• Title/Summary/Keyword: nutritional

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Nutrient Intake Status of Male and Female University Students in Chuncheon Area (춘천지역 남녀 대학생들의 영양소 섭취 상태)

  • Kim, Yoon-Sun;Kim, Bok-Ran
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.44 no.12
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    • pp.1856-1864
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    • 2015
  • The purpose of this study was to investigate the nutrient intake status of university students in Chuncheon area (175 males and 131 females). This study was conducted by employing a self-administered questionnaire. Dietary assessment was measured by a 24-h recall method. The average height and weight of male students were $175.2{\pm}6.2cm$ and $68.2{\pm}9.9kg$, respectively. For female students, average values were $161.7{\pm}5.2cm$ and $55.1{\pm}6.5kg$, respectively. The mean BMIs for both male and female students were 22.2 and 21.1, respectively. In both male and female students, the rate of skipping breakfast was high. Daily averages for energy, carbohydrates, protein, and fat intakes in male students were significantly higher than those of female students (P<0.001). For male students, protein, vitamin B1, P, Fe, and Na were above recommended nutrient intake and adequate intake, whereas for female students, they were protein, vitamin A, P, and Na. For male students, nutrient intakes for Ca, vitamin $B_2$, vitamin C, and vitamin $B_6$ were below the estimated average requirement (EAR) by at least 50% or more, whereas for female students, they were vitamin C, Fe, vitamin $B_6$, vitamin $B_2$, niacin, folate, and Ca. Ca was alarmingly low, with more than 75% of both male and female students showing levels below the EAR. Therefore, it is important that nutritional education be facilitated for college students to take responsibility of their own health through learning about nutrient intake as well as developing positive eating habits.

Comparison of Nutrient Intakes of Korean Elderly People Living in Rural Area Between 24-hour Recall and Food Frequency Method (24시간회상법과 식품섭취빈도조사법을 이용한 농촌지역 노인의 영양소 섭취수준 비교)

  • Cho, Young-Eun;Lee, Soo-Lim;Cho, Eun-Hyun;Lomeda, Ria-Ann L;Kwak, Eun-Hee;Kim, Yang-Ha;Kwun, In-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.6
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    • pp.698-707
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    • 2006
  • Precise and correct assessment of nutrient intake using appropriate dietary intake method is necessary to improve the nutritional status of the target people group. It is more likely so in elderly people since their dietary habits and inadequate nutrient intakes are of special concern even worse in rural areas. Two popular methods of gathering dietary intake are 24-hour recall and food frequency method (or food frequency questionnaire). In the present study, we conducted both 24-hour recall and food frequency method on 120 rural elderly people $(aged\;65{\sim}74\;years)$, 62 male and 58 female. The dietary intakes were analyzed and the correlation of the dietary intake between 24-hour recall and food frequency method to determine the reliability between two methods. Also each nutrient intake was compared to recommended dietary allowance (RDA) or nutrient reference value (NRV) as appropriate. Even correlation did not show significance between the two methods except for dietary fiber intake (0.65 at p<0.01) and energy-yielding nutrients which mostly showed similar results with nutrient intake level. These support the possible reliability between 24-hours record and food frequency method that is also shown on the cases of most mineral and vitamin intakes. Thus, the food frequency method used in this study for the assessment of nutrient intakes of the elderly people would be reliable for the assessment of the nutrient intake along with the 24-hour recall. Also, the present study results suggested that rural female elderly people would be under optimal nutriture status due to the lower food intake measured by 24-hour recall. The optimal food frequency method would be considered to be developed for the precise nutrient assessment.

Effects of Added WPC and WP on the Quality and Shelf Life of Tofu (WPC 및 WP 첨가가 두부 품질 및 저장성에 미치는 영향)

