• Korean Journal of Community Nutrition
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• v.26 no.1
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• pp.1-11
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• 2021

Objectives: This study was conducted to assess the eating behavior, growth, and dietary practices of children aged 3~5 years living in the Seoul and Gyeonggi Provinces. Methods: Self-administered questionnaires were completed by 237 mothers of preschool children between April and June 2018. Z-scores for weight-for-age, height-for-age, and BMI-for-age were calculated to determine the children's growth status. Dietary practices were evaluated using the nutrition quotient for Korean preschoolers (NQ-P). Results: In our study, 29.5% of children were in the eating-small-amounts group, 46.8% of children were in the neophobic behavior group, and 61.2% of children were in the refusal-of-specific food group. Specific foods found to have a high frequency of rejection are listed in descending order as follows: shellfish, soy, mushroom, shrimp, vegetables, milk, eggs, yogurt, seaweed, meat, fruits, and fish. The eating-small-amounts group had lower Z-scores for weight-for-age, height-for-age, and BMI-for-age than the non-picky eaters' group. Compared to the non-picky eaters' group, the eating-small-amounts group of picky eaters had lower scores on the moderation and environment items of the NQ-P, the neophobic behavior group had lower scores on the balance and environment items of the NQ-P, and the refusal-of-specific food group had lower scores on the balance, moderation, and environment items of the NQ-P. Conclusions: Children classified with picky eating behavior had lower growth and development, lower diet diversity, less balanced food intake, and had greater difficulty in abstaining from eating unhealthy foods than non-picky eaters. Therefore, a lot of patience and intensive efforts are needed to encourage children to encounter, experience, and accept unfamiliar food. It is more effective to provide eating behavior guidance by gently encouraging children, than by being strict and forceful. Besides, since the eating behavior of children is influenced maximally by the dietary lifestyle at their homes, it is important to ensure that a healthy dietary lifestyle is maintained at home.

• Journal of the East Asian Society of Dietary Life
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• v.17 no.4
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• pp.474-482
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• 2007

Korea used to be a country where individuals ate diets high in vegetables and rice, but in recent years, it has become a country where western-style diets are increasingly popular. Consequently, the age for chronicle disease, including obesity and diabetes, has become lower. The purpose of this study was to compare the dietary habits of kindergarten children between lacto-ovo vegetarian and non-vegetarian families. The data were collected from the children(n=300) at Sahmyook University Kindergarten. The results showed that non-vegetarians had higher intakes of cookies, cakes, processed foods, ice cream, and fast foods, while vegetarian children consumed high amounts of vegetables, fruits, and kimchi. The non-vegetarian children tended to have irregular meals, and ate high-fat meats such as kalbi and samgyupsal. However, the results show it is important that many children among both vegetarian and non-vegetarian families should be encouraged to have appropriate essential nutrients, because a high percentage of children in both groups appeared to have low intakes of energy, vitamin $B_2$, vitamin C, calcium, zinc, iron, etc.

• The Korean Journal of Food And Nutrition
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• v.29 no.5
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• pp.818-827
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• 2016

This study was conducted to develop and validate the Sugar Intake Reduction Test (SIRT) for young children, and included eating behaviors, attitude, and nutritional knowledge about sugars. A draft version of the SIRT was developed after literature review. The final draft of the SIRT was established after two pilot tests of 5 year old children and an expert group's review, and is comprised of a one on one test between an investigator and a child using picture tools. It contained of 20 questions which included 3 components: eating behaviors (5 items), preference for sugar sweetened food (10 items), and nutritional knowledge about sugars (5 items). The final SIRT was conducted on 181 children 5 (n=100) to 6 (n=81) years old, to examine its item and test adequacies. The passing rate of most items significantly increased with increasing age, and most of the item discrimination also differed significantly between the below and upper score groups. The content validity was given a high score by professionals (mean score 3.9 out of 4). Reliability of all the items in the SIRT was high (Cronbach's ${\alpha}=0.82$). Moreover, the total component and the sub-component scores of the SIRT correlated significantly. Our results indicate that the SIRT is a valid tool to measure sugar intake reduction in young children aged 5~6 years.

