• Nutrition Research and Practice
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• v.14 no.6
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• pp.621-636
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• 2020

BACKGROUND/OBJECTIVES: The Seoul Metabolic Syndrome Management (SMESY) program is a 1-yr lifestyle modification program targeting metabolic syndrome (MetS) in Seoul residents. This study investigated the associations between adherence to dietary guidelines and MetS among the SMESY program participants. SUBJECTS/METHODS: Data of 54,385 participants aged 20-64 yrs who completed the SMESY program in 2015, had information on adherence to dietary guidelines, and were not medicated for diabetes, hypertension, or dyslipidemia were analyzed. Participants underwent MetS screening and completed a lifestyle questionnaire including adherence to 10 dietary guidelines before and after participation. Participants were classified according to the number of MetS risk factors at baseline (MetS group, ≥ 3; risk group, 1-2; healthy group, none). Adherence to dietary guidelines was determined from the number of "yes" responses regarding the fulfillment of each guideline on ≥ 5 days/week. Multiple logistic regression was used to evaluate associations between newly diagnosed MetS and changes in adherence to dietary guidelines. RESULTS: In the MetS group, MetS prevalence decreased after the SMESY program (men, -41.9%p; women, -48.7%p), and all risk factors were significantly improved (P < 0.0001). All groups exhibited improved adherence to all dietary guidelines after participation (P < 0.0001). In the MetS group with positively changed adherence scores, the MetS prevalence decreased by -44.1%p for men and -49.5%p for women, whereas the prevalence in those with negative changes decreased by -38.1%p for men and -48.6%p for women. In the risk group, those with positively changed adherence scores had significantly decreased odds ratios (ORs) for newly diagnosed MetS compared with those with negative changes (OR, 0.70; 95% confidence interval [CI], 0.61-0.80 for men; OR, 0.88; 95% CI, 0.79-0.99 for women). CONCLUSIONS: The SMESY program may effectively reduce the risk of MetS among adults with risk factors by improving adherence to dietary guidelines.

• Journal of Nutrition and Health
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• v.46 no.3
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• pp.276-284
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• 2013

This study compared levels of health and dietary behavior practices and health beliefs according to the stage of weight loss behavior change of Korean male workers. A self-administered survey questionnaire was collected from 411 male adult workers residing in Seoul, Kyeonggi, Chungcheong region. Practices of health related behavior, including smoking, drinking, exercise, work related physical activity, and dietary behavior according to dietary guidelines were evaluated. In addition, the levels of perceived benefit, perceived barrier, perceived susceptibility, perceived seriousness, and perceived cue to action from the health belief model were measured according to the stages of weight loss behavior change. Significant differences in BMI, level of daily exercise, and practices of dietary behavior according to dietary guidelines were observed among stages of weight loss behavior change. Subjects who were in action/maintenance stage showed a more desirable level of health behavior and health belief model variables, except perceived barrier. Based on the findings of this study, it is suggested that subjects with different stages of behavior change need an appropriate specific nutrition education method and material for improvement of nutrition education efficacy.

• Journal of Nutrition and Health
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• v.40 no.8
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• pp.745-752
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• 2007

While metabolic syndrome(MS) is rapidly expanding and dietary pattern, the known risk factor of MS, goes through heavy transition to western diet, not many researches have been done on the association between dyslipidemia and dietary factors in Korean adults. The purpose of this study was to investigate the association between compliance with dietary guidelines and dyslipidemia among Koreans. The subjects of 399 adults who visited health examination center were classified into dyslipidemia(n=180) and control(n=219). Diagnosis of dyslipidemia was based on NCEP-ATPIII criteria(triglyceride>=150mg/d, HDL-C<50mg/dl for male, HDL-C<40mg/dl for female). A questionnaire based interview was done to collect information on compliance with dietary guidelines, general characteristics and health related behaviors. Anthropometric variables were measured during the survey. Mean compliance score of dietary guideline was significantly lower in dyslipidemia group than in control. It was associated negatively with waist circumference and positively with serum HDL-cholesterol(p<0.05). Risks of dyslipidemia were significantly decreased in the group with highest dietary guideline score, high serum triglyceride levels(OR=0.484, 95% CI=0.268-0.875), abdominal obesity(OR=0.296, 95% CI=0.159-0.553), and dyslipidemia(OR=0.481, 95% CI=0.266-0.869). These results indicated that increasing compliance with dietary guidelines could be an effective strategy to lower the risk of dyslipidemia among Koreans.