  • Kim, Jong-Un;Song, Kwang-Young;Seo, Kun-Ho;Yoon, Yoh-Chang
    • Journal of Dairy Science and Biotechnology
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    • v.30 no.2
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    • pp.93-109
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    • 2012
  • This study was performed to investigate the effects of added whey protein concentrates (WPC) and whey powder (WP) on the quality and shelf life of Tofu, a traditional food in Korea. Combined whey powder and whey protein concentrates were obtained at drainage after the casein was separated by using rennet enzyme or acidification of milk. We manufactured whey Tofu and evaluated its nutritional quality by testing, the general composition for yield, moisture, pH, crude protein, crude fat, carbohydrate, rheology, sensory properties, and change during storage. 1. The general compositions of WPC and WP were as follows: (a) WPC: moisture, 5.9%; crude protein, 56.2%; crude fat, 0.1%; carbohydrate, 32.6%; ash, 5.2%; and pH 5.93 and (b) WP: moisture, 3.7%; crude protein, 13.2%; crude fat, 1.6%; carbohydrate, 74.4%; ash, 7.1%; and pH, 6.65. 2. The yield of Tofu was as follows: (a) in WPC, the content was $CaCl_2$:GDL=6:4 > $CaCl_2$:GDL=9:1 > $CaCl_2$:GDL=7:3 > $CaCl_2$:GDL=8:2 and (b) in WP, 2% addition was the highest (265%) at $13.3g/cm^2$, but with 4% addition WP was the lowest (184%) at $22.2g/cm^2$. 3. The moisture content of Tofu was as follows: (a) in WPC, the content was $CaCl_2$:GDL = 6:4 > $CaCl_2$:GDL=9:1 > $CaCl_2$:GDL=7:3 > $CaCl_2$:GDL=8:2 and (b) in WP, 2% addition was the highest at 79.82% ($13.3g/cm^2$), but 4% was the lowest at 75.18% ($22.2g/cm^2$). 4. The pH of Tofu was as follows: (a) in WPC, the value was WPC 6% > WPC 4% > WPC 2% > control and $CaCl_2$:GDL=6:4 > $CaCl_2$:GDL=8:2 > $CaCl_2$:GDL=9:1 > $CaCl_2$:GDL=7:3 and (b) in WP, WP 4% > WP 2% > control. 5. The ash content of Tofu was as follows: (a) in WPC, the content was $CaCl_2$:GDL=8:2 > $CaCl_2$:GDL=7:3 > $CaCl_2$:GDL=6:4 > $CaCl_2$:GDL=9:1 and (b) in WP, there was no difference between 2% and 4% addition. 6. The crude protein content of Tofu was as follows: (a) in WPC, the content was $CaCl_2$:GDL=8:2 > $CaCl_2$:GDL=7:3 > $CaCl_2$:GDL=9:1 > $CaCl_2$:GDL=6:4 and (b) in WP, there was no difference between 2% and 4% addition. 7. The crude fat content of Tofu was as follows: (a) in WPC, the content was $CaCl_2$:GDL=8:2 > $CaCl_2$:GDL=7:3 > $CaCl_2$:GDL=9:1 > $CaCl_2$:GDL=6:4 and (b) in WP, values decreased with increasing pressed weight. 8. The carbohydrate content of Tofu was as follows: (a) in WPC, the content was $CaCl_2$:GDL=8:2 > $CaCl_2$:GDL=7:3 > $CaCl_2$:GDL=6:4 > $CaCl_2$:GDL=9:1 and (b) in WP, values increased with increasing pressed weight. 9. The rheology test results of Tofu were as follows: (a) in WPC, hardness and brittleness was highest with $CaCl_2$:GDL=8:2 and 6% added WPC. Cohesiveness was highest with $CaCl_2$:GDL=6:4 and 2% added WPC. Elasticity was the highest with $CaCl_2$:GDL=7:3 and the added WPC control. (b) in WP, hardness was the highest with $22.2g/cm^2$ and added WP control. Cohesiveness was the highest with $17.8g/cm^2$ and added WP 2%. Elasticity was the highest with $17.8g/cm^2$ and added WP 4%. Brittleness was the highest with $17.8g/cm^2$ and added WP control. 10. The sensory test results of Tofu were as follows: (a) in WPC, the texture, flavor, color, and smell were the highest with $CaCl_2$:GDL=6:4 and 6% added WPC. (b) in WP, the texture was the highest in the control with $22.2g/cm^2$. Flavor and smell were the highest in WP 2% and $22.2g/cm^2$. Color was the highest in WP 2% and $17.8g/cm^2$. 11. The quality change of Tofu during storage was as follows: (a) in WPC, after 60 h, all samples began to get spoiled and their color changed, and mold began to germinate. (b) in WP, the result was similar, but the rate of spoilage was more rapid than that in the control.

