• Journal of the Korean Society of Food Science and Nutrition
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• v.42 no.5
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• pp.818-827
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• 2013

The purpose of this study was to identify food consumption patterns of the elderly and factors affecting them to improve their dietary health. Data from 1,172 elderly subjects (over 65 years old) from the fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1) were used in our analysis. Validity and reliability analyses of food consumption frequency allowed the identification of seven factors: fruits, foods for Korean style meal, instant foods, alcohols, carbohydrate-rich snacks, vegetables, and legumes/mixed grains. Food consumption patterns were classified into four groups (according to the food consumption frequency) using cluster analysis. Cluster 4 showed a significantly higher food consumption frequency and Cluster 3 had a relatively high overall food consumption frequency but lower alcohol consumption frequency compared to the other clusters. Cluster 2 was characterized by a generally low food consumption frequency but a significantly higher alcohol consumption frequency. Cluster 1 showed a generally low food consumption frequency; however, the consumption frequency of legumes/mixed grains was higher than Cluster 2. Further analysis showed that the food consumption patterns of the elderly were affected by variables such as gender, age, town, economic status, education level, family type, and frequency of eating out. We conclude that a proper nutritional education program should be conducted to address specific dietary problems for each elderly segment.

• Journal of Nutrition and Health
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• v.46 no.2
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• pp.137-146
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• 2013

The purpose of this study was to evaluate diet-related Quality of Life (QOL) and to analyze the relationship among diet-related QOL, dietary regimen practice, health-related QOL, and gastrointestinal symptoms in hemodialysis patients. Subjects were recruited from an artificial kidney center in Seoul. The self-report questionnaire consisted of socio-demographic characteristics, diet-related QOL, compliance with dietary regimen practice, health-related QOL, and gastrointestinal symptoms was distributed. Diet-related QOL includes a 'Quality of Life and Related to Dietary Change Questionnaire', 'Satisfaction Survey', and 'Dietary Impact Survey'. According to their responses, participants had experienced the greatest difficulty with 'Dietary Impact'. In particular, the mean score for general health was low. Association of dietary regimen practice showed a positive association with 'Cost' and 'Self-care' score. In addition, diet-related QOL showed positive correlation with health-related QOL, particularly in 'taste'. Scores for 'Taste', 'Convenience', and 'Dietary Impact' were lower for subjects with constipation compared to those of subjects without constipation. Scores for 'Taste' and 'Dietary Impact' were lower in subjects with irritable bowel syndrome compared to those of subjects without the syndrome (p < 0.05). Diet-related QOL showed a positive association with health-related QOL (p < 0.05), whereas it showed a negative association with constipation (p < 0.01). In conclusion, hemodialysis patients in Korea suffer from burden of dietary regimen practice and most scores for diet-related QOL and health-related QOL from patients with gastrointestinal symptoms were low. Therefore, appropriate nutrition education considering gastrointestinal symptoms is necessary for improvement of patients' QOL during dietary regimen practice.

• Journal of Nutrition and Health
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• v.52 no.5
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• pp.422-434
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• 2019

Purpose: The consumption of processed foods has recently been increasing due to changes in the living environment. The purpose of this study was to identify the contribution of processed food to the nutrient intake of adult Koreans. Methods: A total of 15,760 adult people in the $6^{th}$ National Health and Nutrition Examination Survey (2013 ~ 2015) were included in this study. According to the Korea Food and Drug Administration's classification criteria for processed foods, the 24 hour dietary recall data of the subjects were classified as processed food or natural food. The processed food intake, nutrient intake and major processed food sources by food groups were analyzed. Results: Men consumed more processed foods than did the women. Consumption of processed foods decreased with age, but it increased with the education level and the income level. The total daily processed food intake accounted for 68.1% of the total food intake. The food groups with high processed food intake were beverage, vegetables, cereals and grain products, fruits, and milk and dairy products in this order. The top food source of each food groups were beer, kimchi, bread, processed apple products, and milk. After adjusting for age, gender, and energy intake, all the nutrient intakes and percentage of dietary reference intakes for Koreans, except carbohydrates, were significantly higher in processed foods than in natural foods. The sodium intake from the processed food was 96.3% of total daily sodium intake. The intakes of nutrients from processed foods, excluding vitamins C, dietary fiber, iron, and vitamin A, were higher in men than in women. The intake of sodium from processed foods was highest for people of 30 ~ 49 years of age, and the intake of sodium from processed foods decreased for people over 50. Conclusion: Korean adults consumed more processed food than the natural food, consuming more calories and most of the nutrients from the processed food overall total daily intakes. The intake of processed foods is expected to further increase in the future, and nutritional education and research on the ingestion and selection of healthy processed foods are necessary.

