• Nutrition Research and Practice
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• v.17 no.2
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• pp.307-315
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• 2023

BACKGROUND/OBJECTIVES: Previous studies have shown an association between breastfeeding and higher fruit and vegetable consumption and the level of dietary variety in children. However, few studies have reported this association on the feeding characteristics. Therefore, this study examined the association of the feeding characteristics with the consumption of fruit and vegetable and dietary variety in children. SUBJECTS/METHODS: This study recruited 802 participants from their parents with information on their feeding, and 24-h dietary recall. The associations of the feeding characteristics with fruit and vegetable consumption and dietary variety score (DVS) were analyzed using a multiple logistic regression model. RESULTS: Compared to the feeding type of exclusive breastfed children, exclusive formula-fed children had a significant association with a lower DVS (odds ratio [OR], 0.42, 95% confidence interval [CI], 0.23-0.77). Fruit and vegetable consumption was classified into 6 groups: non-salted vegetables (NSV), salted vegetables (SV), fruit (F), total vegetables (TV), non-salted vegetables + fruit (NSVF), and total vegetables + fruit (TVF). According to the mean level of fruit and vegetable consumption, compared to the duration of total breastfeeding for 6 month or less, a greater duration of breastfeeding for 12 mon had a significant association with a higher intake of NSVF and TVF (OR, 1.85, 95% CI, 1.20-2.85 and OR, 1.89, 95% CI, 1.22-2.92). On the other hand, the early introduction of formula feeding for 4 mon had a significant association with a lower intake of F and NSVF (OR, 0.59, 95% CI, 0.38-0.91 and OR, 0.63, 95% CI, 0.40-0.99). CONCLUSIONS: These results confirm that breastfeeding is associated with higher fruit and vegetable consumption and dietary variety, whereas formula feeding is associated with lower fruit and vegetable consumption and dietary variety. Therefore, the feeding characteristics in infants may affect fruit and vegetable consumption and dietary variety in children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.4
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• pp.173-180
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• 2023

Purpose: Gastro esophageal reflux disease (GERD) is a burdensome disease affecting many children. A clinical examination is reported to be unreliable to diagnose GERD in children. This study aimed to investigate the relationship between the Pediatric Gastroesophageal Reflux Disease Symptom and Quality of Life Questionnaire (PGSQ) and endoscopic and histopathological findings in children with symptoms suggesting GERD. Changes in the PGSQ score in children with esophagitis as response to one month therapy were recorded as secondary outcome. Methods: This is a prospective cohort study in the pediatric outpatient clinic in an Indonesian tertiary hospital. Children aged 2-17 years old with clinical symptoms suspected of GERD are included in the study. Blinded endoscopic and histopathological examination was performed in all patients before one month proton pump inhibitors (PPI) therapy. The PGSQ information was collected at inclusion and after one month PPI treatment. Results: Fifty-eight subjects were included. Esophagitis was found in 60.9% of subjects according to endoscopy and 58.6% according to histology. There was no significant relationship between the PGSQ score and endoscopic (p=0.781) nor biopsy (p=0.740) examinations. The PGSQ showed a low diagnostic value compared to endoscopy and biopsy (area under the curve [AUC] 0.477, p=0.477, 95% confidence interval [CI] 0.326-0.629 and AUC 0.474, p=0.740 (95% CI 0.321-0.627 respectively). The PGSQ improved significantly post one month of PPI treatment. Conclusion: The PGSQ cannot be used to diagnose esophagitis in children with clinical symptoms suggesting GERD. However, the PGSQ can be used to monitor the treatment response in children with esophagitis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.26 no.2
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• pp.116-126
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• 2023

