• Journal of the Korean Dietetic Association
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• v.22 no.3
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• pp.179-192
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• 2016

The purpose of this study was to evaluate a nutrition education program designed to reduce sugar intake in preschool children. The nutritional knowledge, dietary attitude, dietary behavior, and food intake with a sweet taste in preschool children were tested before and after 4 weeks of nutrition education from March 8 to April 1, 2016. The preschool children were recruited in Dobong-gu, Seoul. The subjects were divided into two groups; educated (N=59) and non-educated group (N=40). Statistical analyseis were performed using SPSS 22. The nutritional knowledge about sweet tasting food was significantly increased (P<0.01) in the educated group and significantly decreased (P<0.01) in the non-educated group. The dietary attitude toward sweet tasting food was significantly decreased (P<0.05) in the educated group but not significantly changed in the non-educated group. The dietary behavior toward sweet tasting food was significantly decreased (P<0.05) in the educated group and significantly decreased (P<0.01) in the non-educated group. The major food sources of sugar intake were not significantly changed in either groups. The major food sources of sugar intake in the 5 years old children were yogurt products>sweetened breads>cookies/biscuits>chocolate>cereals>beverages>sweetened milk>sweet spicy chicken>Tteokbokki. Although there are some limitations in this study, due to the short length of the nutrition education and lack of active participation by the parents, the results suggest that effective nutrition education on sweet tasting food can bring about changes in nutritional knowledge as well as dietary attitude.

• Nutrition Research and Practice
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• v.14 no.5
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• pp.490-500
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• 2020

BACKGROUND/OBJECTIVES: A cross-sectional study was undertaken to evaluate fluid intake and hydration status in association with cognitive function among 230 adolescents (10-14 years of age) in Petaling Perdana, Selangor, Malaysia. SUBJECTS/METHODS: Urine color was used to measure hydration status, while fluid intake was assessed using the 15-item beverage intake questionnaire. Cognitive function was assessed using the Wechsler Intelligence Scale for Children, Fourth Edition. RESULTS: More than half of the adolescents were mildly or moderately dehydrated (59.6%) and only one-third (33.0%) were well hydrated. Among the daily fluid types, intakes of soft drinks (r = -0.180; P = 0.006), sweetened tea (r = -0.184; P = 0.005) and total sugar-sweetened beverages (SSBs) (r = -0.199; P = 0.002) were negatively correlated with cognitive function. In terms of hydration status, cognitive function score was significantly higher (F-ratio = 4.102; P = 0.018) among hydrated adolescents (100.38 ± 12.01) than in dehydrated (92.00 ± 13.63) counterparts. Hierarchical multiple linear regression analysis, after adjusting for socio-demographic factors, showed that soft drinks (β = -0.009; P < 0.05) and sweetened tea (β = -0.019; P < 0.05) negatively predicted cognitive function (ΔR² = 0.044). When further control for sources of fluid, hydration status (β = -2.839; P < 0.05) was shown to negatively predict cognitive function (ΔR² = 0.021). The above variables contributed 20.1% of the variance in cognitive function. CONCLUSIONS: The results highlight the links between fluid intake (soft drinks, sweetened tea, total SSBs) and hydration status with cognitive function in adolescents. Interventions aimed at decreasing the consumption of SSBs and increasing hydration status through healthy fluid choices, such as water, could improve cognitive performance in adolescents.

• Korean Journal of Community Nutrition
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• v.29 no.1
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• pp.51-64
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• 2024

Objectives: This study examined the association between ultra-processed food (UPF) consumption and chronic diseases in elderly Koreans. Methods: Data from the 2019-2021 Korea National Health and Nutrition Examination Survey were analyzed. Dietary intake and UPF consumption were assessed using the NOVA food classification based on 24-hour recall data from 3,790 participants (aged 65+ years). Participants were divided into 4 groups based on the quartile of energy intake from UPFs. Regions were classified as urban or rural. Multivariable logistic regression was employed to estimate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) after controlling for potential confounders. Results: Among the participants, 71.3% resided in urban and 28.7% in rural areas. Compared to the urban elderly, rural participants tended to be older, have lower education and income levels, be more likely to live in single-person households, and have a higher smoking rate (P < 0.05). Urban elderly consumed more UPFs daily (146.1 g) compared to rural residents (126.6 g; P < 0.05). "Sugar-sweetened beverages" were the most consumed category in both regions. "Sweetened milk and its products" and "traditional sauces" were prominent in urban areas, while rural elderly consumed more "traditional sauces" and "distilled alcoholic beverages." Rural areas also had a higher carbohydrate-to-calorie ratio than urban areas. Compared to the lowest quartile of UPF intake, the highest quartile was significantly associated with impaired fasting glucose only in rural areas (AOR, 1.48; 95% CI, 1.00-2.19; P for trend = 0.0014). No significant associations were observed for diabetes in either urban or rural areas. Conclusions: This study suggests that high intake of UPFs is associated with increased odds of impaired fasting glucose in rural elderly. Further research is needed to elucidate the specific negative health effects of UPFs in different populations, and targeted efforts should promote healthy diets in both urban and rural areas.