• The Korean Journal of Food And Nutrition
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• v.31 no.3
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• pp.335-344
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• 2018

This study aimed to develop and evaluate a sugars intake reduction program (SIRP) that was designed to increase the knowledge, attitude, and skills of Korean children aged 5 years regarding sugars intake reduction. A total of 101 children aged 5~6 years from 6 preschools participated in SIRP. SIRP consisted of 4 sessions including 10 activities (e.g., story-telling, arts, experiment, checking nutrition facts, pledge), delivered to children at preschools by nutritionists over a one-month period. Three letters were sent to parents throughout the program to inform them of the children's activities at the preschools and to provide additional information on reducing children's sugars intake. A total of 90 children completed the program; 83 parents of these children completed the SIRP evaluation survey. The children's sugars intake reduction score was significantly increased after attending SIRP. Teachers (n=6) who participated in this program agreed to improve their students' attitudes on reducing sugars intake and to decrease students' behaviors related to sugars intake. Parents agreed to improve their children's attitude on reducing sugars intake and to decrease children's behaviors related to sugars intake. The outcome showed SIRP improved participants' attitudes towards sugars reduction and increased the skills to reduce the sugars intake of children aged 5~6 years. Future studies should examine whether SIRP reduces actual sugars intake among children.

• The Korean Journal of Food And Nutrition
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• v.30 no.3
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• pp.539-551
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• 2017

This study investigated the current status and needs for nutrition education to help reduce children's sugars intake at the Center for Children's Foodservice Management (CCFM, n=115), and Child Care Facilities (CCF, n=646) through an online survey conducted from October $5^{th}$ to $30^{th}$ 2015. A total of 14.8% of CCFM respondents and 31.9% of CCF respondents provided nutrition education on sugars intake to young children as a main topic (p<0.001). A higher percentage (CCFM 47.8%: CCF 42.4%) delivered nutrition education on sugars intake to young children as a sub-component (p<0.001). Over 90% of the CCFM and CCF participants agreed on the necessity of providing nutrition education on sugars intake to children. The most common reasons given for delivering nutrition education on children's sugar intake were "there are many more urgent nutrition education topics" for CCFM, and "insufficient nutrition education information and materials" for CCF. The percentage of nutrition education on children's sugar intake provided to the children's parents was low showing about 20% in the both groups. The percentage of CCFM participants providing nutrition, education on children's sugar intake to the teachers in CCF was also low, showing about 14.8%; however, 68.0% of the CCF participants wanted to received teacher's education on guiding children's sugar intake. Regarding ideas about a nutrition education program on children's sugar intake for young children, most respondents in both groups answered "sugar intake and dental cavities or obesity" for appropriate education contents, "story telling or puppet show" for appropriate education methods, and "dietitian from CCFM and class teacher together" for appropriate educator. For appropriate education time, there was a significantl difference between the CCFM responses (average 2.7 times) and the CCF responses (average 4 times). Based on the above results, we found that implementing nutrition education on children's sugar intake at the CCFM and CCF, was low; however, awareness of the need for nutrition education on children's sugar intake and the program development and supply was very high. Also, the opinions of CCFM and CCF participants about a nutrition education program on children's sugar intake for young children can provide foundation data to develop and implement the CCFM-based nutrition education program.

• Journal of the Korean Dietetic Association
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• v.15 no.2
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• pp.97-112
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• 2009

The purpose of this study was to develop a nutrition education curriculum with teacher's guide which includes discretionary activities for obese children. A survey was carried out to investigate the recognition of body image and food behaviors according to the obesity index (mild, moderate, severe) in school children (4~6th grade, 158 boys and 60 girls) who were selected based on a physical examination in May, 2006 in the Gyeongnam province. Next, a nutrition education curriculum with teacher's guide was developed on the basis of the findings from the survey and from preceding researches. The results are summarized as follow. The results of this study showed the existence of some nutritional problems such as overeating, prejudice, skipping meals, snacking patterns, etc, which indicate the need for nutritional management for obese children. Most overweight children (80.3%) showed the most interest in the nutrition education program, particularly with regards to dieting for weight control (64.7%). The developed nutrition education curriculum consisted of 8 main subjects and 13 subtitles. The curriculum was prepared for 13 lessons and included songs and singing, making-up lyrics, games about nutrition, discussions of the experience of eating (satiety, thirst, hunger), debates on dietary habits, writing and others to promote the interest for learning. We aimed to develop this program in an attempt to improve the dietary habits of obese school children. This is very important because once a dietary habit is formed in adults, it is difficult to change and the best adjustable stage is during childhood. Therefore, early nutrition education during elementary school can change and build-up the awareness of health in young elementary school children.