• Korean Journal of Community Nutrition
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• v.20 no.2
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• pp.129-140
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• 2015

Objectives: We examined the association between the adherence to dietary guidelines for breast cancer survivors and health-related quality of life in a cross-sectional study of Korean breast cancer survivors. Methods: A total of 157 women aged 21 to 79 years who had been diagnosed with stage I to III breast cancers according to the American Joint Committee on Cancer (AJCC) and had breast cancer surgery at least 6 months before the baseline were included. We used a Korean version of the Core 30 (C30) and Breast cancer 23 (BR23) module of the European Organization for Research and Treatment Cancer Quality of Life Questionnaire (EORTC-QLQ), both of which have been validated for Koreans. Participants were asked about their adherence to dietary guidelines for breast cancer survivors, suggested by the Korean breast cancer society, using a 5-point Likert scale. We summed dietary guideline adherence scores for each participant and calculated the least squares means of health-related quality of life according to dietary guideline adherence scores using the generalized linear model. Results: Breast cancer survivors who had higher adherence to dietary guidelines for breast cancer survivors had lower constipation scores than those with lower adherence (p for trend=0.01). When we stratified by the stage at diagnosis, this association was limited to those who had been diagnosed with stage II or III breast cancers. Also, sexual functioning scores increased significantly with increasing adherence scores of dietary guidelines among those with stage II or III breast cancers (p for trend < 0.001). However, among those who had been diagnosed with stage I, higher scores of dietary guidelines were associated with higher scores of pain (p for trend=0.03) and breast symptoms (p for trend=0.05). Conclusions: Our study suggested that the health-related quality of life levels of breast cancer survivors are associated with the adherence to dietary guidelines and may differ by the stage of the breast cancer.

• Journal of Nutrition and Health
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• v.57 no.2
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• pp.244-260
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• 2024

Purpose: With the 2021 revision of dietary guidelines in Korean emphasizing environmentally sustainable dietary practices, this study attempted to develop an evaluation tool to comprehensively evaluate the degree of practice and compliance with food and nutrient intake, dietary habits, and dietary culture guidelines based on the revised dietary guidelines. Methods: The candidate evaluation items were collected by reviewing 934 literature reviews on domestic and foreign dietary evaluations. Fifty-nine candidate items were derived by selecting the items corresponding to dietary guidelines. The content validity ratio (CVR) cutoff point evaluation was conducted with 11 experts to delete 11 items that did not meet the CVR standard. Fifty-five pilot survey candidate items were selected through revision and additional process according to expert opinion. Seventy final candidate items were selected by adding 15 questions for validity verification and reference. A pilot survey was conducted online and offline on 332 adults aged 19-64 in Seoul and the metropolitan area, and exploratory factor analysis was used to verify the construct validity of the evaluation items. Through exploratory factor analysis, the Kaiser-Meyer-Olkin, Bartlett's sphericity test, variance explained, and Cronbach's alpha criteria were confirmed in each process. Results: Exploratory factor analyses derived three criteria: food and nutrient intakes (11 items), eating behaviors (9 items), and dietary culture (14 items), consisting of 34 evaluation items. Conclusion: The present scale was validated and can be used for comprehensive evaluations of the dietary guidelines for Korean adults in a simple way.