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Evaluation of External Quality of Brand Soybeans (콩 시판 브랜드 제품의 외관 품질 평가)

  • Jong, Seung-Keun;Woo, Shun-Hee;Kim, Hong-Sig
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.52 no.3
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    • pp.239-248
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    • 2007
  • Although high nutritional values and continuous identification of important functional substances of soybean [Glycine max (L.) Merrill.] promote consumption of soybean products worldwide, informations on quality of brand soybean is not enough for consumers. Total of 100 brand soybeans [32 for soypaste and source, 45 black testa (lage), and 17 black testa (small) or medicinal soybean and beansprout soybean] were collected at supermarkets and several external quality factors were analyzed. Brand soybeans were marked with the environmental friendly and intimating words along with soybean (white or yellow), black soybean (black-, frost-, late frost-, green or inner-green-), medicinal soybean and beansprout soybean. Among 100 brand soybeans 30% was 1 kg package and 59% was 500 g package, difference between printed and actual weights of 70% brand soybeans was ${\pm}1%$ and weights of 2/3 of brand soybeans were higher than printed weight. Range of 100 seed weights of soypaste and source, black testa (large) and black testa (small) and beansprout soybeans were $23.7{\sim}47.8g$, $21.9{\sim}44.5g$ and $9.5{\sim}15.0g$, respectively. Although ranges of 100 seed weights of soypaste and source and black testa (large) soybeans were similar, 63% of soypaste and source were less than 29 g, while 78% of black testa (large) soybeans were higher than 30 g. Although average and highest percentages of seeds separated with 6.7 mm sieve were similar with 87.4% and 99.9% for soypaste and source soybean and 86.5% and 99.5% for black testa (large) soybean, respectively, the lowest percentages were 70.7% for soypaste and source soybean and 14.4% for black testa (large) soybean. When 100 seed weight was greater than 35 g, 90% of seeds were remained on 6.7 mm sieve. On the other hand 100 g weight and percentage of seeds remained on 6.7 mm sieve showed significantly positive correlations [r=0.7488** for soypaste and source soybean and r=0.7874** for black testa (large) soybean when 100 seed weight was $20{\sim}30g$. Based on hilum color and/or appearance, 76% of brand soybeans collected (more than 90% in yellow testa soybeans) were found to be mixed more than 10% with other cultivars or landraces. Foreign materials such as sand, piece of clothe, wood piece, dead insects, other soybeans were found in 20% of brand soybeans. Average test weight of brand soybeans was 762g $L^{-1}$ with a range of $645{\sim}820g\;L^{-1}$. Soybeans from local markets were as good as brand soybeans in 100 seed weight, uniformity of seeds, weight of foreign materials and test weight.

Age difference in association between obesity and Nutrition Quotient scores of preschoolers and school children (어린이 영양지수로 살펴본 유아와 초등학생의 식행동과 비만 사이의 관련성에 있어서 연령의 차이)

  • Bae, Joo-Mee;Kang, Myung-Hee
    • Journal of Nutrition and Health
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    • v.49 no.6
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    • pp.447-458
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    • 2016
  • Purpose: This study was conducted among 235 children aged 3 up to 11 yrs to examine the relationship between subjects' eating behaviors and obesity. Methods: The subjects were divided into three age groups: preschoolers aged 3 to 5 yrs, early elementary school students aged 6 to 8 yrs, and late elementary school students aged 9 to 11 yrs. As a tool for eating behaviors, the recently developed nutrition quotient (NQ) questionnaire was utilized. By age group, scores were gathered and calculated in the five factors, "Balance", "Diversity", "Moderation", "Regularity", and "Practice", which make up the NQ scores. Results: The NQ scores among those aged 3 to 5, 6 to 8, and 9 to 11 yrs did not exhibit any significant differences. Among the scores for the five factors of the NQ, the Diversity scores of those aged 9 to 11 yrs were significantly higher than the scores of those aged 3 to 5 and those aged 6 to 8 yrs. The scores of those aged 3 to 5 and those aged 6 to 8 yrs were higher than the scores of those aged 9 to 11 yrs in Moderation and Regularity. When the subjects were divided into loww-eight/normal and overweight/obese groups, among those aged 6 to 8 yrs, the NQ scores, Moderation, Regularity, and Practice scores were higher in the overweight/obese group than those in the low-weight/normal group. Among those aged 9 to 11 yrs, the overweight/obese group scored higher than the low-weight/normal group only in the Moderation component. Conclusion: From the results, to prevent obesity in elementary school students, it is practical to focus on training related to eating behavior items included in the Moderation component. Furthermore, personalized instructions on eating behaviors and nutritional education based on age are necessary to prevent obesity in children.