• 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.

• Nutrition Research and Practice
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• v.17 no.6
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• pp.1143-1154
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• 2023

BACKGROUND/OBJECTIVES: Body shape misperception (BSM) is the disagreement between the subjectively perceived body size and body mass index. This study investigated the association between BSM and unhealthy eating behaviors (UEB) among Korean adolescents. SUBJECTS/METHODS: This cross-sectional study used data from the 2019 Korea Youth Risk Behavior Web-based Survey with 55,748 participants. UEB were measured according to the weekly consumption frequency of caffeinated energy drinks, fast food, carbonated beverages, and sugar-sweetened beverages. The covariates included demographic and socioeconomic characteristics and health-related factors. Multiple logistic regression analysis determined the association between BSM and UEB. RESULTS: Among the participants, 37,607 (67.5%) reported UEB. The gap between UEB among those with BSM was the largest between the underestimated and accurately estimated groups. Participants who underestimated their body shape were likelier to engage in UEB (adjusted odds ratio [AOR], 1.18; 95% confidence interval [CI], 1.11-1.25). Both sexes with underestimation of body size showed an association with UEB compared to those with accurate estimations (girls: AOR, 1.19; 95% CI, 1.09-1.30; boys: AOR, 1.16; 95% CI, 1.08-1.26). CONCLUSIONS: Underestimating body shape can provoke UEB among Korean adolescents. The need for appropriate school health interventional programs to prevent underestimating body shape is emphasized to avoid UEB.

• Journal of Korean society of Dental Hygiene
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• v.18 no.5
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• pp.785-795
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• 2018

Objectives: This study aimed to: 1) investigate the beverage consumption pattern among Korean adults, and 2) analyze the relationship between the frequency of beverage consumption and oral health status. Methods: We used data from the 6th Korean National Health and Nutrition Examination Survey. A general linear model was employed to assess the associations between demographic factors and frequency of beverage consumption; and oral health status and the frequency of beverage consumption. Results: The beverage with the highest frequency of intake was coffee (11.5 times per week). More frequent consumptions of fruit juices and carbonated drinks were associated with higher numbers of decayed teeth. Conclusions: To improve oral health, frequent intake of acidic and sweetened beverages should be reduced, and the consumption of milk should be encouraged.

• Archives of Obesity and Metabolism
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• v.3 no.1
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• pp.9-13
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• 2024

The prevalence of obesity has been increasing worldwide. Several dietary treatments have been suggested to control weight, and recent guidelines recommend individualizing the composition of macronutrients. Carbohydrates are the most important nutrients in meals, and carbohydrate restriction is a dietary strategy that promotes weight loss. A low-carbohydrate diet is effective for short-term weight loss and can help improve glycated hemoglobin, systolic blood pressure, diastolic blood pressure, and triglyceride levels; however, the long-term effects and safety of this diet remains doubtful. In the short term, there is a risk of gastrointestinal symptoms such as vomiting, diarrhea, constipation, and gastroesophageal reflux, and type 1 diabetes patients are at risk of severe hypoglycemia, while in the long term, it can lead to malnutrition and decreased exercise capacity. Thus, rather than limiting the intake of carbohydrates, it is important to limit the intake of refined grains, sugar, honey, syrup, and sweetened beverages while maintaining the planned carbohydrate intake rate and improving meal quality.