• Journal of Nutrition and Health
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• v.48 no.3
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• pp.221-227
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• 2015

Purpose: Confronting the growing burden of dementia requires understanding the causes and predictors of dementia in order to develop preventive strategies. In Korea a large proportion (71%) of dementia is Alzheimer's disease, and the risk factors have not yet been elucidated. Dietary factors may be possible risk factors, however research on the relationship between Alzheimer's disease and dietary behaviors has been insufficient. The purpose of this study was to investigate the association between compliance with the "Dietary Guidelines for Elderly (The Ministry of Health and Welfare, 2011)" and Alzheimer's disease among Korean elderly. Methods: Elderly persons who visited a University hospital or a dementia center of Seoul and agreed to participate in the examinations were selected. Among 277 subjects, 89 Alzheimer patients were selected with diagnosis and 118 subjects were assigned to the control group. Diagnosis of Alzheimer's disease was based on Alzheimer's disease criteria of Diagnostic and Statistical manual of Mental Disorders, 4th edition (DSM-IV) and criteria of National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and related Disorders Association (NINCDS-ADRDA). Information on the general characteristics, health related behaviors and compliance with the dietary guidelines for Korean elderly was collected by face to face interview using a structured questionnaire. Anthropometric variables were measured during the survey. Results: Total compliance score of dietary guidelines was significantly lower in the Alzheimer's disease group than in the control group (p = 0.0001). The odds ratio of Alzheimer's disease was significantly decreased in the group with the highest dietary guideline compliance score (OR = 0.47, 95 % CI = 0.18~1.09) compared to the group with the lowest compliance score. Conclusion: The results indicate that increasing compliance with the dietary guidelines could be an effective strategy to decrease the risk of Alzheimer's disease among Korean elderly.

• Korean Journal of Community Nutrition
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• v.9 no.6
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• pp.742-752
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• 2004

The purpose of this study is to offer information related to recommended dietary allowances for young children and food guidelines for preschool children in Sweden. Sweden, located in Europe, is the most developed country for young child care system. Swedish nutrition policy background, Swedish recommended dietary allowances for young children, and food guidelines of early childhood education center in Sweden were used. The number of Swedish child care centers increased from 70,000 in 1970 to 700,000 in 2000. The Swedish Institute of Public Health promoted children's indoor and outdoor activity. The aim of the Swedish public health contains children's safety, good food habits, and eating food safely. Swedish Food Administration made recommended dietary allowance and food guidelines for children care centers. The aim of food guidelines was to increase energy, calcium, iron, and dietary fiber intake. Swedish RDA contains minimum and maximum intake as well as mean intake for macro and micro nutrients. The fat intake ratio of energy is increased for younger children. For preschool children, the food guideline is determined by dietary allowances for breakfast, lunch, and snack respectively. Food guideline contains meal time schedule, menu for each meal using food model, amount of food for age group, and recommended dietary allowance for each meal. It is recommended for Korean early childhood education center: 1) Korean RDA for young children should be made range of intake, minimum and maximum intake. 2) Food guideline should be make for Korean child care center. 3) Korean child care centers should offer an afternoon snack twice for children who return home late. 4) Nutrition education program for preschool teachers should be developed for children's good eating habits and health promotion.

• Korean Journal of Community Nutrition
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• v.20 no.4
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• pp.259-272
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• 2015

Objectives: A higher consumption of vegetables is emphasized as the core component of most dietary guidelines. Thus, this research investigated the dietary habits and influencing factors of vegetable preferences of adolescents. Methods: This study was conducted by using a self-administered questionnaire. 400 students from two high schools in Gyeongnam (193 boys, 207 girls) participated in the survey. The questionnaire consisted of the following variables: dietary habit, dietary action guide and factors based on Social Cognitive Theory (SCT). Results: The dietary habits of subjects showed significant differences depending on whether they prefer vegetables or not. The subjects in the group who liked vegetables had better dietary habits than the other group. Also, the study determined that the most important reason for liking or disliking vegetables is due to the taste. In the practice of dietary guidelines, the group of subjects who liked vegetables followed dietary guidelines more closely than the other group (p < 0.001). When the factors based on SCT were analyzed, personal factors showed significant differences between the groups: outcome expectation (p < 0.001), self-efficacy (p < 0.001) and affective attitude (p < 0.001). Personal factors and rated vegetable preferences showed a significant correlation in multiple regression analysis (F=42.015, p < 0.001). Conclusions: These results showed that vegetable preference is associated with a key point of desirable dietary habits among subjects. In order to increase vegetable preference or consumption, it is important to focus on strengthening not only self-efficacy of students, but also affective attitude of vegetable.

