Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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Development and evaluation of semi-quantitative food frequency questionnaire for marriage migrant women in multicultural families

다문화가정 결혼이주여성 대상 식사조사를 위한 반정량 식품섭취빈도 조사지의 개발 및 평가

  • Kim, Jung-Hyun (Department of Home Economics Education, Pai Chai University) ;
  • Kim, Oh Yoen (Department of Health Sciences, Graduate School of Dong-A University) ;
  • Lee, Min June (Department of Food and Nutrition, Yonsei University) ;
  • Park, Eunju (Department of Food and Nutrition, Kyungnam University)
  • Received : 2020.09.14
  • Accepted : 2021.01.12
  • Published : 2021.02.28
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Abstract

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.

본 연구는 결혼으로 한국에 이주한 다문화여성의 영양상태를 파악할 수 있는 SQ-FFQ를 개발하고 이 조사지의 신뢰도와 타당도를 검증하기 위하여 실시하였다. 본 연구에서 개발된 SQ-FFQ는 결혼이주여성 대상 선행 연구, 국민건강영양조사의 SQ-FFQ 및 국민건강영양조사 결과를 고려하여 다소비, 다빈도 식품목록과 영양소별 섭취량에 대한 기여도가 높은 급원식품들을 고려하여 41개의 식품항목으로 선정하였다. 1회 섭취 분량은 0.5인분, 1인분, 1.5인분의 3개의 구간으로 나누었고 섭취빈도는 지난 1년 동안 평균적으로 얼마나 자주 먹었는지를 10개의 구간으로 분류한 SQ-FFQ를 개발하였다. 개발한 조사지의 재현성 및 타당도를 평가하기 위하여 서울과 대전 일부 지역의 건강가정·다문화가족지원센터를 방문한 35명의 결혼이주여성을 대상으로 SQ-FFQ (2회) 및 3일 식사 기록지를 조사한 후 1, 2차 반정량 식품섭취빈도 간의 영양소 섭취량 차이 및 SQ-FFQ와 3일 식사기록 간의 영양소 섭취량의 차이를 분석하였다. 1-2주간격으로 조사한 식품섭취빈도조사지의 재현성을 검토한 결과 에너지와 다량영양소 (탄수화물, 지방, 단백질)의 섭취량 간에는 유의적인 차이가 없었고, 비타민 A, 리보플라빈, 칼슘, 칼륨의 경우 1차 조사의 평균 섭취량보다 2차 조사의 평균 섭취량이 유의적으로 약간 높았다. 1차 및 2차 조사에서 도출된 동일 영양소 섭취량 간의 상관관계를 분석한 결과, 모든 동일 영양소 섭취량 간의 상관관계는 전반적으로 높은 상관관계를 보였다 (r = 0.453-0.885). 식품섭취빈도 조사와 3일 식사기록의 결과 비교를 통한 타당도 검증 결과, 식사 기록법보다 식품섭취빈도 조사법에서 에너지, 탄수화물, 탄수화물, 비타민 C, 티아민, 엽산, 비타민B12, 칼슘, 나트륨의 섭취량이 유의적으로 높아 식품섭취빈도법이 식사기록법보다 다소 과대 추정되는 것을 알 수 있었다. 1차 식품섭취빈도조사와 식사기록법의 상관관계는 대부분의 영양소에서 유의적으로 나타났는데, 식물성 지방이 0.602로 가장 높았고, 총 섭취 에너지, 탄수화물, 지방, 티아민의 상관계수도 0.512-0.599로 다른 영양소들에 비해 상대적으로 높았다. 반면 비타민 A와 C, 칼슘, 철, 나트륨 등의 영양소에 대해서는 유의적인 상관관계를 보이지 않았다. 본 연구에서 결혼이주 다문화여성의 식생활 및 영양소 섭취실태를 파악하고자 개발된 자기기입식 SQ-FFQ는 신뢰성이 검증된 조사도구이며 에너지와 주요 영양소의 섭취 상태를 추정할 수 있는 도구로 사용하기에 적합한 것으로 사료된다. 그러나, 본 연구 결과는 최종 35명을 대상으로 분석하여 도출된 것으로 향후 대상자 수를 확대하여 적용해 볼 필요가 있다. 또한, 일부 영양소의 섭취 결과에 대한 타당성을 확보하기 위해서 조사식품 항목에 대한 조정을 고려해 보아야 할 것이며, 특히, 미량영양소의 경우 계절의 영향을 많이 받기 때문에 정성적인 조사를 병행하는 등의 보완이 필요하다. 또한 식품 및 영양소 섭취량 산출을 위한 분석 데이터베이스 구성을 위한 근거자료들이 더 확보되어야 할 것이다.

Keywords

Acknowledgement

This work was supported by grants from Ministry of Food and Drug Safety.

