• Journal of Nutrition and Health
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• v.55 no.5
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• pp.558-571
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• 2022

Purpose: The purpose of this study was to analyze the dietary intake of Korean adults with atopic dermatitis (AD) to determine whether the risk of developing AD was related to their diet. Methods: Among the participants in the 7th National Health and Nutrition Survey (2016 to 2018), 10,571 adults aged 19-64 were divided into AD (AD group, n = 366) and control groups (non-AD group, n = 10,205) to compare and analyze their nutrient intake status and Korean Healthy Eating Index (KHEI) score. Depending on the prevalence of AD, the nutrient intake, nutrient intake per 1,000 kcal, acceptable macronutrient distribution range, and KHEI score were tested for significance by correcting for age, sex, body mass index, education, marriage, occupation, residence area, physical activity, and energy intake variables that were derived for confounding factors. Results: The acceptable macronutrient distribution range for protein was lower in the AD group than in the non-AD group. Comparing the nutrient intake per 1,000 kcal, the intakes of protein, phosphorus, iron, and potassium of the AD group were significantly lower than those of the non-AD group. In the KHEI, the scores of total vegetables, vegetables excluding kimchi and pickles, meat, fish, eggs, and legumes of the AD group were significantly lower than those of the non-AD group. In addition, as these food intake scores increased, the risk of AD significantly decreased. Conclusion: In conclusion, adult AD patients had low intakes of vegetables, meat, fish, eggs, and legumes, and it was confirmed that high intakes of these foods may be associated with low AD risk. Therefore, we suggest that an adequate intake of vegetables and foods containing protein would be necessary for the management and treatment of AD in adults.

• Nutrition Research and Practice
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• v.17 no.5
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• pp.959-968
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• 2023

BACKGROUND/OBJECTIVES: Few studies have provided evidence of the association between diet quality and dental caries. This study aimed to examine the association between diet quality and untreated dental caries in a Korean representative population. SUBJECTS/METHODS: The study population included a sample of 13,815 participants, aged ≥ 19 from the Korea National Health and Nutrition Examination Survey during 2013-2015. The explanatory variable was diet quality and the outcome variable was untreated dental caries. Untreated dental caries were defined by the number of decayed teeth recorded according to the criteria established by the World Health Organization. Diet quality was defined by using the Korean Healthy Eating Index (KHEI) through the 24-h recall methods. We assessed the association between diet quality and untreated dental caries while adjusting for age, sex, education, income, smoking status, dental visits, toothbrushing frequencies, obesity, and diabetes mellitus. RESULTS: The mean overall KHEI scores in the untreated dental caries group were significantly lower than those in the group without untreated dental caries. Significant differences were observed in the untreated dental caries group based on the KHEI quartiles (P < 0.001). After adjusting for potential confounders, the quartiles of KHEI scores showed an association with untreated dental caries, demonstrating a dose-effect trend (odds ratio [OR], 1.57; 95% confidence interval [CI], 1.35-1.84 for 1st quartile; OR, 1.38; 95% CI, 1.19-1.59 for 2nd quartile; OR, 1.32; 95% CI, 1.14-1.53 for 3rd quartile; reference quartile highest]). CONCLUSIONS: The findings indicated an inverse association between diet quality and untreated dental caries in Korean adults. Healthcare providers should take into account the significant role of diet quality in preventing and managing oral health.

