• Nutrition Research and Practice
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• v.10 no.5
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• pp.537-545
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• 2016

BACKGROUND/OBJECTIVES: Dietary sugar intake, particularly added sugar and sugar-sweetened beverages, has received worldwide attention recently. Investigation of dietary behaviors may facilitate understanding of dietary sugar intakes of children and adolescents. However, the relationship between dietary sugar intake and dietary behaviors in the Korean population has not been investigated. Thus, this study aimed to estimate dietary sugar intake and food sources according to sex as well as examine the relationship of dietary sugar intake with frequent snacking and dietary patterns among Korean children and adolescents. SUBJECTS/METHODS: We pooled data from five studies involving Korean children and adolescents conducted from 2002 to 2011. A total of 2,599 subjects aged 9-14 years were included in this study. Each subject completed more than 3 days of dietary records. RESULTS: Mean daily total sugar intake was 46.6 g for boys and 54.3 g for girls. Compared with boys, girls showed higher sugar intakes from fruits (7.5 g for boys and 8.8 g for girls; P = 0.0081) and processed foods (27.9 g for boys and 34.9 g for girls; P < 0.0001). On average, 95.4% of boys and 98.8% of girls consumed snacks during the study period, and total sugar intake showed a significantly increasing trend with increasing energy intake from snacks (P < 0.0001 for both sexes). Two dietary patterns were identified by cluster analysis: Traditional and Westernized patterns. Total sugar intake was higher in the Westernized pattern (56.2 g for boys and 57.2 g for girls) than in the Traditional pattern (46.5 g for boys and 46.3 g for girls). CONCLUSIONS: These results suggest that multilateral and practical development of a nutrition education and intervention program that considers dietary behaviors as well as absolute sugar intake is required to prevent excessive sugar intake in Korean children and adolescents.

• The Korean Journal of Food And Nutrition
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• v.28 no.4
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• pp.658-665
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• 2015

This study was conducted to provide desirable way on the eating of sugar foods, specifically the differences between dietary attitude, dietary behaviors and intake frequency. Data was collected from 279 middle students in the Incheon region through a self-administered questionnaire. According to the results of the reliability and factor analysis, the dietary attitude, dietary behaviors and intake frequency was 3.52, 2.89 and 2.51, with a Cronbach alpha coefficient of 0.867, 0.789, 0.940 and KMO of 0.899. Factor analysis extracted three components of the sugar preference, which we named dietary attitude (factor 1), dietary behaviors (factor 2), and intake frequency (factor 3). The dietary attitude and dietary behaviors showed a significant difference between sugar preference and non-preference (p < 0.05). Also, intake frequency of sugar food showed a significant differences in chocolate, chocolate products, and ice cream between sugar preference and non-preference (p < 0.05), whereas no significant differences were found in cake, bread kinds, juice, sweetness milk, yogurt between sugar preference and non-preference (p > 0.05). A significant positive result of intake frequency of sugar food (p < 0.05) was shown for the dietary attitude, BMI, weight, and monthly pocket money. Based on this study, the reduction of sugar intake is needed especially for middle students.

• Journal of the Korean Dietetic Association
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• v.28 no.2
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• pp.127-142
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• 2022

This study was undertaken to investigate the association between maternal nutrition knowledge, dietary attitudes, and behaviors related to sugar intake and sugar intake reduction in preschool children. Eighty-three children aged 5 to 6 years attending kindergartens in Hongseong and their mothers participated in this study from October 2020 to February 2021. The average age of the mothers was 38.7 years, and 53.0% of the children were male. As child age increased, nutrition knowledge of sugar intake reduction increased, but no relation was found between age and, dietary behavior and preference related to sugar intake reduction. For children whose mothers perceived that their child's sugar preference was high, the behavioral score of sugar intake reduction was low. The more mothers allowed their children to eat sweet food; the higher was their child's preference for sweet food, which was also significantly associated with an increased risk of high sugar intake. When mothers were provided education that encouraged reducing children's sugar intakes, knowledge about reducing sugar intake in children was significantly increased. The study emphasizes the importance of the roles of mothers and primary caregivers regarding reducing the sugar intakes of preschool children.

