• Nutrition Research and Practice
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• v.15 no.1
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• pp.80-94
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• 2021

BACKGROUND/OBJECTIVES: Recent studies have reported chocolate consumption has beneficial effects on blood pressure, obesity, and dyslipidemia, which are components of metabolic syndrome (MetS). However, evidence regarding these relationships in Asia is limited. The aim of this study was to investigate relations between chocolate consumption and MetS in Korea. SUBJECTS/METHODS: Study subjects were 6,982 adults aged 19-64 years free of major chronic diseases that participated in the 2014-2016 Korea National Health and Nutrition Examination Survey. Information on chocolate consumption was obtained using food frequency questionnaires. For primary analysis, subjects were divided into two groups: non-consumer (n = 3,741, 53.6%); consumer (n = 3,241, 46.4%). In order to investigate dose-response effects on MetS, chocolate consumers were divided into quartiles based on amounts consumed: Q1 (n = 789, 24.3%); Q2 (n = 837, 25.8%); Q3 (n = 863, 26.6%); Q4 (n = 752, 23.2%) in second analysis. RESULTS: Chocolate consumers; 1) were more physically active(P < 0.0001); 2) less likely to smoke(P < 0.0001); 3) paid more attention to food nutrition labels (P < 0.0001), and 4) had healthier dietary patterns, that is, they consumed vegetables, fruits, and dairy products more frequently(P < 0.0001) than non-consumers. Furthermore, chocolate consumers had a 30% lower risk of MetS (odds ratio, 0.70; 95% confidence interval, 0.58-0.86; P = 0.0005). However, dose-response effects between chocolate intake and MetS was not found by secondary analysis after excluding non-consumers. CONCLUSIONS: In conclusion, chocolate consumers had healthier lifestyles and dietary patterns and a lower prevalence of MetS than non-consumers, as determined by our primary analysis. Although dose-response effects were not found to be significant among chocolate consumers during secondary analysis, the patterns were partially similar. This cross-sectional finding shows chocolate consumption does not increase the risk of MetS. The prospective studies and intervention trials in Korea are needed to confirm this cross-sectional finding.

• Korean Journal of Community Nutrition
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• v.25 no.6
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• pp.502-511
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• 2020

Objectives: This study investigated the health and nutritional status of the elderly according to the number of chronic diseases, using data obtained from the Korea National Health and Nutrition Examination Survey 2013~2015. Methods: Data from a total of 2,310 individuals, aged 65 years and over, were used for the analysis. The elders were divided into 0 (n=375), 1 (n=673), 2 (n=637) and 3 or more (n=625) groups, by considering the number of chronic diseases. Results: Compared to other groups, the elderly subjects who were living with their spouse had the highest ratio in group 0 (P < 0.05), whereas subjects without economic activities had highest ratio in 3 or more group (P < 0.05). The EQ-5D index of subjects in the 0 group (0.90 ± 0.01) was higher than that in the 3 or more group (0.86 ± 0.01) (P < 0.05). After adjusting for confounding factors, the energy intake of subjects was determined to be lowest in the 3 or more group (P < 0.05). Protein (P < 0.05) and riboflavin (P < 0.05) intakes of the 3 or more group were also lower than other groups. Conclusions: This study indicates that multimorbidity of the elderly is associated with their health and nutritional status. The nutrients intake of the elderly, especially energy, protein and riboflavin, tended to be lowest in the 3 or more group. Further research is required to elucidate the risk factors related to presence of multimorbidity in the elderly.

• The Korean Journal of Food And Nutrition
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• v.33 no.6
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• pp.721-731
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• 2020