• Journal of Nutrition and Health
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• v.54 no.5
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• pp.501-514
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• 2021

Purpose: The purpose of this study was to provide basic data for the management of atopic dermatitis (AD) in adults by analyzing the relationship between AD and intake of soft drinks in adults. Methods: This study was conducted on 5,931 adults aged 19 to 64 who completed the food frequency questionnaire (FFQ) for participants in the Korea National Health and Nutrition Examination Survey VII-3 and VII-1. Subjects were divided into an AD-diagnosed group and a non-AD group according to the diagnosis of AD. In addition, the group diagnosed with AD was divided into a 'symptom-AD' group and a 'no symptom-AD' group. The amount, frequency of intake, and nutritional status of soft drinks were analyzed using the FFQ. Results: Compared with the nutrient intake per 1,000 kcal of energy consumption, fat intake was higher in the AD-diagnosed group than in the non-AD group, and carbohydrate, dietary fiber, calcium, phosphorus, iron, potassium, vitamin A, thiamin, and vitamin C were lower in AD-diagnosed group. The daily intake of soft drinks and the percentage of 'more than 0.5 servings per day' were also higher in the AD-diagnosed group than in the non-AD group. Also, the frequency of the intake of soft drinks was significantly higher in the AD-diagnosed group than in the non-AD group. The odds ratio of AD symptoms due to the intake of soft drinks increased 2.6 times when the intake was 'less than 0.5 serving per day'. Conclusion: AD in adults appears to be related to malnutrition and excessive consumption of soft drinks, and the current prevalence of AD symptoms may also be related to the intake of soft drinks. Based on these results, we suggest that one of the ways to manage AD in adults would be to limit their intake of soft drinks.

• Journal of Nutrition and Health
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• v.54 no.2
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• pp.165-178
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• 2021

Purpose: This study examined the eating-out patterns of Korean infants and school-aged children and compared diet quality. Methods: Data were obtained from the 2016-2018 Korea National Health and Nutrition Examination Survey. The subjects were 306 children aged 3 to 11 years old that ate dinner at restaurants. Percentage energy intakes of 24 food groups were calculated, and cluster analysis was used to identify eating-out patterns. Diet quality was assessed by calculating percentage energy and nutrient intakes using one-third of the 2015 Dietary Reference Intakes for Korean (KDRIs), nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ). Results: Cluster analysis identified 2 eating-out patterns, that is, a 'rice-centered' (53%) and a 'mixed diet' (47%) pattern. For those with the mixed diet pattern, ratios of carbohydrates, protein, and fat to total calories were 48:20:31, whereas for the rice-centered pattern, ratios were 62:15:21 (p < 0.001). Intakes of energy and most nutrients in the mixed diet pattern were excessive, but the intakes of the most nutrients in the rice-centered pattern were much lower than their KDRIs. MARs were higher for the mixed diet pattern than the rice-centered pattern (0.74 vs. 0.66) (p < 0.001), and INQs for vitamin C (p = 0.007) and calcium (p = 0.018) were lower for the rice-centered pattern, whereas INQ for iron (p = 0.003) was lower for the mixed diet pattern. Conclusion: The quality of meals for infants and school-aged children depended on eating-out patterns, but the rice-centered and mixed diet patterns both failed to provide an appropriately balanced meal pattern. The results of this study suggest that healthy menus need to be developed for children in restaurants.

• Journal of Nutrition and Health
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• v.54 no.1
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• pp.76-94
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• 2021