• Nutrition Research and Practice
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• v.8 no.6
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• pp.705-712
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• 2014

BACKGROUND/OBJECTIVES: Dietary guidelines for Korean children were released in 2009. The goal of the present study was to examine diet quality in terms of adherence to these dietary guidelines as well as explore the association between guideline adherence and risk of obesity in Korean children. SUBJECTS/METHODS: Children aged 5-11 years (mean age = 8.9 years old, n = 191, 80.6% girls) were recruited from a university hospital in Seoul, Korea. Adherence to dietary guidelines for Korean children was calculated using the Likert scale (1-5), and children were then categorized into low, moderate, and high groups based on adherence scores. Obesity or being overweight was determined based on an age- and gender-specific percentile for body mass index (BMI) of the 2007 Korean National Growth Charts. Diet quality was evaluated from 3 days of dietary intake data. RESULTS: Children in the high adherence group were characterized by significantly lower BMI percentiles and paternal BMIs as well as higher percentages of fathers with a high level of education and higher household incomes compared to those in the low or moderate group. Children in the high adherence group consumed significantly higher amounts of milk and dairy products, were less likely to consume lower than the EAR of phosphorus and iron, and had higher NARs for calcium, phosphorus, iron, zinc, and MAR than those in low groups. The ORs for obesity ($BMI{\geq}95^{th}$ percentile) or being overweight including obesity ($BMI{\geq}85^{th}$ percentile) were significantly lower in the high adherence group compared to the low adherence group (OR: 0.33, 95% CI = 0.13-0.82, P for trend = 0.019; OR: 0.26, 95% CI: 0.11-0.61 P for trend = 0.002). CONCLUSIONS: Korean children who adhered to dietary guidelines displayed better diet quality and a reduced risk of obesity.

• Korean Journal of Community Nutrition
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• v.19 no.1
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• pp.27-40
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• 2014

Dyslipidemia is a component of the metabolic syndrome and a risk factor for cardiovascular diseases. Nutrition counseling is important to improve dyslipidemia. The purpose of this study was to evaluate the effectiveness of nutrition counseling in adults with risk factors for dyslipidemia diagnosed by the national health screening program. The nutrition counseling for adults with risk factors for dyslipidemia was carried out at a public health center in Gyeonggi-do. Thirty four patients out of forty five participants in the program completed the nutrition counseling program. The nutrition counseling was provided 3 times during a 12-week period. Individualized nutrition counseling to improve dietary habits was conducted after examining participants' dietary intake through questionnaires about dietary habits and whether they practice dietary guidelines. Data about serum lipid profiles, body composition, nutrition knowledge, the practice of dietary guidelines, and dietary behavior were collected before and after nutrition counseling to evaluate the effectiveness of nutrition counseling. All data were statistically analyzed by SPSS program (Korea ver.18.0) and significant difference was evaluated by paired t-test and ${\chi}^2$-test. Body weight, body fat and WHR were significantly decreased after nutrition counseling. Total-cholesterol, TG, and LDL-cholesterol were significantly decreased but HDL-cholesterol did not show significant changes. Both scores of nutrition knowledge and the practice of dietary guidelines improved significantly (p < 0.001). This study shows that nutrition counseling helps to encourage healthy eating practices and to improve serum lipid profiles of adults with risk factors for dyslipidemia. Overall, results indicated that nutrition counseling resulted in positive changes to lower the reliance on medications. Therefore, nutrition counseling should be considered for the initial treatment of dyslipidemia.