• Korean Journal of Community Nutrition
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• v.22 no.5
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• pp.441-455
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• 2017

Objectives: The purpose of this study is to describe beverage patterns among healthy Korean adults and investigate their association with prevalence and components of metabolic syndrome. Methods: Subjects consisted of 6,927 Korean adults, aged 19-64 years in the $6^{th}$ Korea National Health and Nutrition Examination Survey (KNHANES, 2013-2015). Beverages were regrouped into twelve groups based on food codes and beverage intake (g/day) was assessed by 24-hour recall. Factor analysis was used to obtain beverage patterns. Waist circumference and body mass index (BMI) were used as anthropometric data; fasting blood glucose, triglyceride, high density lipoprotein (HDL), and blood pressure were used as biochemical indicators. The odds ratio (OR) for prevalence of metabolic syndrome and components of metabolic syndrome was assessed using logistic regression analysis. Results: Three beverage patterns were identified using factor analysis: 1) carbonated soft drinks 2) coffee (without added sugar or powdered creamer), and 3) alcoholic beverages. Subjects with high scores for the carbonated soft drink and coffee without added sugar or powdered creamer patterns were younger and subjects with high scores for the alcoholic beverage pattern were older. There were significant differences in gender distribution in all three beverage patterns, with men more likely to have high scores for carbonated soft drink and alcoholic beverage patterns. On the other hand, women were more likely to have higher scores for coffee without added sugar or powdered creamer pattern. Within each pattern, there were significant differences in sociodemographic and lifestyle characteristics such as education, household income, frequency of eating out, and smoking status according to the quartile of pattern scores. Alcoholic beverages and carbonated soft drinks patterns were associated with an increased levels of metabolic syndrome components, but coffee without added sugar or powdered creamer was not associated with any of metabolic syndrome components in healthy Korean adults after adjusting for age, sex, education, BMI, weight management, household income, smoking status, frequency of eating out, and energy intake. Conclusions: Alcoholic beverages and carbonated soft drinks patterns are associated with increased levels of metabolic syndrome components while coffee without added sugar or powdered creamer pattern is not associated with any of metabolic syndrome components in healthy Korean adults.

• 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.

• The Korean Journal of Food And Nutrition
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• v.25 no.1
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• pp.105-115
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• 2012

The purpose of this study was to investigate the dietary habits and snack consumption behaviors of middle school students with different obesity indexes in the Chungnam area. The survey was carried out using self-questionnaires and included 385 students(119 underweight, 193 normal weight, 66 overweight). The rate of skipping meals was higher for underweight students than overweight students; however, this difference was not statistically significant. The mean time of meal was 10 to 20 minutes and the criteria for choosing to eat a meal were 'hunger' and 'taste' in all groups. More than half of the subjects ate snacks 1 time a day, which were purchased outside. The typical snack time was 'between lunch and dinner'. The criteria of for consuming a meal were 'taste' and 'price' in all groups. In the underweight group, the snack food scores were ice cream(4.4), fruit(4.3), fried chicken(4.1), sports beverage(4.0), fruit juice(4.0), pizza(4.0) and, tteokbokki(3.9). In the normal weight group, the snack food scores were ice cream(4.3), fried chicken(4.2), pizza(4.0), sports beverage(3.9), fruit juice(3.9) and, tteokbokki(3.9) in the overweight group, the snack food scores were ice cream(4.3), fruit(4.3), fried chicken(4.2), yogurt(4.0), sports beverage(4.0), fruit juice(4.0) and, ramen(4.0). In conclusion, the snaking behaviors of the subjects were not significantly different based on their obesity index. However, this study may provide basic information on the snacking behaviors of middle school students, and the findings suggest that nutrition education or counseling can improve snack intake habits and positive behaviors toward healthy adolescents diets.

• Journal of Nutrition and Health
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• v.57 no.1
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• pp.88-104
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• 2024

