Nutrition Research and Practice

The Korean Nutrition Society (한국영양학회)
권호 표지
DOI QR코드

DOI QR Code

Development of a Korean Diet Score (KDS) and its application assessing adherence to Korean healthy diet based on the Korean Food Guide Wheels

  • Lee, Myoungsook (Research Institute of Obesity Sciences and Department of Food and Nutrition, Sungshin Women's University) ;
  • Chae, Soo Wan (Clinical Trial Center and Clinical Trial Center for Functional Foods, Chonbuk National University Hospital & Medical school) ;
  • Cha, Youn-Soo (Department of Food Science and Human Nutrition, Obesity Research Center, Chonbuk National University) ;
  • Cho, Mi Sook (Department of Nutritional Sciences and Food Management, College of Health Science, Ewha Womans University) ;
  • Oh, Hea Young (Carcinogenesis Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center) ;
  • Kim, Mi Kyung (Carcinogenesis Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center)
  • Received : 2012.08.20
  • Accepted : 2013.01.09
  • Published : 2013.02.01
Download PDF
⟨ Previous Next ⟩

Abstract

The most critical point in the assessment of adherence to dietary guidelines is the development of a practical definition for adherence, such as a dietary pattern score. The purpose of this study was to develop the Korean Diet Score (KDS) based on the Korean Food Balance Wheel and to examine the association of KDS with various lifestyle characteristics and biochemical factors. The dietary data of 5,320 subjects from the 4th Korean National Health and Nutritional Examination Survey were used for the final analysis. The food guide was composed of six food group categories; 'grain dishes', 'fish and meat dishes', 'vegetable dishes', 'fruits', 'milk' and 'oils and sugars'. Based on the recommended serving numbers for each group, the scores measuring adherence to this food guide were calculated from the dietary information from the 24-hour dietary recall questionnaire, and then its correlation with various characteristics was assessed. KDS was significantly associated with several clinical, lifestyle and socioeconomic factors as well as diagnosed disease history. The higher quintile group of KDS showed a significantly lower level in fasting blood glucose, systolic blood pressure, triglycerides, current smoking and drinking as well as higher leisure time activity, house income and education. Furthermore, the KDS quintile group of women was inversely associated with hypertension, osteoporosis and diabetes. A higher KDS quintile was characterized with a higher intake of several critical nutrients, such as Ca, Fe and vitamins as well as a desirable nutrition balance such as the ratio of macronutrients. Our results demonstrate that KDS is a beneficial tool in assessing the adherence to a healthy diet based on the Korean dietary guidelines. We suggest that KDS could be a useful indicator for evaluating the dietary balance of the Korean population.