The Ability of Anti-tumor Necrosis Factor Alpha(TNF-${\alpha}$) Antibodies Produced in Sheep Colostrums

  • Yun, Sung-Seob
    • 한국유가공학회:학술대회논문집
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    • 2007.09a
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    • pp.49-58
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    • 2007
  • Inflammatory process leads to the well-known mucosal damage and therefore a further disturbance of the epithelial barrier function, resulting abnormal intestinal wall function, even further accelerating the inflammatory process[1]. Despite of the records, etiology and pathogenesis of IBD remain rather unclear. There are many studies over the past couple of years have led to great advanced in understanding the inflammatory bowel disease(IBD) and their underlying pathophysiologic mechanisms. From the current understanding, it is likely that chronic inflammation in IBD is due to aggressive cellular immune responses including increased serum concentrations of different cytokines. Therefore, targeted molecules can be specifically eliminated in their expression directly on the transcriptional level. Interesting therapeutic trials are expected against adhesion molecules and pro-inflammatory cytokines such as TNF-${\alpha}$. The future development of immune therapies in IBD therefore holds great promises for better treatment modalities of IBD but will also open important new insights into a further understanding of inflammation pathophysiology. Treatment of cytokine inhibitors such as Immunex(Enbrel) and J&J/Centocor(Remicade) which are mouse-derived monoclonal antibodies have been shown in several studies to modulate the symptoms of patients, however, theses TNF inhibitors also have an adverse effect immune-related problems and also are costly and must be administered by injection. Because of the eventual development of unwanted side effects, these two products are used in only a select patient population. The present study was performed to elucidate the ability of TNF-${\alpha}$ antibodies produced in sheep colostrums to neutralize TNF-${\alpha}$ action in a cell-based bioassay and in a small animal model of intestinal inflammation. In vitro study, inhibitory effect of anti-TNF-${\alpha}$ antibody from the sheep was determined by cell bioassay. The antibody from the sheep at 1 in 10,000 dilution was able to completely inhibit TNF-${\alpha}$ activity in the cell bioassay. The antibodies from the same sheep, but different milkings, exhibited some variability in inhibition of TNF-${\alpha}$ activity, but were all greater than the control sample. In vivo study, the degree of inflammation was severe to experiment, despite of the initial pilot trial, main trial 1 was unable to figure out of any effect of antibody to reduce the impact of PAF and LPS. Main rat trial 2 resulted no significant symptoms like characteristic acute diarrhea and weight loss of colitis. This study suggested that colostrums from sheep immunized against TNF-${\alpha}$ significantly inhibited TNF-${\alpha}$ bioactivity in the cell based assay. And the higher than anticipated variability in the two animal models precluded assessment of the ability of antibody to prevent TNF-${\alpha}$ induced intestinal damage in the intact animal. Further study will require to find out an alternative animal model, which is more acceptable to test anti-TNF-${\alpha}$ IgA therapy for reducing the impact of inflammation on gut dysfunction. And subsequent pre-clinical and clinical testing also need generation of more antibody as current supplies are low.

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Hyperfractionated Radiotherapy and Concurrent Chemotherapy for Stage III Unresectable Non Small Cell Lung Cancer : Preliminary Report for Response and Toxicity (절제 불가능한 제 3기 비소세포성 페암의 다분할 방사선 치료와 MVP 복합 항암요법의 동시 치료에 대한 예비적 결과)