This study used a food-frequency questionnaire to estimate fruit consumption by sex, age, and type of fruit to analyze the association between fruit type and metabolic factors. Using food-frequency-questionnaire data from 3,091 adults aged 19~64 years (1,184 men and 1,907 women) in the 2016 Korea National Health and Nutrition Examination Survey, this study analyzed weekly fruit consumption and the consumption frequency of strawberry, oriental melon, watermelon, peach, grape, apple, pear, persimmon/dried persimmon, tangerine, banana, orange, and kiwi by sex and age groups. Apple was the most-consumed fruit (459.45 g/wk), followed by pear (165.80 g/wk), watermelon (124.80 g/wk), and banana (115.32 g/wk). After adjustment for confounding factors, ED: Please give examples. in the women who ate more than the median consumption of apple, the prevalence of hyperglycemia was 27.4% (OR: 0.726, 95% CI: 0.539~0.979) (p=0.0362), and of high triglycerides, 25.7% (OR: 0.743, 95% CI: 0.564~0.978) (p=0.0340). These rates were lower than those of women who ate less than the median consumption of apple. The results of this study suggest that apple consumption helps improve metabolic indicators in Korean adults.

• Nutrition Research and Practice
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• v.16 no.6
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• pp.755-764
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• 2022

BACKGROUND/OBJECTIVES: Cardiovascular diseases (CVDs) are the leading cause of death in Koreans, and eating habits, including diet quality, are among the etiologies of these diseases. Recently, various studies on regional health disparities have been conducted. However, there are limited studies on their relationship with nutritional factors. This study aimed to identify the magnitude of regional disparities in diet quality and prevalence of CVD in Korean adults. SUBJECTS/METHODS: This study included 17,646 participants aged ≥ 20 years from the 7^th (2013-2016) Korean National Health and Nutrition Examination Survey. Participants were classified into four groups based on their residential areas: City 1, City 2, City 3, and non-city. Demographic characteristics, health-related factors, body mass index (BMI), metabolic syndrome index, diet quality, and CVD prevalence were evaluated. RESULTS: In terms of demographic characteristics, age (P < 0.001), marital status (P < 0.001), educational level (P < 0.001), and income (P < 0.001) were lower in the non-city category. Health-related factors such as monthly drinking rate (P < 0.01) and mental stress (P < 0.05) were the highest in City 1 and lowest in the non-city group. Conversely, the current smoking rate (P < 0.05), BMI (P < 0.05), and prevalence of metabolic syndrome (P < 0.001) were the highest in the non-city group (P < 0.05). The non-city group also had the highest prevalence of CVDs (35.6%). This group had the lowest diet quality index (68.36 ± 0.22, P < 0.01), caused by low intake of fruit and calcium, a lack of sodium moderation, and an overall imbalance in the macronutrient and fatty acid ratio. When the diet quality index was increased by 1, the odds ratio for the prevalence of CVDs was reduced by 0.991 (P < 0.001), but this was not the case in all regions. CONCLUSIONS: This study provides useful information and data in identifying and resolving the regional health disparities related to CVD prevalence and implementation of public health nutrition systems.

• Korean Journal of Community Nutrition
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• v.27 no.4
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• pp.321-340
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• 2022

Objectives: This study established a practical direction for the prevention and management of metabolic syndrome by evaluating the health status, nutrition intake level, and diet quality according to metabolic syndrome and related drug treatment in Korean adults. Methods: The data from the 2017 KNHANES (Korea National Health and Nutrition Examination Survey) was analyzed. The analysis included 2,978 adults, classified into the normal, metabolic syndrome (MetS), metabolic syndrome with medicines (MetS-M), and without medicines (MetS-noM) groups. The nutrient intake, NAR (nutrient adequacy ratio), INQ (index of nutritional quality), and DDS (dietary diversity score) were analyzed. Results: The mean BMI was significantly higher in the MetS group than in the normal group for all subjects. Subjects of the MetS group tended to consume less energy and major nutrients, while males aged 50 ~ 64 and all females showed less intake of nutrients in the MetS-M group. The energy intake ratio was within 55 ~ 65 : 7~ 20 : 15 ~ 30 of KDRI (Korean Dietary Recommended Intake), but the carbohydrate energy ratio of all subjects aged 50 to 64 was over 65%. The NAR of the major nutrients was lower in the MetS-M group, the average INQ was around 0.8, especially the INQ of calcium and vitamin A was less than 1, and the total DDS score was less than 4 points. Conclusions: This study confirmed that the nutrient intake and diet quality differed among subjects diagnosed with metabolic syndrome and managed with medical care. The intakes of energy and many nutrients, the quality of diets, and the diversity of food groups in the MetS-M group were lower than in the normal group. Therefore, these will be an important basis for establishing a specific direction of diet education for preventing and managing metabolic syndrome according to gender, age, metabolic syndrome, and drug treatment.