• Journal of Nutrition and Health
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• v.46 no.4
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• pp.382-390
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• 2013

This study was designed to investigate the amount of free sugar according to each beverage category in coffee and beverage stores. The groups were categorized as 15 groups based on the kind of beverage material. The beverage groups contributing to total sugar per 100 mL were milk + syrup or powder, hot (12.9 g), ade (12.6 g), milk + syrup or powder + crushed ice (11.9 g), and espresso shot + milk + syrup + crushed ice (11.4 g). The beverage groups contributing to free sugar per 100 mL were ade (12.6 g), milk + syrup or powder + crushed ice (10.8 g), espresso shot + milk + syrup + crushed ice (10.3 g), and milk + syrup or powder, hot (9.7 g). The beverage groups contributing to total sugar (energy) per portion size were milk + syrup or powder + crushed ice 56.6 g (332.3 kcal), espresso shot + milk + syrup + crushed ice 49.3 g (333.4 kcal), milk + syrup or powder, hot 46.3 g (372.1 kcal), and milk + syrup or powder, ice 38.1 g (325.9 kcal). The beverage groups contributing to free sugar per portion size were milk + syrup or powder + crushed ice 51.2 g, espresso shot + milk + syrup + crushed ice 44.9 g, ade 37.1 g, milk + syrup or powder, hot 34.6 g, and milk + syrup or powder, ice 30.1 g. The percent of average free sugar per portion size of the WHO recommendation (free sugars <10% of total energy; <50 g/2,000 kcal) was milk + syrup or powder + crushed ice 102.4%, espresso shot + milk + syrup + crushed ice 89.8%, ade 74.1%, and milk + syrup or powder, hot 69.2%. The proportion of beverage in excess of WHO recommendation per portion size was 14.6% in espresso shot + milk + syrup + crushed ice, 22.7% in ade, and 10.9% in milk + syrup or powder, hot. Therefore, in coffee and beverage stores, menu development with reduced sugar content is needed, and nutrition information should be provided through sugar nutrition labeling.

• Nutrition Research and Practice
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• v.16 no.sup1
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• pp.21-36
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• 2022

BACKGROUND/OBJECTIVES: The long-term health impacts of dietary sugar have begun to be reported. The committee on the 2020 Dietary Reference Intakes for Koreans for sugar intended to update the scientific evidence on the association of added sugar intake with health outcomes, including mortality. This study evaluated the evidence on the association of dietary sugar with the all-cause and cardiovascular disease mortality from cohort studies. SUBJECTS/METHODS: The PubMed and ScienceDirect databases were searched until July 2021. The search terms were based on multiple combinations of keywords, such as added sugar, beverage, and mortality, included in the title or abstract. Two authors independently assessed the eligibility criteria of study selection and extracted the information from each selected article for this systematic review. RESULTS: The literature search identified 276 articles. Seventeen cohort studies met the inclusion criteria and were included in this systematic review. This study extracted information on the cohort and participants, dietary assessment methods, exposure and its comparison groups, health outcomes, and risk measures. Five articles reported added sugar intake, and 15 articles reported the food sources of the added sugar in the association with mortality. Increased mortality was observed in higher added sugar intake and a lower intake of less than 5% of energy, while higher discrepancies between gender, age groups, and countries were noted. In addition, nutritious sugary foods and beverages did not increase mortality. CONCLUSIONS: A 'U' or 'J' shaped relationship between the added sugar intake and mortality was estimated. The observed discrepancy indicated the need for more evidence to establish the dose-response relationship for Koreans.

• Food Quality and Culture
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• v.2 no.2
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• pp.80-84
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• 2008

In this study, sixth grade school children in the Guri area were surveyed via questionnaire regarding their sociodemographic characteristics, snacking patterns, and intakes of different food groups and sugared snacks. Students with employed mothers had more frequent snacking events and were more dependent on store-purchased snacks compared to those having an unemployed mother. A high consumption of snack sugar was associated with a higher dietary diversity score. There was a positive relationship between snack sugar intake and the intakes of meat and dairy products and foods in the oil and nut group, respectively. A high snack sugar intake had a negative effect on fruit intake. Specific nutrient intake data will be required before conclusions can be made on whether nutrient imbalances are a concern in elementary school children having sweet snacks. Yet, the current data indicate that an increased snack sugar intake can decrease fruit intake, which could result in certain nutrient deficits. Specific dietary guidance may be necessary to address the snacking habits of elementary school children.