References

  1. Ministry of Gender Equality. Yearly Statistics on Multicultural Families [Internet]. Seoul: Ministry of Gender Equality; 2018 [cited 2020 Jan 24]. Available from: http://www.mogef.go.kr/mp/pcd/mp_pcd_s001d.do?mid=plc503&bbtSn=704742.
  2. Kim YK, Choi HM, Kim KH, Sung SM. The changes of multicultural families and social welfare policies. Seoul: The Korea Institute for Health and Social Affairs; 2012.
  3. Kim HR, Yeo JY, Jeong JJ, Baek SH. Health status of marriage immigrant women and children from multicultural families and health policy recommendations. Seoul: Korea Institute for Health and Social Affairs; 2012.
  4. Willett WC. Nutritional epidemiology. 2nd ed. New York (NY): Oxford University Press; 1998.
  5. Willett WC, Hu FB. The food frequency questionnaire. Cancer Epidemiol Biomarkers Prev 2007; 16(1): 182-183. https://doi.org/10.1158/1055-9965.EPI-06-0843
  6. Jang BS. Study on dietary status of female marriage immigrants [master's thesis]. Seoul: Kyung Hee University; 2009.
  7. Kim JM, Lee NH. Analysis of the dietary life of immigrant women from multicultural families in the Daegu area. J Korean Diet Assoc 2009; 15(4): 405-418.
  8. Kwak DW. Research to ingestion of food and an attitude from food and drink of Multicultural family [master's thesis]. Daejeon: Woosong University; 2009.
  9. Lee SE. Association between stress, and nutritional and health status of female immigrants to Korea in multi-cultural families [master's thesis]. Seoul: Ewha Womans University; 2009.
  10. Ko HJ. A study on the dietary habits and nutritional knowledge of marriage-immigrant females in GwangJu and Chonnam province [master's thesis]. Gwangju: Chonnam University; 2010.
  11. Cha SM, Bu SY, Kim EJ, Kim MH, Choi MK. Study of dietary attitudes and diet management of married immigrant women in Korea according to residence period. J Korean Diet Assoc 2012; 18(4): 297-307. https://doi.org/10.14373/JKDA.2012.18.4.297
  12. Jeong MJ, Jung EK, Kim AJ, Joo N. Nutrition knowledge and need for a dietary education program among marriage immigrant women in Gyeongbuk region. J Korean Diet Assoc 2012; 18(1): 30-42. https://doi.org/10.14373/JKDA.2012.18.1.030
  13. Kim JM, Lee HS, Kim MH. Food adaptation and nutrient intake of female immigrants into Korea through marriage. Korean J Nutr 2012; 45(2): 159-169. https://doi.org/10.4163/kjn.2012.45.2.159
  14. Lee JS. The factors for Korean dietary life adaptation of female immigrants in multi-cultural families in Busan. J Korean Soc Food Sci Nutr 2012; 41(6): 807-815. https://doi.org/10.3746/JKFN.2012.41.6.807
  15. So JS, Han SR. Diet-related behaviors, perception and food preferences of multicultural families with Vietnamese wives. Korean J Community Nutr 2012; 17(5): 589-602. https://doi.org/10.5720/kjcn.2012.17.5.589
  16. Kim DY. An analysis of dietary patterns of multicultural housewives [master's thesis]. Seoul: Seoul National University of Education; 2013.
  17. Yoon SH, Sim JS, Kwon S, Oh K. Development of a food frequency questionnaire for the Korea National Health and Nutrition Examination Survey: data from the fourth Korea National Health and Nutrition Examination Survey (KNHANES IV). Korean J Nutr 2013; 46(2): 186-196. https://doi.org/10.4163/kjn.2013.46.2.186
  18. Asano K, Yoon JH, Ryu SH. Chinese female marriage immigrants' dietary life after immigration to Korea: comparison between Han-Chinese and Korean-Chinese. Korean J Community Nutr 2014; 19(4): 317-327. https://doi.org/10.5720/kjcn.2014.19.4.317
  19. Hwang JY, Lee H, Ko A, Han CJ, Chung HW, Chang N. Dietary changes in Vietnamese marriage immigrant women: the KoGES follow-up study. Nutr Res Pract 2014; 8(3): 319-326. https://doi.org/10.4162/nrp.2014.8.3.319
  20. Jung SO, Yang SJ. Types of dietary acculturation according to socio-demographic and dietary factors among female marriage immigrants in Korea. J Korean Data Anal Soc 2015; 17(5): 2675-2689.
  21. Kim JH. A study on the dietary patterns affecting acculturation among marriage migrant women in urban area. J Korean Home Econ Educ Assoc 2015; 27(4): 173-189. https://doi.org/10.19031/jkheea.2015.12.27.4.173
  22. Yang EJ. Dietary behaviors of female marriage immigrants residing in Gwangju. J Nutr Health 2016; 49(3): 179-188. https://doi.org/10.4163/jnh.2016.49.3.179