Keywords

References

  1. Jacobs DR Jr, Tapsell LC. Food, not nutrients, is the fundamental unit in nutrition. Nutr Rev 2007;65:439-50. https://doi.org/10.1301/nr.2007.oct.439���450
  2. Moeller SM, Reedy J, Millen AE, Dixon LB, Newby PK, Tucker KL, Krebs-Smith SM, Guenther PM. Dietary patterns: challenges and opportunities in dietary patterns research an Experimental Biology workshop, April 1, 2006. J Am Diet Assoc 2007;107: 1233-9. https://doi.org/10.1016/j.jada.2007.03.014
  3. Wirt A, Collins CE. Diet quality--what is it and does it matter? Public Health Nutr 2009;12:2473-92. https://doi.org/10.1017/S136898000900531X
  4. Kant AK. Indexes of overall diet quality: a review. J Am Diet Assoc 1996;96:785-91. https://doi.org/10.1016/S0002-8223(96)00217-9
  5. Arvaniti F, Panagiotakos DB. Healthy indexes in public health practice and research: a review. Crit Rev Food Sci Nutr 2008;48: 317-27. https://doi.org/10.1080/10408390701326268
  6. Waijers PM, Feskens EJ, Ocke MC. A critical review of predefined diet quality scores. Br J Nutr 2007;97:219-31. https://doi.org/10.1017/S0007114507250421
  7. Kourlaba G, Panagiotakos DB. Dietary quality indices and human health: a review. Maturitas 2009;62:1-8. https://doi.org/10.1016/j.maturitas.2008.11.021
  8. Weinstein SJ, Vogt TM, Gerrior SA. Healthy Eating Index scores are associated with blood nutrient concentrations in the third National Health And Nutrition Examination Survey. J Am Diet Assoc 2004;104:576-84. https://doi.org/10.1016/j.jada.2004.01.005
  9. Boynton A, Neuhouser ML, Wener MH, Wood B, Sorensen B, Chen-Levy Z, Kirk EA, Yasui Y, Lacroix K, McTiernan A, Ulrich CM. Associations between healthy eating patterns and immune function or inflammation in overweight or obese postmenopausal women. Am J Clin Nutr 2007;86:1445-55. https://doi.org/10.1093/ajcn/86.5.1445
  10. Kant AK, Graubard BI. A comparison of three dietary pattern indexes for predicting biomarkers of diet and disease. J Am Coll Nutr 2005;24:294-303. https://doi.org/10.1080/07315724.2005.10719477
  11. Alberti A, Fruttini D, Fidanza F. The Mediterranean Adequacy Index: further confirming results of validity. Nutr Metab Cardiovasc Dis 2009;19:61-6. https://doi.org/10.1016/j.numecd.2007.11.008
  12. Reedy J, Mitrou PN, Krebs-Smith SM, Wirfält E, Flood A, Kipnis V, Leitzmann M, Mouw T, Hollenbeck A, Schatzkin A, Subar AF. Index-based dietary patterns and risk of colorectal cancer: the NIH-AARP Diet and Health Study. Am J Epidemiol 2008;168:38-48. https://doi.org/10.1093/aje/kwn097
  13. Fung TT, Hu FB, McCullough ML, Newby PK, Willett WC, Holmes MD. Diet quality is associated with the risk of estrogen receptor-negative breast cancer in postmenopausal women. J Nutr 2006;136:466-72. https://doi.org/10.1093/jn/136.2.466
  14. Basiotis PP, Carlson A, Gerrior SA, Juan WY, Lino M. The Healthy Eating Index: 1999-2000. Alexandria: U.S. Department of Agriculture,Center for Nutrition Policy and Promotion; 2002.
  15. Drewnowski A. Concept of a nutritious food: toward a nutrient density score. Am J Clin Nutr 2005;82:721-32. https://doi.org/10.1093/ajcn/82.4.721
  16. Ludwig DS. The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease. JAMA 2002;287:2414-23. https://doi.org/10.1001/jama.287.18.2414
  17. Kim YO, Kim MK, Lee SA, Yoon YM, Sasaki S. A study testing the usefulness of a dish-based food-frequency questionnaire developed for epidemiological studies in Korea. Br J Nutr 2009;101: 1218-27. https://doi.org/10.1017/S0007114508061497
  18. The Korean Nutrition Society; Ministry of Health and Welfare; Korea Food and Drug Administration. Dietary Reference Intakes for Koreans, 1st revision. Seoul: The Korean Nutrition Society; 2010.
  19. McCullough ML, Feskanich D, Stampfer MJ, Giovannucci EL, Rimm EB, Hu FB, Spiegelman D, Hunter DJ, Colditz GA, Willett WC. Diet quality and major chronic disease risk in men and women: moving toward improved dietary guidance. Am J Clin Nutr 2002;76:1261-71. https://doi.org/10.1093/ajcn/76.6.1261
  20. Kim S, Haines PS, Siega-Riz AM, Popkin BM. The Diet Quality Index-International (DQI-I) provides an effective tool for cross-national comparison of diet quality as illustrated by China and the United States. J Nutr 2003;133:3476-84. https://doi.org/10.1093/jn/133.11.3476
  21. Hann CS, Rock CL, King I, Drewnowski A. Validation of the Healthy Eating Index with use of plasma biomarkers in a clinical sample of women. Am J Clin Nutr 2001;74:479-86. https://doi.org/10.1093/ajcn/74.4.479
  22. Patterson RE, Haines PS, Popkin BM. Diet quality index: capturing a multidimensional behavior. J Am Diet Assoc 1994;94:57-64. https://doi.org/10.1016/0002-8223(94)92042-7
  23. Haines PS, Siega-Riz AM, Popkin BM. The Diet Quality Index revised: a measurement instrument for populations. J Am Diet Assoc 1999;99:697-704. https://doi.org/10.1016/S0002-8223(99)00168-6
  24. Kennedy ET, Ohls J, Carlson S, Fleming K. The Healthy Eating Index: design and applications. J Am Diet Assoc 1995;95:1103-8. https://doi.org/10.1016/S0002-8223(95)00300-2
  25. Trichopoulou A, Costacou T, Bamia C, Trichopoulos D. Adherence to a Mediterranean diet and survival in a Greek population. N Engl J Med 2003;348:2599-608. https://doi.org/10.1056/NEJMoa025039
  26. U.S. Department of Health and Human Services; U.S. Department of Agriculture. Dietary Guidelines for Americans, 6th edition. Washington, D.C.: U.S. Government Printing Office; 2005.
  27. Kant AK. Dietary patterns: biomarkers and chronic disease risk. Appl Physiol Nutr Metab 2010;35:199-206. https://doi.org/10.1139/H10-005

Cited by

  1. Development of a Healthy Eating Index for patients with type 2 diabetes vol.28, pp.5, 2015, https://doi.org/10.1590/1415-52732015000500006
  2. Assessment on Dietary Diversity According to Korean Dietary Pattern Score of Korean Adolescents and Children: Using 2007~2013 Korea National Health and Nutrition Examination Survey (KNHANES) Data vol.31, pp.5, 2015, https://doi.org/10.9724/kfcs.2015.31.5.660
  3. An examination of the association of cognitive functioning, adherence to sodium restriction and Na/K ratios in Korean heart failure patients vol.25, pp.11-12, 2016, https://doi.org/10.1111/jocn.13198
  4. Risk Factors for Bone Loss in Patients Having Clinical Conditions that Restrict Physical Activity pp.0278-4807, 2016, https://doi.org/10.1002/rnj.285
  5. Analysis of dimensions and shapes of maxillary and mandibular dental arch in Korean young adults vol.9, pp.5, 2017, https://doi.org/10.4047/jap.2017.9.5.321
  6. Consumption of Han-sik and its Association with Socioeconomic Status among Filipino Immigrant Women: the Filipino Women's Diet and Health Study (FiLWHEL) vol.23, pp.6, 2018, https://doi.org/10.5720/kjcn.2018.23.6.475
  7. Acarbose Add-on Therapy in Patients with Type 2 Diabetes Mellitus with Metformin and Sitagliptin Failure: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study vol.43, pp.3, 2019, https://doi.org/10.4093/dmj.2018.0054
  8. Dietary Interventions for Adult Survivors of Adolescent and Young Adult Cancers: A Systematic Review and Narrative Synthesis vol.9, pp.3, 2013, https://doi.org/10.1089/jayao.2019.0105
  9. Nutrients and Dietary Approaches in Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease: A Narrative Review vol.13, pp.11, 2021, https://doi.org/10.3390/nu13114150