• Journal of Nutrition and Health
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• v.48 no.5
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• pp.419-428
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• 2015

Purpose: The current study was conducted in order to develop the Korean Healthy Eating Index (KHEI) for assessing adherence to national dietary guidelines and comprehensive diet quality of healthy Korean adults using the 5th Korea National Health and Nutrition Examination Survey (KNHANES) data. Methods: The candidate components of KHEI were selected based on literature reviews, dietary guidelines for Korean adults, 2010 Dietary Reference Intakes for Koreans (2010 KDRI), and objectives of HP 2020. The associations between candidate components and risk of obesity, abdominal obesity, and metabolic syndrome were assessed using the 5th KNHANES data. The expert review process was also performed. Results: Diets that meet the food group recommendations per each energy level receive maximum scores for the 9 adequacy components of the index. Scores for amounts between zero and the standard are prorated linearly. For the three moderation components among the total of five, population probability densities were examined when setting the standards for minimum and maximum scores. Maximum scores for the total of 14 components are 100 points and each component has maximum scores of 5 (fruit intakes excluding juice, fruit intake including juice, vegetable intakes excluding Kimchi and pickles, vegetable intake including Kimchi or pickles, ratio of white meat to read meat, whole grains intake, refined grains intake, and percentages of energy intake from carbohydrate) or 10 points (protein foods intake, milk and dairy food intake, having breakfast, sodium intake, percentages of energy intake from empty calorie foods, and percentages of energy intake from fat). The KHEI is a measure of diet quality as specified by the key diet recommendations of the dietary guidelines and 2010 KDRIs. Conclusion: The KHEI will be used as a tool for monitoring diet quality of the Korean population and subpopulations, evaluation of nutrition interventions and research.

• Journal of Community Nutrition
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• v.4 no.3
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• pp.143-150
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• 2002

The objective of this study is to establish outcome validity for three instruments that assess whether subjects met recommendations for daily servings of fruits and vegetables for“Stage of Change”research. A convenience sample of 294 college students was recruited from introductory nutrition classes at Michigan State University in the United States. To measure servings of fruits and vegetables, separately, three types of methods (self-rated intake, 24-hour recall and food frequency) were used in comparison to the servings from a three-day food record, the criterion used. The outcome validity was assessed based on whether or not at least two servings of fruits and three servings of vegetables were reported. Validity was assessed by sensitivity, to measure the ability to detect low intakes, and by specificity, to measure ability to detect adequate intakes. Cohen's kappa was used as well to examine the agreement between the three methods and a three-day food record. The results showed, for fruits, the 24-hour recall had the best agreement (recall 0.54, self-rated : 0.31, food frequency : 0.29) with a three-day food record for servings consumed by people in pre-action or post-action stages. Sensitivity for fruit was also best using a recall (0.81). For vegetables, however, all three methods had low agreement (food frequency : 0.27, recall : 0.21, self-rated : 0.17) with the results of the three-day food record. Self-rated intakes for vegetables had the best sensitivity (0.66) and the food frequency had the best specificity (0.73). Therefore, researcher can use the 24-hour recall method to identify people who consume inadequate servings of fruit. To detect adequate vegetable intake, the food frequency was best of the three methods. Accuracy may be improved by probing for vegetables in mixed dishes and on sandwiches. (J Community Nutrition 4(3)： 143∼150, 2002)

• Korean Journal of Community Nutrition
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• v.8 no.5
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• pp.675-688
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• 2003

The aim of this study was to investigate the dietary habits and the factors related to lifestyles in female college students with constipation. A survey was conducted using a self-administered questionnaires. Two hundred ninety one subjects participated in this study. All respondents were divided into three groups based on their frequency of stool evacuation: 129 subjects (44.3%) comprised the normal group, 109 (37.5%) the mild constipated group and 53 (18.2%) the severely constipated group. Abdominal pain and ailment during evacuation were higher and the feeling of relief after evacuation was lower in the normal group than in the two constipated groups. The greater the symptoms of constipation, the more laxatives were taken. The prevalence of constipation was lower in students who lived at home than in those who lived in other types of residences. The more pocket money the subject had, the more complaints they had about constipation symptoms. Forty three percent of the subjects ate meals regularly. The less frequently they ate meals and the greater the rate of skipping breakfasts and dining-out, the greater were their constipation symptoms. Rice and most of the food items in the vegetable food group were consumed less frequently in the two constipated groups than in the normal group. The severely constipated group ate food items in the fat group less frequently than the normal and mildly constipated groups. The beverage intake of the normal group tended to be lower than those of the two constipated groups; the constipated groups consumed fruits and vegetable juices less frequently and coffee and tea more frequently. The severely constipated group ate the least number of food items in the vegetable & fruit and fat food groups. Therefore, dietary habits and factors related to lifestyles should be changed through nutrition education programs aimed at improving the symptoms of constipation in young women.