  23. Kim HW, Kim MH, Kim JM. Analysis of food adaptation and dietary behavior of marriage migrant women according to their acculturation type in Dongducheon City. J Digit Converg 2018; 16(4): 205-219. https://doi.org/10.14400/JDC.2018.16.4.205
  24. Kim SH, Choi HN, Hwang JY, Chang N, Kim WY, Chung HW, et al. Development and evaluation of a food frequency questionnaire for Vietnamese female immigrants in Korea: the Korean Genome and Epidemiology Study (KoGES). Nutr Res Pract 2011; 5(3): 260-265. https://doi.org/10.4162/nrp.2011.5.3.260
  25. Talegawkar SA, Kandula NR, Gadgil MD, Desai D, Kanaya AM. Dietary intakes among South Asian adults differ by length of residence in the USA. Public Health Nutr 2016; 19(2): 348-355. https://doi.org/10.1017/S1368980015001512
  26. Ngongalah L, Rankin J, Rapley T, Odeniyi A, Akhter Z, Heslehurst N. Dietary and physical activity behaviours in African migrant women living in high income countries: a systematic review and framework synthesis. Nutrients 2018; 10(8): E1017.
  27. Barrett-Connor E. Nutrition epidemiology: how do we know what they ate? Am J Clin Nutr 1991; 54(1 Suppl): 182S-187S. https://doi.org/10.1093/ajcn/54.1.182S
  28. Kim JH. Development of program for food and nutrition improvement through analyzing dietary intake and patterns for children in multicultural family. Cheongju: Ministry of Food and Drug Safety; 2014.
  29. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea health statistics 2016: Korea National Health and Nutrition Examination Survey (KNHANES V-1). Cheongju: Korea Centers for Disease Control and Prevention; 2017.
  30. Ministry of Health and Welfare, The Korean Nutrition Society. Dietary reference intakes for Koreans. Seoul: The Korean Nutrition Society; 2015.
  31. Yun SH, Shim JS, Kweon SH, Oh KW. Development of a food frequency questionnaire for the Korea National Health and Nutrition Examination Survey: data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV). Korean J Nutr 2013; 46(2): 186-196. https://doi.org/10.4163/kjn.2013.46.2.186
  32. Korea Centers for Disease Control and Prevention. Final Report of Validation of Food Frequency Questionnaire for Korea National Health and Nutrition Examination Survey [Internet]. Cheongju: Korea Centers for Disease Control and Prevention; 2010 [cited 2020 Jun 23]. Available from: http://www.cdc.go.kr.
  33. Yum J, Lee S. Development and evaluation of a dish-based semiquantitative food frequency questionnaire for Korean adolescents. Nutr Res Pract 2016; 10(4): 433-441. https://doi.org/10.4162/nrp.2016.10.4.433
  34. Kim DW, Song S, Lee JE, Oh K, Shim J, Kweon S, et al. Reproducibility and validity of an FFQ developed for the Korea National Health and Nutrition Examination Survey (KNHANES). Public Health Nutr 2015; 18(8): 1369-1377. https://doi.org/10.1017/S1368980014001712
  35. Bae YJ, Choi HY, Sung MK, Kim MK, Choi MK. Validity and reproducibility of a food frequency questionnaire to assess dietary nutrients for prevention and management of metabolic syndrome in Korea. Nutr Res Pract 2010; 4(2): 121-127. https://doi.org/10.4162/nrp.2010.4.2.121
  36. Ahn Y, Kwon E, Shim JE, Park MK, Joo Y, Kimm K, et al. Validation and reproducibility of food frequency questionnaire for Korean genome epidemiologic study. Eur J Clin Nutr 2007; 61(12): 1435-1441. https://doi.org/10.1038/sj.ejcn.1602657
  37. Yang YJ, Kim MK, Hwang SH, Ahn Y, Shim JE, Kim DH. Relative validities of 3-day food records and the food frequency questionnaire. Nutr Res Pract 2010; 4(2): 142-148. https://doi.org/10.4162/nrp.2010.4.2.142
  38. Na YJ, Lee SH. Development and validation of a quantitative food frequency questionnaire to assess nutritional status in Korean adults. Nutr Res Pract 2012; 6(5): 444-450. https://doi.org/10.4162/nrp.2012.6.5.444
  39. Shim JS, Oh KW, Suh I, Kim MY, Sohn CY, Lee EJ, et al. A study on validity of a semi-quantitative food frequency questionnaire for Korean adults. Korean J Community Nutr 2002; 7(4): 484-494.
  40. Kim SH, Lee JS, Hong KH, Yeom HS, Nam YS, Kim JY, et al. Development and relative validity of semiquantitative food frequency questionnairefor Korean adults. J Nutr Health 2018; 51(1): 103-119. https://doi.org/10.4163/jnh.2018.51.1.103