  • Choi, Eun-Kyung;Kim, Jong-Hoon;Chang, Hye-Sook;Kim, Sang-We;Suh, Cheol-Won;Lee, Kyoo-Hyung;Lee, Jung, Shin;Kim, Sang-Hee;Ko, Youn-Suk;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Song, Koun-Sik
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.157-162
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    • 1995
  • Lung cancer study group at Asan Medical Center has conducted the second prospective study to determine the efficacy and feasibility of MVP chemotherapy with concurrent hyperfractionated radiotherapy for Patients with stage III unresectable non-small cell lung cancer(NSCLC). All eligible Patients with stage III unresectable NSCLC were treated with hyperfractionated radiotherapy(120 cGy/fx BID. 6480 cGy/54fx) and concurrent 2 cycles of MVP(Mitomycin C $6mg/m^2,$ d2 & d29.Vinblastine $6mg/m^2,$ d2 & d29, Cisplatin $60mg/m^2,$ dl & d28) chemotherapy. Between Aug. 1993 and Nov. 1994, 62 patients entered this study; $6(10\%)$ had advanced stage IIIa and $56(90\%)$ had IIIb disease including 11 with pleural effusion and 10 with supraclavicular metastases. Among 62 patients, $48(77\%)$ completed planned therapy. Fourteen patients refused further treatment during chemoradiotherapy. Of 46 patients evaluable for response, $34(74\%)$ showed major response including $10(22\%)$ with complete and $24(52\%)$ with partial responses. Of 48 patients evaluable for toxicity, $13(27\%)$ showed grade IV hematologic toxicity but treatment delay did not exceed 5 days Two patients died of sepsis during chemoradiotherapy. Severe weight loss(more than $10\%)$ occurred in 9 patients$(19\%)$ during treatment. Nine patients$(19\%)$ developed radiation pneumonitis Six of these patients had grade 1 (mild) Pneumonitis with radiographic changes within the treatment fields Three other patients had grade 11 Pneumonitis, but none of these patients had continuous symptoms after steroid treatment. Concurrent chemoradiotherapy for patients with advanced NSCLC was well tolerated with acceptable toxicity and achieved higher response rates than the first study, but rather low compliance $rate(77\%)$ in this study is worrisome. We need to improve nutritional support during treatment and to use G-CSF to improve leukopenia and if necessary. supportive care will be given as in patients, Longer follow-up and larger sample size is needed to observe survival advantage.

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Physicochemical Characteristics of Silky Fowl(Gallus domesticus var. silkies) (백봉오골계육의 이화학적 특성)

  • Cho, Chae-Min;Park, Chung-Kil;Lee, Min-Young;Lew, In-Deok
    • Food Science of Animal Resources
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    • v.26 no.3
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    • pp.306-314
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    • 2006
  • In this study, the anatomic characteristics and the contents of nutritional ingredients and minerals of silky fowl and yeonsan ogolgye was investigated. Silky fowl is covered with white silky feather. There is a pinch of vertical white tassel on peak of the head, especially a silky fowl cock. The crown of a silky fowl has a nickname of phoenix crown, the crown of a cock is mostly like a rose, while that of a hen like strawberry or mulberry. The ear of silky fowl is mostly peacock green(Light blue turquoise), bronze for a small part. Peacock green is most common for Silky Fowl with a age of $60{\sim}150$ days, over the age of 150 days, the peacock green will be gradually replaced by purplish red. Beaks are leaden blue, short and stout while the face is smooth and fine. The lower jaw of silky fowl has comparatively long tiny hair, similar to beard. The two legs of silky fowl are covered with a handful of feather, or known as 'Putting on trousers'. Each leg of silky fowl has five talons. The whole skin, eyes, mouth, talons of silky fowl are grey black The bone and marrow of silky fowl are light black the periosteum is black. The whole meat, internal organs and abdominal fat of sillry fowl aye black the heart and leg meat are light black. Silky fowl meat had lower moisture and lipids content, but higher Ash and protein content than meats of yeosan ogolgye and general chickens. For mineral contents of leg muscle and breast muscle, silky fowl had higher contents of phosphorus (P), iron (Fe), potassium (K), zinc (Zn) than those of yeonsan ogolgye, while yeonsan ogolgye had higher contents of calcium (Ca) than that of silky fowl. The contents of iron (Fe) and zinc (Zn) is higher in leg muscle than in breast muscle for the silky fowl and yeonsan ogolgye. Leg muscle of silky fowl contains a lot of iron (Fe), about 4 times as much as that of leg muscle of yeonsan ogolgye. For the silky fowl and the yeonsan ogolgye, leg muscles contains a lot of zinc (Zn), about 5 times, 4 times respectively as much as that of breast muscle.