• Nutrition Research and Practice
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• v.17 no.1
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• pp.149-163
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• 2023

BACKGROUND/OBJECTIVES: The purpose of this study was to evaluate the feasibility of application of the draft nutritional standards for school lunches in the Republic of Korea (South Korea) from the supplier perspective. SUBJECTS/METHODS: In November 2018, a pilot operation was conducted at 104 participating schools for 2 weeks each by applying the draft standards A and B. To evaluate the ease and appropriateness of application of the standards, we analyzed the nutritional values and food cost of the school lunches for 2 weeks before and for 4 weeks under the pilot operation. We conducted an online survey of school dietitians or nutrition teachers of the participating schools to evaluate the feasibility of application of the standards in school lunch sites. RESULTS: The proportions of schools of which lunches met the reference values of the school's own nutritional standards were 19.2% for the standards A and 21.2% for the standards B. The food cost of school lunches applying the standards A (KRW 2,880) was significantly lower than that of school lunches applying the standards B (KRW 3,030) or the existing standards (KRW 2,980). As a result of the survey, the mean score for the ease of application was significantly higher for the standards B (2.75) than for the standards A (2.24). The proportions of school dietitians or nutrition teachers reporting no problem in meeting an existing food cost standard were 72.5% for the standards A and 61.8% for the standards B, respectively. The overall appropriateness of application was higher for the standards B, because almost two-thirds (58.8%) of the respondents answered that the standards B were more appropriate than the standards A. CONCLUSION: The standards B were more feasible to apply as nutritional standards for school lunches than the standards A from the supplier perspective.

• Korean Journal of Community Nutrition
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• v.27 no.6
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• pp.480-491
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• 2022

Objectives: This study examined the problems encountered when analyzing the market size, purchase, and consumption of HMR (home meal replacements) in the Republic of Korea. Methods: The macro data relevant to the market size and purchase status of HMR were critically summarized. The micro data retrieved from the 2019 & 2020 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed to understand the consumption of HMR. Results: The Korea Agro-Fisheries & Food Trade Corporation and the Ministry of Food and Drug Administration reported the market size of HMR, whereas the Korean Rural Economic Institute and the Rural Development Administration reported the purchase expense and frequencies of HMR. Since the values on the market size and purchase status were calculated or surveyed using different scopes of HMR, there have been reliability issues for the data presented. Additionally, lack of consensus on the use of Korean terms corresponding to HMR was found to be a problem. To examine the consumption of HMR, analysis of the food intake data from KNHANES presented results with very low validity due to the inappropriate survey and coding scheme not reflecting the inclusion of new food types. Conclusions: Several problematic discrepancies were encountered in the statistics on HMR. The fundamental cause of these problems was the absence of agreement on the scope of HMR and the Korean terms corresponding to it. Considering the increasing importance of HMR in Korean diets, urgent cooperative efforts are required between the government and academia to derive an agreed Korean term and establish the scope of HMR.

• Nutrition Research and Practice
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• v.18 no.2
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• pp.239-256
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• 2024

BACKGROUND/OBJECTIVES: Over the past 10 yrs, the prevalence of diabetes in Korea has continued to incline, and the importance of lifestyle modification to manage diabetes has been highlighted. For patients with diabetes, carbohydrate intake reduction is effective in improving glycemic control; thus, we aimed to analyze the effect of carbohydrate intake ratio and suggest an appropriate carbohydrate intake ratio. SUBJECTS/METHODS: Using the 8th Korea National Health and Nutrition Examination Survey (2019-2021), we analyzed the data including participants aged 30 yrs or older with diabetes, and they were stratified into good and poor glycemic control groups. To analyze the correlation between the dietary behavior characteristics of participants with diabetes and the carbohydrate intake ratio, sociodemographic characteristics, dietary behavior, and health behavior were adjusted, and multivariate logistic regression analysis was conducted to present the adjusted odds ratio and 95% confidence interval (CI). RESULTS: In the unadjusted crude model, when carbohydrate intake ratio in total energy intake increased by 1%, the likelihood of poor glycemic control increased by 1.007-fold (95% CI, 0.998-1.016; P = 0.121). In model 1, which uses age and sex as adjustment variables, an increase of up to 1.011-fold was possible (95% CI, 1.001-1.021; P = 0.008). In model 2, which added variables such as diabetes duration, frequency of fruit consumption, frequency of lunch and, frequency of dinner, the risk of poor glycemic control increased by 1.010-fold as the carbohydrate intake ratio increased (95% CI, 0.998-1.022; P < 0.001). CONCLUSION: This study confirmed that as the ratio of carbohydrate intake to total energy intake increases the likelihood of poor glycemic control also increases in patients with diabetes. Therefore, to improve glycemic control in patients with diabetes, controlling the carbohydrate intake may be helpful.