• Journal of Nutrition and Health
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• v.57 no.1
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• pp.120-135
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• 2024

Purpose: This study examined the factors affecting sugar intake in adults based on social cognitive theory. Methods: An online survey regarding the intake frequency of sugar-source food, factors related to sugar intake based on social cognitive theory, perceptions of sugar intake, and health-related factors was conducted in October 2019 with 1,022 adults (502 men and 520 women) aged 19-49 years. The intake frequency of sugar-source food was divided into tertiles using percentiles based on the daily frequency. Results: The daily intake frequency of sugar-source foods was 4 times, with beverages (1.87 times/day) and sweetened coffee (0.81 times/day) being the highest among the food groups and types, respectively. The group with a high intake frequency of sugar-source food had a high negative outcome expectation for reducing sugar intake, and was in a home and social environment with easy access to sweet food. Women in this group showed low self-efficacy and poor behavioral capability in reducing sugar intake. Self-control had the lowest average score among the factors of social cognitive theory (2.56/5 points), followed by nutrition knowledge related to sugar (5.42/10 points). As a result of regression analysis, the social cognitive factor affecting the intake frequency of sugar-sourced foods was found to be home environment for both men and women. On the other hand, factors contributing to reducing sugar intake were positive outcome expectations for men and behavioral skills for women. Conclusion: Dietary education and nutritional interventions for adults, including changes in the home environment with easy access to sweet foods, can reduce sugar intake and raise positive expectations for reduced sugar intake.

• Clinical and Experimental Pediatrics
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• v.64 no.1
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• pp.12-20
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• 2021

The mean age at menarche (AAM) of Korean females has been rapidly decreasing over the last 50 years; currently, the prevalence of early menarche (<12 years) is 22.3%. Female adolescents who experience early menarche are known to be at greater risk of psychosocial and behavioral problems along with several physical health problems such as menstrual problems. They also tend to achieve a shorter final height and develop obesity. Population-based Korean studies have shown a strong association between early menarche and the risk of obesity, insulin resistance, metabolic syndrome, nonalcoholic fatty liver disease, diabetes, breast cancer, and cardiovascular disease in adulthood. Although the exact mechanism of how early menarche causes cardiometabolic derangement in later adulthood is unknown, childhood obesity and insulin resistance might be major contributors. Recent studies demonstrated that an excessive consumption of fructose might underlie the development of obesity and insulin resistance along with an earlier AAM. A positive association was observed between sugar-sweetened beverages (a major source of fructose) intake and obesity, metabolic syndrome, insulin resistance, and cardiometabolic risk in Korean females. In pediatrics, establishing risk factors is important in preventing disease in later life. In this regard, early menarche is a simple and good marker for the management of cardiometabolic diseases in adulthood. Decreasing one's fructose intake might prevent early menarche as well as the development of obesity, insulin resistance, and cardiometabolic diseases.

• Nutrition Research and Practice
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• v.8 no.1
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• pp.74-80
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• 2014

Water is essential for life and plain water instead of sugar-sweetened beverages is one approach for decreasing energy intake. Due to limited data on characteristics associated with water intake among Korean adolescents, this study examined associations of demographic and behavioral characteristics with plain water intake by using nationally representative sample of South Korean adolescents. The data (2007-2010 Korea National Health and Nutrition Examination Survey) for 1,288 high school-aged adolescents (15-18 years) were used. Multivariable logistic regression was used to calculate adjusted odds ratios (OR) for factors associated with low water intake (< 4 cups/day) and very low water intake (< 2.5 cups/day). Nationwide, 38.4% and 19.0% of adolescents reported drinking water < 4.0 cups/day and < 2.5 cups/day, respectively. The mean plain water intake was 5.7 cups/day for males and 4.1 cups/day for females. Females had significantly higher odds for drinking water < 2.5 cups/day (OR = 2.2) than males, whereas adolescents with low milk consumption had significantly lower odds for drinking water < 2.5 cups/day (OR = 0.7). Factors significantly associated with a greater odds for drinking water < 4 cups/daywere being female (OR = 2.8) and not meeting physical activity recommendations (${\geq}20$ min/day on < 3 days/week) (OR = 1.6). Being underweight, overweight, and obese were significantly associated with reduced odds for drinking water < 4 cups/day (OR = 0.7, 0.4 and 0.5, respectively). However, intake of soda, coffee drinks, fruits, vegetables, and sodium and eating out were not significantly associated with low or very low water intake. These findings may be used to target intervention efforts to increase plain water intake as part of a healty lifestyle.