-drinking female subjects. In addition, the utilization rate of nutrition labels was significantly higher in males and females who exercised by walking and those who experienced disease management education (P < 0.001). After adjusting for individual sociodemographic characteristics, health behavior, and disease management education, the use of nutrition labels was high among females (OR 3.19, 95% CI 2.85-3.58), high income (Q4; OR 1.62, 95% CI 1.41-1.87, Q5; OR 1.58, 95% CI 1.37-1.84) and highly educated (high school; OR 2.87, 95% CI 2.62-3.14, above college; OR 5.60, 95% CI 5.02-6.23) while it was low in the elderly (OR 0.43, 95% CI 0.40-0.47), and economically inactive (OR 0.86, 95% CI 0.76-0.96). The use of nutrition labels was high in non-smokers (OR 1.29, 95% CI 1.13-1.48), nonhigh-risk drinkers (OR 1.22, 95% CI 1.08-1.38), and subjects who exercised walking (OR 1.44, 95% CI 1.34-1.54). There was no difference in the utilization rate of nutrition labels according to obesity, and the utilization rate of nutrition labels was significantly higher in subjects who had experienced disease education (OR 1.34, 95% CI 1.24-1.44). Conclusions: Education on the use of nutrition labels, which contributes to food selection for healthy eating, might be a tool for dietary management. Moreover, the utilization rate can be a good indicator for predicting the proportion of the population practicing the guide for disease management. Improving the utilization rate of nutrition labels through disease management education can be a useful intervention for people with chronic diseases who need healthy eating habits for disease management and preventing complications, particularly those diagnosed with hypertension and diabetes.