Purpose: High-sensitivity C-reactive protein (hs-CRP) is primarily synthesized in the liver upon stimulation of infectious disease cytokines, such as interleukin-6 (IL-6), and is used as a biological marker of systemic inflammation. Previous studies reported that hs-CRP is closely related to diet and abdominal obesity. Furthermore, a dietary score favoring the consumption of vegetables, fruits, and whole grains over meat and saturated fat reduced inflammation and decreased the prevalence of obesity and abdominal obesity. Nevertheless, no studies have examined whether hs-CRP mediates the relationship between dietary scores and abdominal obesity, and research on the Korean Healthy Eating Index (KHEI) is lacking. Therefore, the present study examined the association between the KHEI and abdominal obesity and the mediating effect of hs-CRP. Methods: In total, 17,770 adults aged ≥19 years were included in the study using the Korea National Health and Nutrition Examination Survey 2015-2018. KHEI was developed to assess the overall diet quality of Korean adults. Multivariable linear and logistic regression analyses assessed the relationship between KHEI, hs-CRP, and abdominal obesity. The mediation analysis with the bootstrapping method was performed using SAS MACRO. Results: Among women, the odds ratio (OR) of abdominal obesity prevalence was lower in the highest KHEI compared to the lowest KHEI after adjusting for age, body mass index, educational level, income level, occupational status, marital status, household type, region type, alcohol consumption, smoking status, physical activity, total energy intake, and hsCRP (OR 0.744, 95% confidence interval 0.598-0.926). The association between KHEI and abdominal obesity was partially mediated via hs-CRP, and the mediated proportion was 68.7% in men and 38.1% in women. Conclusion: A substantial relationship was observed between the KHEI and abdominal obesity among females. Moreover, according to the KHEI, abdominal obesity may be mediated partially by hs-CRP.

• Nutrition Research and Practice
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• v.17 no.2
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• pp.269-283
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• 2023

BACKGROUND/OBJECTIVES: This study aimed to examine the food security status of urban poor adolescents and its association with diet quality. SUBJECTS/METHODS: A cross-sectional survey was conducted among 188 adolescents aged 13-18 yrs living in Kuala Lumpur, Malaysia. Household food insecurity and dietary intake data were collected using the Radimer/Cornell hunger and food insecurity instrument and 2-day 24-h dietary recalls, respectively. Diet quality was determined using the Malaysian Healthy Eating Index (HEI). Weight and height were measured and body mass index-for-age, as well as height-for-age z scores were calculated. RESULTS: The present study revealed that 47.9% of the adolescents experienced household food insecurity, 24.5% experienced individual food insecurity, 18.6% household food security, and 9.0% child hunger. The mean score of diet quality was 56.83 ± 10.09, with a significantly lower HEI score among food insecure adolescents (household food insecure, individual food insecure, and child hunger) than household food secure adolescents (P = 0.001). The differences between food secure and food insecure households were found to be significant for energy (P = 0.001) and nutrients including proteins (P = 0.006), carbohydrates (P = 0.005), dietary fiber (P = 0.001), folate (P < 0.001), and vitamin C (P = 0.006). The multiple linear regression showed that adolescents who experienced food insecurity (β = -0.328; P = 0.003) were found to be significantly associated with poor diet quality (F = 2.726; P < 0.01), wherein 13.3% of the variation in the diet quality was explained by the food security status. CONCLUSIONS: Experiencing food insecurity contributed to poor diet quality among urban poor adolescents. Further longitudinal studies are needed to comprehensively understand this association to improve food insecurity and diet quality among urban poor communities.

• Korean Journal of Community Nutrition
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• v.10 no.6
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• pp.892-904
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• 2005