Purpose: This study aimed to evaluate the prevalence and risk factors of infant dyschezia as well as pediatrician awareness regarding this disease in Indonesia. Methods: This is a two-part cross-sectional study, which was divided into study A and B. Study A: Parents whose infants were under 9 months old and attended well-baby clinics were recruited at two randomly selected primary health centers. Parents also provided information on the infant's previous medical history, and socio-demographic and family details. The Rome IV criteria was translated and validated to be used for diagnosis of infant dyschezia. Study B: Randomly selected pediatricians were surveyed by using a questionnaire to evaluate their knowledge regarding infant dyschezia. Results: The prevalence of infant dyschezia based on the result of this study was 11.8%. Three risk factors had a significant relationship with infant dyschezia i.e., the number of children in the family (odds ratio [OR], 5.619; 95% confidence interval [CI], 2.194-14.390; p<0.001), complementary food diet (OR, 4.238; 95% CI, 1.902-9.443; p<0.001), and social-emotional disturbance (OR, 5.670; 95% CI, 2.550-12.609; p<0.001). The percentage of pediatricians correctly diagnosed infant dyschezia was 71.5%. Most pediatricians agreed that they did not perform any diagnostic testing (79.7%) and only provided education in cases of infant dyschezia (58.5%). Conclusion: The prevalence of infant dyschezia identified in our study was higher than that in other neighboring Asian countries, with the highest prevalence observed in infants 7-9 months old. Being an only child, receiving complementary food diet, and sociao-emotional disturbances were significant risk factors of infant dyschezia.

• Journal of Preventive Medicine and Public Health
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• v.55 no.3
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• pp.289-296
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• 2022

Objectives: Integrating retail and manufacturing enables limitless potential for food businesses, but also creates challenges for navigating within complex food safety regulations. From public health inspectors' (PHIs) perspective, this study aimed (1) to describe the characteristics of crossover businesses in Louisiana, and (2) to evaluate regulation awareness and food safety education needs for business owners and PHIs who inspect crossover businesses. Methods: A self-administered questionnaire was administered to Louisiana Department of Health PHIs using Qualtrics^®. A descriptive analysis was performed, focusing on the frequency of each item. Results: In total, 1774 retailers were conducting or planned to conduct specialized processes, while 552 food manufacturers were performing or planned to perform retail functions. Reduced oxygen packaging, the use of additives such as vinegar as a method of preservation, and smoking food as a method of preservation were observed by 62%, 36%, and 35% of the PHIs, respectively. The PHIs perceived crossover businesses as "not aware" or "somewhat aware" of the food safety regulations. The current food safety training level for these businesses was reported to range from "no training" to "some training but not sufficient." When asked for a self-assessment, the majority of PHIs reported themselves as being "familiar" with the variance requirement for specialized processing. Their confidence in inspecting crossover businesses, however, leaned towards "not confident" or "somewhat confident." Conclusions: To better guard public health, food safety training is needed for crossover food business owners, as well as PHIs, on regulations and conducting or inspecting specialized processes.

• Journal of the Korean Society of Food Culture
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• v.23 no.4
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• pp.455-461
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• 2008

The purpose of this study was to investigate the actual conditions, satisfaction towards, and effects of children's cooking activity programs held at children's cooking schools, which have recently been gaining interest as an effective integrated educational method. Also, based on the results, the study provides information on good teaching-learning methods, which can be applied to kindergarten and elementary schools. The results of the evaluation showed that 84.1% of the respondents were satisfied with the educational aspects of the programs. People were most satisfied with the teachers' "teaching ability", and were least satisfied with "the educational fees". The satisfaction scores for the children's cooking programs were higher when they were performed in a school class environment as compared to a cultural center environment, and children who had participated for more than 12 months were more satisfied than those who had only participated 1 to 3 months. Quantitatively, of the 24 measured evaluation categories grouped into 6 fields that measured the effects of participation in the cooking programs, the greatest effects were found on the children's self-confidence and sense of achievement in the social emotion field, and the lowest effect was found on their writing ability in the language field. In addition, scores were higher when the cooking activities were performed in a private cooking school environment as compared to a cultural center environment. Scores were also higher when the educational program lasted 7 to 9 months as compared to only 1 to 3 months.