Comparative Evaluation of Dietary Intakes of Calcium, Phosphorus, Iron, and Zinc in Rural, Coastal, and Urban District (농촌, 어촌, 도시 지역별 칼슘, 인, 철, 아연의 섭취상태 비교평가)

  • Choi, Mi-Kyeong;Kim, Hyun-Sook;Lee, Won-Young;Lee, Hyomin;Ze, Keum-Ryon;Park, Jung-Duck
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.5
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    • pp.659-666
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    • 2005
  • The purpose of this study was to compare the intake status of calcium, phosphorus, iron, and zinc of Korean adults residing in different regions. Subjects were recruited and divided into three groups according to the districts where they lived, which included rural (n=137), coastal (n=100), and urban district (n=117). Subjects were interviewed using a general questionnaire and 24-hour recall method for dietary intake. The average age of the subjects were 58.1 years for rural district, 57.7 years for coastal district, and 48.6 years for urban district. There was no significance in total food intake by regions. The food intakes from cereals, mushrooms, vegetables of rural district, that from fishes of coastal district, and those from sugars, milks, oils of urban area were the highest among three districts. The calcium, phosphorus, iron, and zinc intakes were $60.1\%,\;123.9\%,\;95.2\%,\;and\;73.1\%$ of RDAs, respectively. The calcium intakes as percentage of RDA in rural and coastal district were significantly (p<0.01) lower than that in urban district. A larger number of subjects from coastal or urban district ate under $75\%$ of zinc RDA compared to those from rural village. Major sources of dietary calcium in total subjects were anchovy, kimchi, milk, soybean curd, rice, ice cream, sea mustard, yogurt, loach, and welsh onion. Rice supplied $15.5\%$ for phosphorus, $22.1\%$ for iron, and $35.9\%$ for zinc of total intake. Except for rice, major sources of dietary zinc were pork, beef, small red bean, dog meat, chicken, jacopever, soybean curd, glutinous millet, and kimchi. In conclusion, the food and mineral intakes of adults differed according to the regions in which they resided. The food and nutrient intakes of coastal district were not satisfactory, and calcium and zinc intakes of three regions did not meet RDAs. Therefore, it is required unique and discriminatory nutritional education with each region for increasing intakes of calcium and zinc.

A Comparison of Anthropomery and Nutrient Intakes of Rural Middle School Students Provided with and without National School Lunch Program (경상북도 의성군 농촌지역 급식교와 비급식교 중학생의 영양소 섭취 실태와 체조성과의 상관성에 관한 연구)

  • 장현숙;이옥이
    • Journal of the East Asian Society of Dietary Life
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    • v.10 no.2
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    • pp.116-128
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    • 2000
  • The purpose of this study is to analyze the nutrient intakes and growth development of rural middle school students provided with and without the national school lunch program(NSLP). The subjects consisted of 340 rural middle school students provided with(n=177) and without(n=163) NSLP. Anthropometric measurements were taken for body weight, height, triceps skinfold thickness and percentage of body fat, and nutrient intakes were assessed by food record method. The results of this study were summarized as follows: There was no significant difference in the height, body weight girls provided with (155.8cm 47.2kg) and without (156.0cm, 49.7kg) NSLP. Total energy intakes of boys were 2123kca1 in with NSLP and 1857kca1 in without NSLP. Total energy intakes of girls were 1913kca1 in with NSLP and 1814kca1 in without NSLP. Total daily energy was provided in the ratio of 19.1%, 39.8%, 32.4% and 8.7% by breakfast, lunch, dinner and snacks in the with NSLP and 17.5%, 32.0%, 34.8% and 15.7% in without NSLP, respectively. Phosphorus, vitamin A, vitamin E, ascorbic acid, thiamin, riboflavin, niacin intakes were above the RDA in with NSLP. In without NSLP, phosphorus, vitamin E, thiamin intakes were above the RDA. however, calcium. iron, vitamin A, vitamin B$_{6}$ were less than the RDA. The study showed that total daily energy and nutrient intakes were significantly higher in students provided with than without school-lunch. Thus, the school-lunch program is recommended and necessary to improve the nutritional status of middle school students.

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