• Journal of Nutrition and Health
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• v.45 no.4
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• pp.372-389
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• 2012

The objective of this study is to select a simple and easy measurable food behavior checklist for the development of Nutrition Quotient (NQ) for children, which reflects children's diet quality, as well as to evaluate the validity of the items in the food behavior checklist. The first 36 items in the checklist were established by an expert review, modifying the preliminary 50 items in the checklist, which had been selected by a literature review and the Korean National Health and Nutrition Examination Survey data. 341 children in 5th and 6th grades at an elementary school participated in a one-day dietary record survey, and later responded to 36 food behavior questions of the checklist. Pearson's correlation coefficients between the responses to the food behavior checklist items along with the mean nutrient intakes of the children were calculated. From the result, in which responses of food frequency and food behavior items showed certain association with the dietary record data, a second checklist with 22 items was selected. A survey was conducted by using the second checklist. 1,393 children in the 5th and 6th grades at 12 elementary schools in metropolitan cities, such as Seoul, Busan, Gwangju, Daegu, Daejeon, and Incheon, participated in the survey. Further, an exploratory factor analysis was performed. After the analysis, 19 items (10 items from food frequency and 9 items from food behavior) were finalized as the food behavior checklist items for the NQ. The final 19 food behavior checklist items were composed of 5 factors: 'Balance', 'Diversity', 'Moderation', 'Regularity', and 'Practice'. This study is a significant first trial to establish a comprehensive system for evaluating children's food habit and diet quality. This checklist might need continuous modification and revision reflecting the change of children's dietary life and the social environment.

• Journal of Nutrition and Health
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• v.46 no.5
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• pp.427-439
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• 2013

The aim of this study was to determine whether Nutrition Quotient (NQ) for children, which has been developed from data on urban children, can be applied to children in rural areas. A total of 200 children (108 boys and 92 girls) in fifth and sixth grade at three elementary schools in rural areas of Gyeongbuk participated in the survey conducted during June 2012. Questionnaires consisted of items on food intake frequency and dietary behavior. Food intake data were obtained using the 24-hour recall method, and nutrient intake was calculated using the CAN-Pro 4.0 Program. Percentages of children who took less than the estimated average requirement were 76.5%, 49.5%, 45.5%, 33.5%, and 26.0% for calcium, vitamin C, iron, vitamin A, and folate, respectively. Significant associations were observed between intake frequencies of vegetables, kimchi, and fruits, and intake of vitamin C, folate, and dietary fiber. White milk and legumes showed positive correlation with intake of calcium and vitamin A. Eating breakfast, meal regularity, and diverse side dishes showed positive correlation with intake of folate and calcium. The 19 food checklist items could be categorized according to five factors. The mean NQ score of the subjects was 62.0, which was similar to that of urban children, 64.4. NQ score and factor scores for balance, regularity, and practice were significantly lower in children with lower socioeconomic level as compared to those with higher socioeconomic level. Higher NQ score showed an association with increased intake of vitamin B2, folate, vitamin C, and calcium. In conclusion, NQ offers a valuable instrument for evaluation of food habit and dietary quality of rural children as well as urban children, and children with low socioeconomic status should be monitored by testing with NQ checklist before implementation of nutrition programs.

• Journal of Nutrition and Health
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• v.50 no.2
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• pp.142-157
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• 2017

Purpose: The purpose of this study was to develop a nutrition quotient for adolescents (NQ-A) to assess overall dietary quality and food behavior of Korean adolescents. Methods: Development of the NQ-A was undertaken in three steps: item generation, item reduction, and validation. Candidate items of the NQ-A checklist were selected based on literature reviews, results of the fifth Korea National Health and Nutrition Examination Survey data, dietary guidelines for Korean adolescents, expert in-depth interviews, and national nutrition policies and recommendations. A total of 213 middle and high school students participated in a one-day dietary record survey and responded to 41 items in the food behavior checklist. Pearson's correlation coefficients between the responses to the checklist items along with nutritional status of the adolescents were calculated. Item reduction was performed, and 24 items were selected for the nation-wide survey. A total of 1,547 adolescents from 17 cities completed the checklist questionnaire. Exploratory factor and confirmatory factor analyses were performed to develop a final NQ-A model. Results: Nineteen items were finalized as the checklist items for the NQ-A. Checklist items were composed of five factors (balance, diversity, moderation, environment, and practice). The five-factor structure accounted for 47.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-A and five-factor scores were calculated based on the obtained weights of the questionnaire items. Conclusion: Nutrition Quotient for adolescents (NQ-A) would be a useful instrument for evaluating dietary quality and food behavior of Korean adolescents. Further research on NQ-A is needed to reflect changes in adolescent's food behavior and environment.