• Journal of Preventive Medicine and Public Health
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• v.56 no.6
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• pp.533-541
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• 2023

Objectives: This study analyzed the relationship between parental body mass index (BMI; BMI_p) and hypertension in their adolescent offspring (HTN_a), focusing on the mediating effect of adolescents' BMI (BMI_a). Methods: Utilizing data from the Korea National Health and Nutrition Examination Survey, including participants aged 12-18, we conducted a mediation analysis while controlling for confounding factors such as age, sex, physical activity, dietary habits, household income quartile, and parents' alcohol and smoking habits. Results: The study included a total of 5731 participants, of whom 3381 and 5455 participants had data on fathers' and mothers' BMI, respectively. For adolescent systolic blood pressure (SBP_a), the father's BMI (BMI_f) had a significant total effect (β, 0.23; 95% confidence interval [CI], 0.12 to 0.34) and average controlled mediated effect (ACME) (β, 0.27; 95% CI, 0.23 to 0.32), but the average direct effect (ADE) was not significant. The mother's BMI (BMI_m) had a significant total effect (β, 0.17; 95% CI, 0.09 to 0.25), ACME (β, 0.25; 95% CI, 0.22 to 0.28) and ADE (β, -0.08; 95% CI, -0.16 to 0.00). For adolescent diastolic blood pressure, both BMI_f and BMI_m had significant ACMEs (β, 0.10; 95% CI, 0.08 to 0.12 and β, 0.09; 95% CI, 0.07 to 0.12, respectively), BMI_m had a significant ADE (β, -0.09; 95% CI, -0.16 to -0.02) but BMI_f had an insignificant ADE and total effect. Conclusions: The study found that parental BMI had a significant effect on SBP_a, mediated through BMI_a. Therefore, a high BMI in parents could be a risk factor, mediated through BMI_a, for systolic hypertension in adolescents, necessitating appropriate management.

• Nutrition Research and Practice
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• v.17 no.5
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• pp.984-996
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• 2023

BACKGROUND/OBJECTIVES: Prior studies, mostly conducted in Western countries, have suggested that the low cost of energy-dense foods is associated with an increased risk of obesity. This study aimed to investigate the association between food costs and obesity risk among Koreans who may have different food cost and dietary patterns than those of Western populations. SUBJECTS/METHODS: We used baseline data from a cohort of 45,193 men and 83,172 women aged 40-79 years (in 2006-2013). Dietary intake information was collected using a validated food frequency questionnaire. Prudent and Western dietary patterns extracted via principal component analysis. Food cost was calculated based on Korean government data and market prices. Logistic regression analyses were performed to investigate the association of daily total, prudent, and Western food cost per calorie with obesity. RESULTS: Men in the highest total food cost quintile had 15% higher odds of obesity, after adjusting for demographic characteristics and lifestyle factors (adjusted odds ratio, 1.15; 95% confidence interval, 1.08-1.22; P-trend < 0.001); however, this association was not clear in women (P-trend = 0.765). While both men and women showed positive associations between prudent food cost and obesity (P-trends < 0.001), the association between Western food cost and obesity was only significant in men (P-trend < 0.001). CONCLUSIONS: In countries in which consumption of Western foods is associated with higher food costs, higher food costs are associated with an increased risk of obesity; however, this association differs between men and women.

• Nutrition Research and Practice
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• v.17 no.6
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• pp.1225-1237
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• 2023

BACKGROUND/OBJECTIVES: Unhealthy dietary behaviors constitute one of risk the factors for chronic and cardiovascular diseases, which are prevalent in middle-aged and older populations. Milk and dairy products are high-quality foods and important sources of calcium. Calcium protects against osteoporosis and cardiovascular disease. Therefore, this study investigated the association of milk and dairy product consumption with cardio-cerebrovascular disease incidence in middle-aged and older Korean adults. SUBJECTS/METHODS: Data were derived from the Ansan-Anseong cohort study, and a total of 8,009 individuals aged 40-69 years were selected and followed up biennially. Cox proportional hazard models were used to examine the association of milk and dairy product consumption with cardio-cerebrovascular disease incidence. RESULTS: During a mean follow-up period of 96.5 person-months, 552 new cases of cardio-cerebrovascular disease were documented. Milk consumers (< 1 serving/day) exhibited a 23% lower risk of cardio-cerebrovascular disease incidence than non-milk consumers (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.61-0.97; P for trend = 0.842). High yogurt consumption was associated with a 29% lower incidence risk (≥ 0.5 servings/day vs. none: HR, 0.71; 95% CI, 0.53-0.96; P for trend = 0.049), whereas high ice cream consumption was associated with a 70% higher risk of cardio-cerebrovascular disease incidence (≥ 0.5 servings/day vs. none: HR, 1.70; 95% CI, 1.01-2.88; P for trend = 0.070). CONCLUSIONS: This study indicates that less than one serving of milk and high yogurt consumption are associated with a lower cardio-cerebrovascular disease risk in the middle-aged and older populations.