• Korean Journal of Community Nutrition
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• v.19 no.2
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• pp.142-162
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• 2014

Objectives: To evaluate the critical environmental factors on healthy-aging of Korean people, we investigated the significant factors influencing health status of septuagenarians living in rural area of Jeonla province, known to be one of the representative longevity regions in Korea. Methods: We divided subjects into healthy group (36M/25F) or poor-health group (26M/73F) based on self-reported health status, body mass index, a number of prescription, and blood test data. General characteristics, physical measurements, lifestyle, dietary behavior and nutrient intake, physical health and mental health data were statistically compared between the two groups. Results: Average age was not different between healthy group and poor-health group in men and women, respectively. In men, significantly favorable factors to health were observed to be higher education, regular exercise, higher grip strength and walking function, body mass index (${\geq}18.5kg/m^2$), moderate frequency of drinking and eating-out, non-smoking, normal red blood cell (RBC) count, higher serum dehydroepiandrosterone-sulfate (DHEAS) level, good digestive function and appetite, normal hearing function, regular meals, adequate vegetable and fruit intake, diverse food intake, adequate energy and nutrients (protein, vitamin $B_1$, $B_6$, C and E, folate, niacin, P, Zn and K) intake, higher mini-nutrient status assessment (MNA) score and low level of depression. On the other hand, in women, those were literacy, living arrangement, moderate frequency of drinking, healthy teeth, higher grip strength and walking function, bone mineral density, normal RBC and white blood cell (WBC) count, higher DHEAS concentration, higher MNA score, normal cognition and memory function, having snack and adequate fruit intake. Conclusions: These results could be useful to plan effective strategies to increase health-life expectancy of Korean old people living in rural areas.

• Journal of Nutrition and Health
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• v.42 no.2
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• pp.146-157
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• 2009

Korean diet is high in plant foods but also high in salted vegetables. World Cancer Research Fund (WCRF) recommends consumption of fruits and vegetables excluding salted vegetables for prevention cancer. This study aimed to analyze relations between intakes of salted and non-salted vegetables and socioeconomic factors, providing a data for targeted groups in promotion of fruits and vegetables consumption. Dietary and socioeconomic status data of the 5,400 subjects over 30 years of age from the 2005 Korea National Health and Nutrition Examination Survey (KNHANESIII) were used. Dietary intake data from KNHANESIII was obtained by one day 24-hour recall method. Mean daily intakes of salted vegetables, non-salted vegetables and fruits of subjects were 151 g, 237 g, and 71 g respectively. Mean daily intake of salted vegetables was significantly higher in men than women for daily amount (173 g vs. 133 g) as well as percentage of total food intake (9.9% vs. 9.6%). Subjects living in rural area consumed more salted vegetables. Salted vegetables as percent of total food were lower in subjects with higher education levels (p < 0.001). Intakes of non-salted vegetables were significantly affected by age and gender. Intake levels of fruit were significantly higher in younger groups, in females, and subjects with higher income and education levels (p < 0.05). Average intake of fruits and non-salted vegetables was 307 g, lower than WCRF recommended level of 400 g for personal guideline. Intake of salted vegetables was positively correlated with sodium intake (Pearson's correlation coefficient, r = 0.43) but less so with potassium (r = 0.16) and other micronutrients intake (r < 0.1). On the other hand, non-salted vegetables had higher correlations with potassium (r = 0.45), carotene (r = 0.38), vitamin A (r = 0.37), iron (r = 0.34) and low for sodium (r = 0.13). Fruits intake was highly correlated with vitamin C intake (r = 0.46). Proportion of subjects satisfying WCRF personal guideline of fruits and non-salted vegetables was 25.7%. Results of this study indicate that intake of salted vegetable is considerably high among Koreans, and it is highly correlated with sodium intake and less so with other micronutrients.