• Journal of Nutrition and Health
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• v.34 no.4
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• pp.458-471
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• 2001

To evaluate the infra structure supporting hospital nutrition services, we conducted a survey on the unit of organization, unit of dietitians work system, number of personnel engaged on nutrition services, productivity of food service, management of dietitians works, computerization of nutrition services etc. Total ninety-six hospitals were participated in the survey, and they were varied in terms of hospital classification, location, number of beds and type of food service management. All of the large hospitals with more than 400 beds conducted nutrition services under the department of nutrition, but some of the middle and small hospitals with less than 400 beds conducted nutrition services under the other department such as administration. In most of the tertiary hospitals, the work of dietitians were separated in which food services and medical nutrition services were conducted independently by different dietitians, whereas, in most of general hospitals and all the hospital, food services and medical nutrition services were conducted by the same dietitians in all time. The numbers of dietitians and cooks per 100 beds were fewer in the large hospitals with more than 400 beds than the hospitals with less than 400 beds, and the number of cooking and meal serving assistants were the just opposit. The average productivity of food service was 44.5 meals per hour for each dietitian, 84.8 meals per hour for a cook and 7.0 meals per hour for a cooking and meal serving assistant. The productivities for dietitians and cooks tend to be higher in large hospitals than middle and small hospitals, whereas the productivities for cooking and meal serving assistants were just opposite. The large hospitals seemed to solve the problem on the lack of working personnels by hiring part-time workers and by utilization of computer system for their works. The pattern of daily work management in food service area was not much different between dietitians duties, but the pattern of daily work management in medical nutrition service area was different in a way which the analysis of patients nutrient intakes was almost not conducted by dietitians handling both food services and medical nutrition services. Therefore, this study demonstrates that there are significant differences in the infra structures conducting nutrition services among hospitals, suggesting that the strategies to improve this improve this structure in relation to the improvement of service qualities need to be investigated in the future. (Korean J Nutrition 34(4) : 458∼471, 2001)

• Journal of Nutrition and Health
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• v.50 no.6
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• pp.624-644
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• 2017

Purpose: This study analyzed iodine intake by establishing an iodine database of general Korean foods eaten by Korean adults based on the data from the 1998 ~ 2014 KNHANES (Korea National Health and Nutrition Examination Survey). Methods: Data on 56,818 subjects aged 19 years and older were obtained from health behavior interviews and a 24-hour dietary recall survey. Iodine intake of subjects was analyzed according to general characteristics, dietary lifestyle, food groups, and cooking method. Results: An iodine database was established for 312 food items. The mean iodine intake of Korean adults decreased from $641.6{\mu}g$ in 1998 to $236.2{\mu}g$ in 2014 per day. Iodine intake of women was higher than that of men. For age distribution, those aged 30 ~ 49 years constituted more than 39 ~ 46% of subjects by survey year. Regarding iodine intake according to dietary lifestyle, the highest iodine intake was 29.4 ~ 34.4% for lunch while that of breakfast decreased. The highest iodine contribution by food group was seaweed such as kelp, sea mustard, and laver. Conclusion: The results of this study indicate that iodine intake of Korean adults has been decreasing, and iodine intake is associated with the prevalence of thyroid disease. This study provides basic data for the estimation of iodine intake in Korean adults.