Purpose: This study was implemented to develop and validate a semi-quantitative food frequency questionnaire (SQ-FFQ) to assess the dietary intake of married migrant women in multicultural families. Methods: The SQ-FFQ consisting of 41 food items was selected based on the information of frequently consumed foods from the preliminary studies on dietary intake survey for married migrant women or a Korean Health and Nutrition Examination survey. Thirty-five subjects who visited the Multicultural Family Support Center in Seoul and Daejeon area completed their three-day diet records and SQ-FFQ 2 times. The reproducibility and relative validity of SQ-FFQ were assessed by comparing the 1st and 2nd SQ-FFQ and by comparison with the three-day diet records, respectively. Results: The reliability of SQ-FFQ, which was examined 1-2 weeks apart, showed no significant difference in the energy and macronutrient intake (carbohydrate, fat, protein), while the average intakes of vitamin A, riboflavin, calcium, and potassium were slightly higher in the 2nd than 1st SQ-FFQ. All correlation coefficients for the reliability for nutrients were statistically significant, ranging from 0.453 to 0.885. The mean intakes of energy, carbohydrate, vitamin C, thiamin, folate, vitamin B12, calcium, and sodium obtained from the SQ-FFQ were greater than those of the 3-day dietary records. The Spearman's correlation coefficient between the 2 methods was the highest for plant fat (r = 0.602; p < 0.001) and relatively higher for energy, carbohydrate, fat, and thiamin ranging from 0.512 to 0.599; and protein, riboflavin, niacin, folate ranging from 0.335 to 0.499, while no significant correlation was observed for vitamin A, C, calcium, iron, and sodium. Conclusion: The developed SQ-FFQ for married migrant women in multicultural families in this study appears to be useful for estimating the nutritional status, particularly energy, carbohydrates, fat, and vitamin B group.

• Journal of Nutrition and Health
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• v.54 no.1
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• pp.39-53
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• 2021

Purpose: This study examined the dietary behavior, health status and nutrient intake by considering the level of household income of elderly people using data obtained from the Korea National Health and Nutrition Survey (KNHANES VII) 2018. Methods: The study subjects were 1,355 elderly people over 65 years old (558 men, 797 women). Based on their household income, participants were classified into three groups: low-income, middle-income, and high-income. The variables consisted of general characteristics, dietary behavior, health status, health related behavior, and dietary intakes. Dietary data were estimated by the 24-hour dietary recall. Results: In men, the low-income group encompassed older, less educated, less employed, and living with family of first generation. However, in women, there were no differences in employment by the level of income, and women living alone had lower income than subjects living with family. Elderly men in the high-income group had a significantly higher level of nutrient intake (energy, protein, fat, phosphorous, riboflavin, niacin and vitamin C). Men in the low-income group consumed a significantly lower intake of fruits, seaweeds and eggs, including total food. Women in the low-income group had significantly less intake of protein, fat, calcium, phosphorous, iron, vitamin A, riboflavin, and niacin whereas women in the high-income group had significantly higher intake of sugar & sweet, eggs, and beverages, including total food. Conclusion: These results suggest that the level of household income is an important factor that influences food and nutrient intake in the Korean elderly. The socioeconomic status needs to be considered differently among elderly men and women when implementing food assistant programs and designing nutrition education programs.

• Journal of Nutrition and Health
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• v.54 no.2
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• pp.179-198
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• 2021

Purpose: This study examined general characteristics, health status, accessibility to medical services, health-related quality of life, dietary behavior, and energy and nutrient intakes of the elderly at different levels of food security utilizing data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). Methods: The elderly subjects (1,721 males and 2,271 females) were divided into 3 groups (secure, mildly insecure, moderately/severely insecure) according to their food security levels. Health and nutrient status was determined using energy intake, nutrient density, the prevalence of insufficient nutrient intake, dietary behavior, and health status. Results: The elderly with food insecurities had a lower self-evaluated health status and a higher prevalence of physician-diagnosed chronic diseases such as arthritis, osteoarthritis, rheumatoid arthritis, osteoporosis for males, and hypertension, stroke, arthritis, and osteoarthritis for females. The associated financial burden was the major reason for not accessing medical services in the food insecure group. Furthermore, the food insecure group had a higher risk of impaired health-related quality of life compared to the secure group. The proportion of subjects with an energy intake below the estimated energy requirement was higher in the food insecure group and a significantly higher prevalence of insufficient intake was observed for all the nutrients (proteins, vitamin A, vitamin B₁, vitamin B₂, niacin, vitamin C, calcium, and iron) assessed in this study compared to the food secure group. Conclusion: This study suggests that food insecurity poses a challenge to the health and nutritional status of the elderly population in Korea and needs proper management. It would be helpful to develop food and nutrition assistance programs to ensure the food stability of the elderly population and assure quality to address gaps in their nutrient intake.

