• Korean Journal of Community Nutrition
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• v.12 no.6
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• pp.838-853
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• 2007

The aim of this study was to develop various types of a dish frequency questionnaire (DFQ) for estimating the habitual sodium intake and to evaluate the validity of a 125 item dish frequency questionnaire (DFQ 125) with the DFQ 70, DFQ 36 and DFQ 15. For the DFQ 125, one hundred and twenty five dish items were selected based on the information of sodium content of a one serving size, consumption frequency and dish items that contributed most to the variation of sodium intake. Frequency of consumption was determined through nine categories ranging from more than 3 times a day to almost never to indicate how often the specified amount of each food item was consumed during the past 6 months. The sodium intake estimated with DFQ 125 was $5775.0{\pm}3636.3mg$, 12.6% higher than that estimated with a 24 hr urine analysis ($5009.7{\pm}1541.9mg$) and significant correlation was observed between them (r=0.3315, p<0.001). When sodium content in broth leftover was subtracted from the total intake, the actual sodium intakes was decreased to $5309.6{\pm}3076.6mg$, which was 3.2% higher than that with a 24-hr urine analysis. Overall, 56% of subjects in the lowest quintile of sodium intake computed with DFQ 125 were also in the lowest of adjacent quintile while categorization into the opposite quintile were 4.9%. DFQ 70 was developed from DFQ 125 by omitting the food items not frequently consumed, selecting the dish items that showed higher sodium content per one portion size and higher consumption frequency. The sodium intake estimated with DFQ 70 ($5026.6{\pm}3107.1mg$) showed only 0.2% difference from that estimated with a 24-hr urine analysis, significant correlation with it (r=0.3199, p<0.001) and higher proportion of subjects to be classified into the same or adjacent quintile. The sodium intake estimated with DFQ 36 or DFQ 15 was also significancy correlated with that estimated with a 24-hr urine analysis (r=0.3441, p<0.001; r=0.321, p<0.001 respectively) and more. The proportion of subjects was classified into the same or adjacent quintile. However, the actual sodium intake estimated with DFQ 36 or DFQ 15 were $3534.0{\pm}1804.6mg\;and\;2508.0{\pm}1261.5mg$, respectively, 31.3% or 51.3% less than that estimated with a 24-hr urine analysis. It seems the DFQ 125 with subtraction of sodium content in broth leftover or DFQ 70 can be used quantitatively to estimate sodium intake of adults. DFQ 36 or DFQ 15 can be used as a screening tool or to assess the changes of sodium intake after nutrition education.

• Journal of Nutrition and Health
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• v.43 no.6
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• pp.638-652
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• 2010

A valid food or dish frequency questionnaire needs to be developed in Korea for accurate dietary assessment because the dietary practices of Koreans are very different from those of other countries. This study was conducted to evaluate the accuracy of the newly developed, semi-quantitative, dish-based frequency questionnaire (Semi-DFQ) with 12-day dietary records (12-DRs) as a gold standard. The study subjects were 115 men and 173 women aged 30-65 years old. We calibrated the frequency, portion size and daily intake of 112 dish items reported in Semi-DFQ with those in 12-DRs by Spearman rank correlation coefficients (SCCs). The consumption frequency and portion size reported in Semi-DFQ were higher than those in 12-DRs. The SCCs for the consumption frequency of various dishes ranged from -0.07 (fried seaweed) to 0.70 (instant coffee), the portion size ranged from -0.09 (cold seaweed soup) to 0.68 (soju), and the daily intake ranged from -0.07 (fried seaweed) to 0.71 (soju). The SCCs were higher for dishes consumed daily, such as steamed rice,milk, coffee and alcohol, than those of foods eaten rarely. The overall agreements between the Semi-DFQ and 12-DRs were low for categories of consumption frequency and portion size, even though some dishes showed high SCCs. The SCCs of the two methods in consumption frequency and amount were higher among the women and younger subject. The results revealed the limitation of the Semi-DFQ for evaluating the status of usual individual intake. Therefore, the Semi-DFQ can be used in addition as dietary records and 24-hour recall depending on the research aims.

• The Korean Journal of Community Living Science
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• v.26 no.1
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• pp.167-176
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• 2015

This study compares salt-related dietary patterns according to sodium intake. A survey was conducted with 257 college students(130 male and 127 female students) in the Busan area. Dish Frequency Questionnaire 70(DFQ 70) was used to quantitatively estimate sodium intake. A short dish frequency questionnaire(DFQ 15) was used to screen subjects with high or low- salt intake. The sodium intake of male students based on DFQ 70 was significantly higher than that of female students(p<0.05). Sodium intake has significant negative effects on systolic and diastolic blood pressure(p<0.05). In the high-salt intake(HS) group, classified by DFQ 15, the number of male students was significantly higher than that of female students(p<0.01). The systolic blood pressure of the HS group was significantly higher than that of the low-salt intake(LS) group(p<0.05). Salt-related dietary behavior score and eating habit score for the HS group were significantly higher than those for the LS group(p<0.01). The sodium intake of the HS group based on DFQ 70 was significantly higher than that of the LS group(p<0.01). In these results, college students in Busan area showed high blood pressure and high sodium intake compared to Korean DRIs. The results indicate a need for various education programs to help college students practice a low-sodium diet.