This study was carried out to assess the food habit index of the long-lived elderly who were aged over 85 years living in Ganghwa-gun. A survey was conducted during December 2003. Dietary nutrient intake data was obtained through the 24-hr recall method. The subjects were 96 (32 males, 64 females) aged people and divided into three groups based on food habit index scores. Such as group A: good $16\∼20$, group B: fair $11\∼15$, and group C: poor $5\∼10$. The three groups of the subjects were 90.7 years of age and $21.3\;kg/m^{2}$ of BMI on average. Healthy eating index scores of the subjects were $9.4\%$ in group A, $54.2\%$ in group B and $36.5\%$ in group C. Their level of education were lower and their levels of living standards tended to have been middle and lower of the middle class. The percentage of living together with their families or spouses in all groups were over $60.0\%$ and the rates of the subjects who have responsibility for their meal preparations were also very high in all groups. Most subjects tended not to drink nor smoke, and spend $8\~10$ hours for their sleep. The percent of number of diseases in group A was lower than in groups B and C. Their dietary habits such as taking three meals a day regularly have shown that they have good eating habit in general. There was a positive correlation between the eating behaviors and nutrient intakes. The protein, animal protein, fat, PUFA, vitamin E, vitamin $B_{2}$, niacin, P and K intaks in group A were significantly higher than that of the groups B and C. For group A of good food habits aged had no sufficient intake of Ca and vitamin A than the Korean RDA and long-lived elderly of group C in Ganghwa areas had worse nutrients intakes, especially Ca, vitamin A, vitamin $B_{2}$ and vitamin E. According to this research having a good eating habits could be considered as increasing of the health and nutritional status. (Korean J Community Nutrition 10(6) $892\∼904$, 2005)

• Korean Journal of Biological Psychiatry
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• v.19 no.4
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• pp.211-218
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• 2012

Objectives Body image distortion is found in eating disorder and obesity and there are some evidence that schizophrenia is associated with body image distortion. This study sought to find whether schizophrenic patients report more body image distortion than healthy individuals and whether it is related with symptomatology. Methods A total of 88 inpatients with schizophrenia and 88 healthy controls were recruited. Weight, height, and body image accuracy were assessed in all participants, and assessment of mood, psychotic symptom severity and self-esteem, and personal and social performance scale were conducted. Results The patients with schizophrenia had higher Body Mass Index (p < 0. 001) and underestimated their body size more than controls (26.14% vs. 5.13%, p < 0.001). Multiple regression analysis showed that lower depressive symptoms and higher scores of general psychopathology predicted underestimation of body size. Conclusion Weight gain and metabolic syndrome are common adverse events of pharmacological treatment of schizophrenia. Thus, underestimation of body size among patients with schizophrenia may interfere with effort to lose weight or seek weight reduction programs. Clinicians need to consider possible unterestimation of underestimation of body size in patients whose general symptomatology is severe.

• Nutrition Research and Practice
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• v.17 no.4
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• pp.717-734
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• 2023

BACKGROUND/OBJECTIVES: This study aimed to identify preschool children's eating behaviors associated with early childhood obesity and its multi-level, socio-ecological determinants. SUBJECTS/METHODS: In a cross-sectional study of 364 mothers of preschool children aged 3-5 years, these children's healthy eating behaviors were assessed using a validated preschool nutrition quotient (NQ-P) questionnaire. The children's overweight or obesity statuses were determined based on body mass index percentiles from the 2017 Korean National Growth Chart. The associations between the NQ-P score and risk of overweight or obesity were examined using multivariable logistic regression. The associations of individual, maternal, physical, and media environmental factors with the NQ-P score were also examined using multivariable linear regression. RESULTS: Preschool children with greater NQ-P scores were at a significantly lower risk of overweight or obesity (P < 0.01). The NQ-P score had a significantly positive association with maternal body mass index and an inverse association with household income (all P < 0.05). Maternal parenting and feeding practices exhibited associations with the NQ-P score. Positive associations were observed with "warm," "structured," and "autonomy-supportive" parenting as well as monitoring feeding practices (all P < 0.05). In addition, the NQ-P score had a significantly positive association with the childcare center's anti-obesogenic environment, such as the provision of nutritional and physical-activity support and vicinity of the built food environment to the home, including access to good-quality food, fruits and vegetables, and low-fat foods (all P < 0.05). Regarding media environments, the NQ-P score demonstrated more significant associations with viewing and eating and/or cooking content displayed on online video platforms (all P < 0.05) than with that on television. CONCLUSIONS: Our findings confirm the significance of healthy eating behaviors in early-childhood-obesity prevention and underscore the importance of multilevel maternal, physical, and media environmental interventions that effectively guide eating behaviors in preschool children.