• 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 Nutrition and Health
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• v.55 no.1
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• pp.155-173
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• 2022

Purpose: This study was undertaken to update the Nutrition Quotient for Elderly (NQ-E), which reflects dietary quality and behavior among Korean older adults. Methods: The first 29 items of the measurable food behavior checklist were obtained from a previous NQ-E checklist, recent literature reviews, and national nutrition policies and recommendations. One-hundred subjects (50 men and 50 women) aged ≥ 65 years living in the Seoul Metropolitan Area, including Gyeonggi Province, completed a pilot survey from March to April 2021. Based on the results of the pilot study, we conducted factor analysis and frequency analysis to determine whether the items of the survey were properly organized and whether the distribution of answers for each evaluation item was properly distributed. As a result, we reduced the number of items on the food behavior checklist and used 23 items for the national survey. Nationwide, 1,000 subjects (472 men and 528 women) aged > 65 years, completed the checklist survey, which was applied using a face-to-face survey method from May to August 2021. The construct validity of the NQ-E 2021 was assessed using confirmatory factor analysis, LISREL. Results: Seventeen food behavior checklist items were selected for the final NQ-E 2021. Checklist items addressed three factors: balance (8 items), moderation (2 items), and practice (7 items). Standardized path coefficients were used as the weights of items to determine nutrition quotients. NQ-E and three-factor scores were calculated according to the weights of questionnaire items. Conclusion: The updated NQ-E 2021 produced by structural equation modelling provides a suitable tool for assessing the dietary quality and behavior of Korean older adults.

• Journal of the Korean Society of Food Culture
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• v.39 no.1
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• pp.13-29
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• 2024

A checklist of dietary behavior items for the elderly was developed based on Korean dietary guidelines. First, a literature review was conducted, and 63 preliminary items, including 30 items on food intake, 12 on eating habits, and 21 on dietary culture, were obtained to evaluate the dietary guidelines. The preliminary items were evaluated by experts using Lawshe's method to verify the content validity. They were then revised, resulting in 52 items: 25, 11, and 16 in the food intake, eating habits, and dietary culture domains, respectively. A face-to-face survey was conducted on 331 people over 65 years of age in the metropolitan area, and their one-day food intake was surveyed using a 24-hour recall method in August 2022. The 48 items, including 24, 11, and 13 items on food intake, eating habits, and dietary culture, respectively, correlated significantly with the evaluation indicators of nutrient intake, such as mean adequacy ratio, dietary diversity score, and nutrient intake density. These items were considered suitable for evaluating the elderly's compliance with dietary guidelines.

• 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.45 no.4
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• pp.390-399
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• 2012

The objective of this study was to develop and evaluate the construct validity of a Nutrition Quotient (NQ) for children. In a previous report (Kang, et al., 2012), the food behavior checklist for children's NQ, consisting of 19 items, was grouped into a 5-factor structure according to the exploratory factor analysis: balance, diversity, moderation, regularity, and practice. In this study, the construct validity of the NQ was assessed using a confirmatory factor analysis. Elementary school students (n = 1,393) from six large cities completed the NQ test. Indicator tests suggested an adequate model fit (goodness of fit index = 0.9613; adjusted GFI = 0.95; standardized root mean square residual = 0.0464; chi-square test statistics of < 0.001 p-value, 82.1), and item loadings were significant for all subscales (p < 0.05). The standardized path coefficients were used as the weights of the items. The NQ and the 5 factor scores of the student were calculated by the obtained weights of the questionnaire items. Logistic regression was applied to find the significant factors in order to affect a specific nutrient status. The receiver operation characteristic curve analyses were performed in order to find diagnostic cut-off points of the five factors. The food behavior checklist for children's NQ would be a handy and suitable instrument for evaluating dietary behaviors of Korean children.

• Journal of the East Asian Society of Dietary Life
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• v.27 no.1
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• pp.17-28
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• 2017

The objectives of this study were to assess food intake frequency and food behavior of infants and toddlers by using the Nutrition Quotient (NQ). A total of 368 subjects (infants 111, toddlers 257) in Ganghwa county were analyzed in this study. The NQ was examined using an NQ questionnaire, which consisted of 19 food behavior checklist items. The items were grouped into five categories: balance, diversity, moderation, regularity, and practice. All data were statistically analyzed by SPSS 20, and significant difference was evaluated by Student's t-test and $x^2-test$. The BMIs of infants and toddlers were $16.54kg/m^2$ and $16.01kg/m^2$, respectively. The frequencies of consumption of vegetables and fruits were higher (p<0.001) in girls and toddlers compared to boys and infants, respectively. Food behavior of meal regularity (p<0.001), breakfast eating (p<0.001), and chewing well (p<0.001) were also higher in toddlers compared to infants. Total NQ score of infants and toddlers were 62.05 and 64.91, respectively, which were within medium grade. The NQ score of toddlers was higher than that of infants (p<0.0.5). NQ score was positively correlated with parent's education, monthly income, age, and exercise. Therefore, children and their parents need proper nutrition education and counseling to correct their eating habits and improve their nutritional status.