• Korean Journal of Community Nutrition
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• v.10 no.5
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• pp.677-692
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• 2005

The assessment of sodium intake is complex because of the variety and nature of dietary sodium. This study intended to develop a dish frequency questionnaire (DFQ) for estimating the habitual sodium intake and a short DFQ for screening subjects with high or low sodium intake. For DFQ112, one hundred and twelve dish items were selected based on the information of sodium content of the one serving size and consumption frequency. Frequency of consumption was determined through nine categories ranging from more than 3 times a day to almost never to indicate how often the specified amount of each food item was consumed during the past 6 months. One hundred seventy one adults (male: 78, female: 93) who visited hypertension or health examination clinic participated in the validation study. DFQ55 was developed from DFQ112 by omitting the food items not frequently consumed, selecting the dish items that showed higher sodium content per one portion size and higher consumption frequency. To develop a short DFQs for classifying subjects with low or high sodium intakes, the weighed score according to the sodium content of one protion size was given to each dish item of DFQ25 or DFQ14 and multiplied with the consumption frequency score. A sum index of all the dish items was formed and called sodium index (Na index). For validation study the DFQ112, 2-day diet record and one 24-hour urine collection were analyzed to estimate sodium intakes. The sodium intakes estimated with DFQ112 and 24-h urine analysis showed $65\%$ agreement to be classified into the same quartile and showed significant correlation (r=0.563 p<0.05). However, the actual amount of sodium intake estimated with DFQ112 (male: 6221.9mg, female: 6127.6mg) showed substantial difference with that of 24-h urine analysis (male: 4556.9mg, female: 5107.4mg). The sodium intake estimated with DFQ55 (male: 4848.5mg, female: 4884.3mg) showed small difference from that estimated with 24-h urine analysis, higher proportion to be classfied into the same quartile and higher correlation with the sodium intakes estimated with 24-h urine analysis and systolic blood pressure. It seems DFQ55 can be used as a tool for quantitative estimation of sodium intake. Na index25 or Na index14 showed $39\~50\%$ agreement to be classified into the same quartile, substantial correlations with the sodium intake estimated with DFQ55 and significant correlations with the sodium intake estimated with 24-h urine analysis. When point 119 for Na index25 was used as a criterion of low sodium intake, sensitivity, specificity and positive predictive value was $62.5\%,\;81.8\%\;and\;53.2\%$, respectively. When point 102 for Na index14 was used as a criterion of high sodium intake, sensitivity, specificity and positive predictive value were $73.8\%,\;84.0\%,\;62.0\%$, respectively. It seems the short DFQs using Na index 14 or Na index25 are simple, easy and proper instruments to classify the low or high sodium intake group.

• Journal of Nutrition and Health
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• v.43 no.1
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• pp.79-85
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• 2010

This study assesses the sodium intake of adults by 24-hour urine analysis, dietary records review and a food intake questionnaire. Subjects were 236 adult female in Daegu. The results are summarized as follows: Sodium intake as indicated by the 24-hour urine analysis was $5,805.4\;{\pm}\;3836.8\;mg$. This was significantly higher than intake indicated by dietary records ($4415.4\;{\pm}\;1935.1\;mg$) and the dish frequency questionnaire (DFQ 55) ($4293.5\;{\pm}\;1526.5\;mg$). The results of the 24-hour urine analysis and DFQ 55 showed that sodium intake was higher for the 65-to-74-year-old age group than for other age groups (p < 0.05, p < 0.05). Review of dietary records to examine typical sodium intake by food groups showed that 53.7% of the sodium consumed by subjects in all age groups came from seasonings and spices ($2399.0\;{\pm}\;1526.5\;mg$). The analysis of sodium intake by food groups using DFQ 55 showed 34.2% of their sodium came from consumption of kimchi (p < 0.001) and kimch, soup, stew and fish jorim accounted for 57.8% of total sodium intake. The results indicate positive correlation between age and sodium intake, as shown by the 24-hour urine analysis and food intake questionnaire (p < 0.05). Therefore, these results would be valuable as basic data for planning nutrition education for sodium intake reduction.