• Nutrition Research and Practice
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• v.12 no.4
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• pp.307-314
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• 2018

BACKGROUND/OBJECTIVES: Numerous researches have studied the association between sugar intake and obesity of children in many countries. This study was undertaken to investigate the association between beverage intake and obesity of children by reviewing a database for total sugar contents established in all foods and presented in a nutrition survey by the Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: Data of 1,520 children aged 6-11 years in the 6th KNHANES (2013-2015) were analyzed for this study. A database for total sugar intake comprises the total sugar contents of all foods included in the results of a nutrition survey using the 24-hour recall method of 6th KNHANES. Beverages were categorized into carbonated beverages, fruit & vegetable drinks, other drinks, tea, and coffee. RESULTS: The average daily beverage intake of all children was 131.75 g/day, and the average daily total sugar intake in beverages was 13.76 g/day. Carbonated beverages had the highest intake rate (58.85 g/day) and also ranked highest for sugar intake (6.36 g/day). After adjusting for confounding variables, the odds ratio for obesity in children with beverage intake of ${\geq}200mL/day$ significantly increased by 1.83 times (95% CI, 1.11-3.00) as compared to children with beverage intake of < 200 mL/day. Also, a significant increase was observed in the odds ratio for obesity in total children (2.41 times; 95% CI, 1.35-4.33) and boys (3.15 times; 95% CI, 1.53-6.49) with carbonated beverage intake of ${\geq}200mL/day$ when compared with children who consumed < 200 mL/day. CONCLUSION: A positive association is observed between beverage intake and obesity in Korean children. In particular, an intake of carbonated beverages has a positive correlation with childhood obesity in boys. This study can therefore be used as scientific evidence for reducing sugar, and for the continuous management and research on beverages.

• Journal of Nutrition and Health
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• v.34 no.1
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• pp.30-38
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• 2001

This research was conduced to 1) examine the influence of milk group intake on the dietary, considering dietary diversity and nutrient adequacy, 2) identify which foods truly contribute to the intake of specific nutrients 3) point out the dietary problems of this age group. The subjects were 664(male 357, female 307) healthy toddlers of the ages of 12-36 months, who had neither been taking any medicine-type supplements nor had any diseases that affect the dietary intakes, chosen among the outpatients of university and private hospitals in Seoul and Kyonggi province during Mach-August, 1999. The 24 hour recall method and CAN Pro(food analysis program) were used to analyze the amount of nutrient intake. The grouping of the subjects for the analysis by monthly age was based on the 98 Korean Child growth standard. The results that the milk group intake showed significant negative correlations with the grain group(r=-0.194, p<0.01), the vegetable group(r=-0.115, p<0.01) and the fruit group(r=-0.125, p<0.01). It also showed that the more the milk group intake, the lower the Dietary Diversity Score(r=-0.131, p<0.01), and the more the intake of raw milk, the more dificient the intake of iron(r=-0.211, p<0.01), vitamin A(r=-0.169,p<0.01), vitamin B$_1$(r=-0.078, p<0.05) and vitamin C(r=-0.187, p<0.01). Foods contributory to nutrient intake for of 12-14 months of were mostly infant formula, and the contribution ratio was high. In the age of 15-17 months, the subjects obtained most of the nutrients from raw milk., liquid-type yoghurt, soybean milk, cooked rice, etc. As for iron intake, the age of 21-23 month obtained the most from ionic drinks, and 24-29 months from raw milk, chocolate cakes, ionic drinks, etc. Though the NAR(Nutrient Adequacy Ratio) and MAR(Mean Adequacy Ratio) generally tended to increase accordingly with the DDs, as for nutrients Ca, vitamin A, vitamin B$_1$, and vitamin C the NAR marked the highest when the DDS marked the lowest(due to infant formula). And for iron, even when the DDS was 5 the NAR value was low. Im conclusion, the more the milk group intake, the lower was the dietary diversity. High dependency on infant formula and others from milk group over the age of 12 months proved to result in a decrease of nutritious solid food intake, iron deficiency and a low dietary diversity score, which can lead to an unbalanced diet. Therefore, nutrition education towards mothers/caretakers of toddler is of urgent need, in order to reduce the fluid milk group intake of low nutritional density and to provide various solid foods the children. (Korean J Nutrition 34(1):30-38, 2001)

• Korean Journal of Community Nutrition
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• v.25 no.5
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• pp.406-415
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• 2020