• Clinical Nutrition Research
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• v.12 no.4
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• pp.320-335
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• 2023

Literature showed that soluble fiber has beneficial effects on cardiometabolic risk factors and leptin and adiponectin serum levels. Our aim in this meta-analysis was to determine the effect of soluble fiber supplementation on leptin and adiponectin serum levels. A systematic search was conducted using PubMed, Scopus, and ISI Web of Science for eligible trials up to December 2021. A random-effects model was used to pool calculated effect sizes. Our analysis showed that soluble fiber supplementation did not significantly affect adiponectin (standardized mean difference [SMD], -0.49 Hedges's, 95% confidence interval [CI], -1.20, 0.21, p value = 0.167; I² = 95.4, p value < 0.001) and leptin (SMD, -0.8 Hedges's, 95% CI, -1.70, 0.08, p value = 0.076; I² = 94.6, p value < 0.001) concentrations in comparison with placebo. However, in the subgroup, soluble fiber supplementation had a significant improvement in leptin concentration in overweight and obese patients (SMD, -0.22 Hedges's, 95% CI, -0.43, -0.01, p value = 0.048) and a non-significant beneficial effect in adiponectin level in female (SMD, 0.29 Hedges's, 95% CI, -0.13, 0.71, p value = 0.183) and diabetic patients (SMD, 0.32 Hedges's, 95% CI, -0.67, 1.32, p value = 0.526). A non-linear association between soluble fiber dosage and adiponectin (p_{non-linearity} < 0.001) was observed. Soluble fiber supplementation could not change the circulatory leptin and adiponectin levels. However, beneficial effects were seen in overweight and obese leptin, and increases in adiponectin may also be observed in female and diabetic patients. Further studies are needed to confirm this results.

• Nutrition Research and Practice
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• v.18 no.1
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• pp.98-109
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• 2024

BACKGROUND/OBJECTIVES: The efficacy of Lab4 probiotic and vitamin C combination on the prevention of upper respiratory tract infections (URTIs) was investigated in two studies with children. Our objective was to pool dataset of 57 preschool children from the PROCHILD study (ISRCTN28722693) and the dataset of 50 preschool matched cohort from the PROCHILD-2 study (ISRCTN26587549) to evaluate the impact of probiotic/vitamin C combination on the prevention of upper respiratory tract symptoms and provide a more robust assessment of effect using detailed individual level data. SUBJECTS/METHODS: The children were supplemented daily for 6 months with either the multistrain probiotic (1.25×10¹⁰ cfu/tablet consisting of two strains of Lactobacillus acidophilus CUL21 and CUL60, Bifidobacterium bifidum CUL20 and Bifidobacterium animalis subsp. lactis CUL34) plus 50 mg vitamin C or a placebo. RESULTS: In the pooled analysis of the individual participant data (per protocol population), significant reductions were observed for the incidence (-25%; 95% confidence interval [CI], 0.66, 0.85; P < 0.0001) and duration (-14.9 days; 95% CI, -24.8, -5.1; P = 0.0030) of typical URTI symptoms in the active group compared with the placebo. The incidence rates of absenteeism from preschool (IR ratio, 0.75; 95% CI, 0.66, 0.86; P < 0.0001), paediatric visits (IR ratio, 0.56; 95% CI, 0.47; 0.68; P < 0.0001) and antibiotic usage (IR ratio, 0.53; 95% CI, 0.39, 0.71; P < 0.0001) were also significantly reduced. CONCLUSION: The pooled analysis findings of comparable preschool cohorts from two studies indicate that the supplementation with probiotic and vitamin C combination is beneficial in the prevention and management of URTI symptoms.