• Journal of the Korean Society of Food Science and Nutrition
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• v.37 no.5
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• pp.578-588
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• 2008

The objective of this study was to evaluate associations of dietary sodium (Na) intake with salt-related dietary behaviors of 218 university students (95 men; 123 women) living in Gyeonggi area. Dish frequency questionnaire (DFQ) was used to identify salt-related dietary behaviors and to determine Na intakes. In men, systolic & diastolic blood pressures, Na intakes and DFQ-15 scores were significantly higher than in women. High-salt intake group (HS), classified by DFQ-15, had higher scores of high-salt dietary attitude and more Na intakes than low-salt intake group (LS). HS took protein foods and had balanced diets less frequently than LS (p<0.05). HS had fried dishes & fatty meats, and added salt to dishes more frequently (p<0.05). HS and LS had differences in preference of soy-boiled and Chinese or Japanese foods, in intake frequency of bean-paste soup, in use of soy sauce with fried food or raw fish, and in salt addition to dishes at the table (p<0.05). HS, classified by Na intakes, had high-salt dietary attitudes such as preference of seasoned rice & soy-boiled foods and habitual addition of soy sauce or salt to dishes at the table. The subjects using food labels when purchasing had better salt-related attitudes & behaviors, and lower DFQ-15 scores & Na intakes than the non-users (p<0.01). Self-assessed HS (SHS) had worse salt-related attitudes and behaviors (p<0.05). Male self-assessed LS (SLS) had higher Na intakes, which indicated that self-assessment of salt preference did not actually reflect Na intake. In summary, male university students belonged to a high-risk group of salt intakes, and HS preferred soy-boiled foods or fatty dishes, frequently added salt to dishes and rarely had balanced diets. These results suggest that nutrition education programs for university students should include fundamental dietetics and a balanced diet, in addition to a low-Na diet.

• Korean Journal of Community Nutrition
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• v.12 no.5
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• pp.545-558
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• 2007

This study was performed to assess the sodium intakes of Korean adults using a 24-hr urine analysis and dish frequency questionnaire (DFQ) according to each dish group and the regional area. The subjects of this study were comprised of 522 adults (male : 267, female : 285), aged 20-59yr residing in the metropolitan area (N=200), Chungcheng-Do (N=117), Jeolla-Do(N=117), and Gueongsang-Do provinces (N=118). The subjects were recruited from the residents who once participated or are participating in the various health programs offered by the public health center. The number of subjects who completed the 24-hr urine collection was 205 (male : 110, female : 95). The mean age and BMI of the subjects were $39.0{\pm}$11.7y and $23.1{\pm}2.9 kg/m^2$, respectively. The mean systolic and diastolic blood pressure was $119.5{\pm}15.4 mmHg$, and $77.1{\pm}11.1 mmHg$, respectively. Eighteen percent of the subjects responded that they are currently smoking, 36% drinking and 50.4% exercising. Twenty point six percent of the subjects were assessed as having hypertension according to their systolic or diastolic blood pressure($SBP{\ge}140mmHg$ or $DBP{\ge}90mmHg$) measurements in the present study. Salt intake of the subjects estimated with 24-hr sodium excretion was 12.7g/d (male : 13.4g/d, female : 12.1g/d) based on the sodium excretion rate as 82%. Salt intake estimated with DFQ was 14.7g/d (male : 16.2g/d, female : 13.4g/d), 2 g more than the salt intake estimated with 24-hr urine analysis. The four dish groups that contributed most to the sodium intake in order were kimchi (11571.4mg), soup and stew (1260.5mg), fish and shellfish(706.3mg) and noodle and ramyeon(644.3mg). Salt intake estimated with DFQ was the highest in the subjects of Gueongsang-Do(17.0g/d), second highest Chungcheong-Do (16.4g/d) and the lowest in the metropolitan area (13.0g/d). Subjects of Gueongsang-Do showed the highest sodium intakes in most of the dish group, whereas subjects of the metropolitan area showed the lowest. Residents of Chungcheong-Do revealed the highest sodium intake with kimchi and of Jeolla-Do the higher sodium intake with main dish (meat, fish and beans). The highest salt percentage of kimchi ($3.0{\pm}0.8%$) and soybean paste ($14.5{\pm}5.1%$) were observed in Gueongsang-Do, whereas individuals of the metropolitan area were observed as having kimchi ($1.6{\pm}0.5%$) and soybean paste ($7.4{\pm}1.6%$) with the lowest salt percenage. Men were observed as having more salty kimchi ($2.4{\pm}0.1%$) than women ($2.1{\pm}0.1%$).