Objectives: The aim of this study was to compare the nutritional intake and Diet Quality Index-International (DQI-I) of gynecological cancer survivors and normal women. Methods: This study compared the anthropometric indices, dietary behavior, nutritional intake, and DQI-I in women with previous history of breast or uterine cancer [Gynecological cancer survivors group (GCSG, n=126)] and normal women [Normal control group (NCG, n=7,011)] using the 2013~2016 Korea National Health and Nutrition Examination Survey data. Results: Body mass index and waist circumference were lower in the GCSG compared the NCG. The frequency of skipping breakfast and eating out was higher in the NCG compared to GCSG. Energy and fat intake were significantly higher in the NCG than in the GCSG, whereas intake of all minerals and vitamins (excluding thiamine), and dietary fiber intake were higher in GCSG. It was observed that the fatty acid intake of the GCSG was significantly lower than that of the NCG. The diet quality evaluation using DQI-I results showed that GCSG was higher in the "within-group" diet variety and adequacy of vegetable group than the NCG, whereas the intake level of the fruit group was higher in NCG. Besides, protein, calcium, and vitamin C intake were higher in the GCSG than in the NCG. The GCSG showed higher levels of total fat and saturated fat moderation than the NCG, whereas cholesterol moderation showed the opposite results. The results of DQI-I comparison according to the cancer survival years showed that the overall score and scores related to diet adequacy and balance were higher in the below 5-year group, whereas the over 5-year group scored higher in terms of moderation of diet. Conclusions: The results of this study suggest that a chronic disease based management approach is needed in cancer survivors. The study provides important data which can help in the preparation of guidelines for long-term lifestyle and diet management, in these patients.

• Nutrition Research and Practice
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• v.16 no.2
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• pp.233-247
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• 2022

BACKGROUND/OBJECTIVES: The objective of this study was to describe the development process of the Korean Healthy Eating Index (KHEI) based on the Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: The components of KHEI were selected based on Dietary Guidelines for Koreans, domestic and overseas dietary quality indices, and results of the analysis of association with chronic diseases. The standards for scoring of KHEI were selected based on the 2015 Dietary Reference Intakes for Koreans (KDRI). The KHEI scores of Korean adults were calculated using a 1-day 24-h recall data in the 2013-2015 KNHANES. RESULTS: The KHEI included eight adequacy components evaluating the proper intake of recommended foods such as fruit, vegetable, and milk and three moderation components evaluating the consumption of food that limit intake such as sodium and saturated fatty acid. In addition, three balance components assessing the balance of energy intake were included. The KHEI score was defined to range from the minimum of 0 point to the maximum of 100 points. Among Korean adults, the total KHEI score was 63.2 out of 100. Gender and age differences were found in the average of total KHEI scores. Women showed higher score than men (61.7 in men and 64.7 in women, respectively). By age group, 20s and 30s showed the lowest scores with 57.4 and 61.1 respectively, and the scores increased with age by peaking at 67.8 in ages 60-69 and slowed down again in ages 70 or over. CONCLUSIONS: The KHEI can be useful for establishing and assessing national nutritional policies and in epidemiological studies to assess the relationship between overall dietary quality and chronic diseases. KHEI will need to be continuously updated to reflect changes in dietary guidelines and the KDRI.

• Nutrition Research and Practice
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• v.18 no.5
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• pp.674-686
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• 2024

BACKGROUND/OBJECTIVES: Mukbang, a trend originating in South Korea and gaining global popularity, could influence children's food choices and eating habits. This study analyzed the correlation between Mukbang viewing time in children and adolescents, their meal consumption frequency, nutrition quotient (NQ), and frequency of food intake. SUBJECTS/METHODS: From July to August 2022, this cross-sectional study investigated upper elementary students (ages 9-11 yrs) and adolescents (aged 12-18 yrs) using an online survey. The survey items included key demographic factors, Mukbang viewing frequency and duration, frequency of main meal consumption, commonly consumed foods, and the validated NQ, which was used to assess food intake quality. Multiple linear regression analysis was used to explore the link between Mukbang viewing and nutritional habits. RESULTS: Weekly Mukbang viewing time was significantly correlated with eating habits after adjusting for gender, age, physical activity frequency past week, household income, and primary caregiver's level of education. Increased Mukbang viewing time correlated with reduced frequency of breakfast (P for trend < 0.001) and dinner (P for trend = 0.012), while the frequency of eating out (P for trend < 0.001) and late-night snacking (P for trend = 0.008) increased. Higher Mukbang viewing time notably decreased scores in the moderation domain (P for trend < 0.001), in the practice domain (P for trend = 0.031), and overall NQ (P for trend < 0.001). It also significantly elevated intake of sweets (P for trend = 0.001), Korean-style street food, Western-style fast food, instant noodles, sweetened beverages, caffeinated beverages, and fruit and vegetable juices (P for trend < 0.001). CONCLUSION: This study identifies a negative correlation between Mukbang viewing and eating habits among Korean children and adolescents. The results indicate the importance of incorporating children and adolescents' media usage and environmental factors on dietary education and the development of policy programs.