• Journal of Nutrition and Health
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• v.55 no.1
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• pp.101-119
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• 2022

Purpose: This study examined the demographics, health status, dietary habits, energy, nutrient intake, and protein intake based on levels of inclusion of animal food among females in their 20s by using data from the 7th Korea National Health and Nutrition Examination Survey. Methods: The subjects (n = 912) were divided into 4 groups according to the frequency of animal foods consumed which were categorized as meat, seafood, eggs, and dairy products, or other animal-derived foods. Results: The subjects with a lower frequency of animal food intake ate out less frequently. As the frequency of animal food intake decreased, the total energy intake too decreased with higher carbohydrate and lower protein intake ratios. In the low frequency of animal food intake group, a higher proportion of subjects had energy intake below the estimated energy requirement and the intake of protein, vitamin B₁, vitamin B₂, niacin, calcium, phosphorus, and iron were below the estimated average requirements. The average protein intake was more than the recommended 45 g in all four groups. However, the lower the frequency of animal food intake, the higher the proportion of people having lower protein intake compared to the recommended intake of 0.91 g per kg body weight. It became apparent that people who do not consume animal foods at all did not meet the recommended levels of protein intake. Thus, people pursuing a vegan diet may be at risk of low protein intake. Conclusion: This study suggests that economic characteristics, dietary habits, energy, and nutrient intake are affected by the frequency of animal food consumed, or in other words, by the degree of vegetable-centered diet. Thus, this study would help improve the perception of vegetarianism, develop individualized dietary guidance and nutrition education programs for people practicing vegan or vegetarian diets to ensure that they have a balanced diet.

• Korean Journal of Community Nutrition
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• v.28 no.1
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• pp.38-47
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• 2023

Objectives: This study examined the association between the experience of disease management education and the use of nutrition labels according to the sociodemographic characteristics and health behaviors of people diagnosed with hypertension and diabetes living in the community. Methods: Among the participants from the Community Health Survey (2018), 74,283 individuals diagnosed with hypertension or diabetes were included in the study population. According to gender, this study evaluated nutrition label use by the experience of disease management education, individual sociodemographic characteristics, and health behavior. Finally, using multiple logistic regression analysis, the association between disease management education and nutrition labels was calculated using the odds ratio (OR) and 95% confidence interval (CI). Results: Males (24.5%) experienced more disease management education than females (22.6%). In addition, younger age, higher education level, and higher equalized personal income experienced more disease management education (P < 0.001). The educational experience rate was higher in the male subjects who did not smoke or were involved in high-risk alcohol consumption (P < 0.001). In addition, the rate of disease management education experience was significantly higher for both men and women who exercised by walking (P < 0.001). The use of nutrition labels was higher in females (9.9%) than males (5.8%), and both males and females were significantly higher in young age, high education, high income, and professional and office positions (P < 0.001). The utilization rate of nutrition labels was high in non-smoking male subjects and high-risk-drinking female subjects. In addition, the utilization rate of nutrition labels was significantly higher in males and females who exercised by walking and those who experienced disease management education (P < 0.001). After adjusting for individual sociodemographic characteristics, health behavior, and disease management education, the use of nutrition labels was high among females (OR 3.19, 95% CI 2.85-3.58), high income (Q4; OR 1.62, 95% CI 1.41-1.87, Q5; OR 1.58, 95% CI 1.37-1.84) and highly educated (high school; OR 2.87, 95% CI 2.62-3.14, above college; OR 5.60, 95% CI 5.02-6.23) while it was low in the elderly (OR 0.43, 95% CI 0.40-0.47), and economically inactive (OR 0.86, 95% CI 0.76-0.96). The use of nutrition labels was high in non-smokers (OR 1.29, 95% CI 1.13-1.48), nonhigh-risk drinkers (OR 1.22, 95% CI 1.08-1.38), and subjects who exercised walking (OR 1.44, 95% CI 1.34-1.54). There was no difference in the utilization rate of nutrition labels according to obesity, and the utilization rate of nutrition labels was significantly higher in subjects who had experienced disease education (OR 1.34, 95% CI 1.24-1.44). Conclusions: Education on the use of nutrition labels, which contributes to food selection for healthy eating, might be a tool for dietary management. Moreover, the utilization rate can be a good indicator for predicting the proportion of the population practicing the guide for disease management. Improving the utilization rate of nutrition labels through disease management education can be a useful intervention for people with chronic diseases who need healthy eating habits for disease management and preventing complications, particularly those diagnosed with hypertension and diabetes.