• Korean Journal of Community Nutrition
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• v.19 no.6
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• pp.558-567
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• 2014

Objectives: The purpose of this study was to investigate recognition, dietary attitude and education needs for reducing sodium intakes of dietitian at customized home visiting health service (CHVHS). Methods: The subjects were 75 dietitian at CHVHS. We investigated several variables (recognition, dietary attitude, education needs for reducing sodium intakes) and determined sodium intakes level of subjects as 'low', 'middle' and 'high' by Dish Frequency Questionnaire 25 (DFQ 25). Also, we assessed the differences in recognition, dietary attitude, sodium intake level and education needs by dietitian career period (under 3 yrs vs. over 3 yrs) at CHVHS. Results: In recognition related reducing sodium intake, they showed 'checking a sodium content in nutrition labeling' score 2.5/4.0 and 'perception difference between sodium and salt' score 3.1/4.0. There was no difference in the recognition between under 3yrs' group and over 3yrs' group. In dietary attitude related reducing sodium intake, they showed 'palatability for salty taste' score 0.8/1.0, 'attitude in related soups' 0.7/1.0, 'attitude in related using natural spice' 0.6/1.0. There was a difference in 'attitude in related soups' between under 3yrs' group and over 3yrs' group (0.6 vs. 0.7). In sodium intake level by DFQ 25, they showed 'low group' 41.3%, 'middle group' 41.3% and 'high group' 17.3%. There was no difference in the distribution of sodium intake level by the career. In education needs related reducing sodium intakes, there were 'teaching experience' 93.3%, 'have a difficulty in teaching about reducing sodium intakes' 86.6%, and 'necessity of education for CHVHS dietitians' 100.0%. 'Needed education contents for CHVHS dietitians' were ranked as 'cooking way to reduce sodium intake' 58.7%, 'relation between hypertension and sodium' 17.3%, 'composing way to reduce sodium intake' 17.3%. There was a difference in needed education contents 'relationship between hypertension and sodium' (33.3% vs. 2.6%) and 'The cooking way to reduce sodium intake' (38.9% vs. 76.9%) by the career. Conclusions: The results suggested that a capacity training program for reducing sodium intake may be needed for dietitians at CHVHS to improve health of the community elderly. For effective training program related reducing sodium intake for dietitians at CHVHS, it may be necessary to consider the career period as dietitians at CHVHS.

• Journal of the East Asian Society of Dietary Life
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• v.21 no.5
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• pp.625-636
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• 2011

The purpose of this study was to evaluate the relationship between bone health and sodium intake in female university students using a dish frequency questionnaire (DFQ 125), anthropometric checkups, food records for 3 days, and ultrasound measurement of calcaneus bone mineral density. Subjects were divided into two groups: normal (n=196) and osteopenia (n=52). There were no significant differences in age or height between the two groups. The average weight, body mass index, and body fat in the normal group were significantly higher than in the osteopenia group. The sodium intake of DFQ was positively correlated with the sodium intake of 3 days of dietary records (p=0.0003). There were no significant differences in the sodium intake between the two groups from DFQ. The dishes were ranked by sodium intake: kimchies were 17.68%, noodles and mandu were 16.36%, stews were 13.69%, main dishes such as meat, egg, and beans were 11.47%, and fish and shellfish were 11.07%. The frequency of eating noodles and mandu (p=0.0116), stews (p=0.0008), kimchies (p=0.0482), fish and shellfish (p=0.0362), vegetables (p=0.0064) and seasoning (p=0.0347) were negatively associated with bone mineral density. Bone health was not significantly different with increasing quartiles of sodium intake. As excessive sodium intakes may indirectly affect bone mineral density, these results suggest that to prevent osteoporosis, university students needed to be more educated about diets containing less sodium through nutrition education programs.

• Journal of the Korean Society of Food Science and Nutrition
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• v.45 no.3
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• pp.409-419
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• 2016

The objective of this study was to investigate dietary sodium sources at the dish level in 228 university students (71 men, 157 women) in Gyeonggi-do. Daily sodium intake was estimated from a validated 125-dish frequency questionnaire. In men, body mass index, systolic blood pressure, and sodium intake were significantly higher than in women. Men showed higher sodium intake from soups, fish or shellfish dishes, meat dishes, and soybean dishes than women. The dishes that most largely contributed to daily sodium intake were Napa cabbage kimchi and ramen in both men and women. In addition, relatively higher amounts of sodium from ramen were consumed in men, whereas cookies were the 5th highest sodium source in women. In both men and women, the high sodium intake groups consumed more sodium from kimchi, dishes cooked with kimchi, dishes with broth, and salted mackerel than the low sodium intake group. There were significant differences in major dishes contributing to between-person sodium intake variations between men and women. Short rib soup for men and Korean sausage for women were the largest contributors to sodium variations, which are common dishes served with salt. Men consumed more drinks and also more sodium from drinks than women. In conclusion, there were significant differences in major dishes contributing to absolute and between-person sodium intake variations in university students between men and women. Further studies on effects of gender on blood pressure, sodium and drink intake, and obesity are necessary.