• The Korean Journal of Food And Nutrition
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• v.24 no.2
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• pp.246-257
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• 2011

The purpose of this study was to identify the effectiveness of a nutrition education program of reducing children's sugar intake based on social cognitive theory. This education program composed of 6 units was conducted in discretional activity class of the $3^{rd}$ and $4^{th}$ grade elementary school students. The results are as follows: First, the rate of correct answers and score of nutrition knowledge significantly increased after nutrition education. The scores of nutrition education in male students, students whose mothers have no job, and students with skinny physiques were much improved after nutrition education(p<0.05, p<0.01, p<0.001, respectively). Second, the dietary attitudes toward reducing sugar intake and checking nutrition labels significantly improved(p<0.05). And also, it tended to decrease in preference and intake of sweet foods. Third, the consumption of candy caramel jelly(p<0.05), yogurt(p<0.05), jam honey(p<0.05), and ice cream(p<0.001) were reduced after nutrition education. Besides, obese students' consumption of isotonic beverages, carbonated beverages, and fruit juice was reduced. Therefore, a positive change in dietary behavior appeared. Based on the above results, we confirmed that the nutrition education program focusing on reducing sugar intake applied with social cognitive theory was effective for improving the nutrition knowledge, dietary attitude and dietary behavior in sugar intake in elementary school students. Especially, this program showed the improvement in nutrition knowledge as well as dietary attitude and behavior in sugar intake among obese children. Since nutrition education during childhood significantly influences lifetime-health and disease prevention, it is necessary to develop theory-based nutrition education program and practice systematic and constant nutrition education in elementary schools.

• Journal of the Korean Society of Food Culture
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• v.10 no.2
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• pp.107-117
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• 1995

This study was undertaken to investigate the dietary behavior and sugar intake of korean school children. The subject were 131 school lunch program children and 149 non school lunch program children lived in Soung Nam city. Sugar intake, food intake, dietary behavior and anthropometric measurement were studied through personal interview using 24-hour recall dietary data and records. Total daily energy and nutrient intake of children were higher than RDAs except for intake of Calcium and vitamin A. The nutrients intake of school lunch program children were significantly higher than that of non school lunch program children (p<0.05). The range of daily sugar intake was 10 g to 220 g and the total daily sugar intake was $63.0{\pm}37.4\;g$. Sugar intake of school lunch program children ($51.4{\pm}25.7\;g$) was significantly lower than non school lunch program children ($73.1{\pm}42.9\;g$) (p<0.0001). The more sugar intake increase more intake of Energy, Fat and Carbohydrate. The result of stepwise multiple regression analysis using the sugar intake of children as dependent variable, energy, vitamin $B_2$, protein, niacin, calcium school lunch program, education of fathers are significant explanatory variables, explaining 44.8% of variation. Result of this study suggest that school lunch program is desirable for good dietary behavior and decreation of sugar intake of school children.

• Nutrition Research and Practice
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• v.10 no.2
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• pp.229-236
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• 2016

BACKGROUND/OBJECTIVES: The purpose of this study was to find out the level of knowledge on sugar-related nutrition among mothers with preschool children. SUBJECTS/METHODS: The study conducted a survey on 350 mothers whose children attended daycare. The dietary lives of the children and the nutritional knowledge of the mothers on sugar were checked. In order to analyze results, SPSS 18.0 was used. ANOVA and t-test were also performed to analyze recognition and educational needs. RESULTS: When the degree of nutritional knowledge was measured and analyzed, the results showed about 11 average points out of 15. The higher a group's nutritional knowledge, the better the dietary habits and activities were and the activities were more ccommon. The group with a low level of nutritional knowledge consumed more foods with high sugar content, but this difference was not statistically significant. Also the children from the group of mothers that provided nutritional education to their children were more likely to engage in better dietary habits and activities. CONCLUSIONS: 66.5% respondents did not know about policies to reduce sugar consumption, but most indicated that education on reducing sugar consumption is needed. Therefore, a government-driven search for efficient methods to campaign and publicize sugar reduction is needed in order to continuously provide appropriate education.

• The Korean Journal of Food And Nutrition
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• v.30 no.5
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• pp.923-934
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• 2017

The purpose of this study was to provide the basic information for developing sugar related nutrition education programs for children in child-care facilities and their parents. The results showed that the total score of parent's dietary attitudes towards sugar-rich foods was 17.94 and the total score of parent's nutritional knowledge was 3.67. A positive relationship was observed among items of parent's dietary attitudes (p<0.01), and some correlations were also observed between the total score of parent's nutritional knowledge and the total score of parent's dietary attitudes (p<0.05 or p<0.01). The total average score of children's eating behaviors for sugar-rich foods was 23.98, and the item with the highest score was 'I often eat candy, chocolate and jelly'. For children, food that received the highest preference was chocolate, and soft drinks received the lowest preference. The most frequently consumed food item was candy or caramel, and the least frequently consumed food item was soft drinks. There were positive correlation among the total score of children's eating behaviors, food preferences, and food intake frequency (p<0.01). When parent's tried to reduce the sugar intake, children's total score of eating behaviors (p<0.001) and food intake frequency (p<0.001) for sugar-rich food was lower. We conclude that parent's dietary attitudes may influence children's eating behaviors, food preferences, and food intake frequency for sugar-rich foods.