• Journal of the East Asian Society of Dietary Life
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• v.18 no.5
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• pp.651-661
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• 2008

The mother's obesity-related stress and it's association with obesity, food intake, and physical activity in both mothers and their children were determined. Based on self-reports from 470 mothers, obesity stress of mothers were scored by using a five-point Likert scale; only low and high stress scores were used in this study. The perceptions of mothers' weights and their children's weights, mothers' Body Mass Indices (BMI), and preschoolers' Weight-Length Indices (WLI)(%) were also determined. The obesity stress of mothers was significantly associated with the mothers' BMI (high stress: $23.5{\pm}2.4$ vs. low stress: $19.6{\pm}1.7$, p<0.05), but not with their children's obesity. Mothers with a high obesity stress reported a higher percentage of family history of obesity (62.1% vs. 38.3%, p<0.001) than mothers with low obesity stress. Compared to mothers with low obesity stress, mothers with high stress had lower correct-perceptions about their weights (p<0.05) but higher correct-perceptions for their children's weights. Almost 54.5% of mothers with high stress reported watching television 2 or more extra hours per day, compared with 32.2% of mothers with low stress (p<0.05). More children of mothers with high stress had long hours of daily TV viewing than children of mothers with low stress (36.0% vs. 15.3%, $X^2=10.491$, p<0.05). Mothers with high stress reported lower intake of protein-rich foods (p=0.01) and vegetables (p=0.039), but a higher intake of snacks (p=0.009), compared to mothers with low stress. More children of mothers with high stress reported eating high fat snacks or high sugar snacks everyday, but this was not statistically significant. In conclusion, high obesity stress in mothers were greatly associated with their BMI and their inactive life style, including long TV viewing hours per day and unbalanced food intakes, which can lead their children becoming inactive and obese. Special attention is recommended for overstressed mothers and their children, especially those who enjoy long hours of TV viewing.

• Nutrition Research and Practice
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• v.17 no.4
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• pp.780-788
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• 2023

BACKGROUND/OBJECTIVES: This study examined the relationship between famine exposure in early life and the risk of type 2 diabetes in adulthood during the 1959-1961 Chinese Famine. SUBJECTS/METHODS: A total of 3,418 individuals aged 35-74 years free of diabetes from two studies in 2006 and 2009 were followed up prospectively in 2009 and 2012, respectively. Famine exposure was classified as unexposed (individuals born in 1962-1978), fetal exposed (individuals born in 1959-1961), child exposed (individuals born in 1949-1958), and adolescent/adult exposed (born in 1931-1948). A logistic regression model was used to assess the relationship between famine exposure and diabetes after adjustment for potential covariates. RESULTS: During a three-year follow-up, the age-adjusted incidence rates of type 2 diabetes were 5.7%, 14.5%, 12.7%, and 17.8% in unexposed, fetal-exposed, child-exposed, and adolescent/adult-exposed groups, respectively (P < 0.01). Relative to the unexposed group, the relative risks (95% confidence interval) for diabetes were 2.15 (1.29-3.60), 1.53 (0.93-2.51), and 1.65 (0.75-3.63) in the fetal-exposed, child-exposed, and adolescent/adult-exposed groups, after controlling for potential covariates. The interactions between famine exposure and obesity, education level, and family history of diabetes were not observed, except for the urbanization type. Individuals living in rural areas with fetal and childhood famine exposure were at a higher risk of type 2 diabetes, with relative risks of 8.79 (1.82-42.54) and 2.33 (1.17-4.65), respectively. CONCLUSIONS: These findings indicate that famine exposure in early life is an independent predictor of type 2 diabetes, particularly in women. Early identification and intervention may help prevent diabetes in later life.

• Clinical and Experimental Pediatrics
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• v.63 no.11
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• pp.447-450
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• 2020

Background: Esophageal stricture (ES) is an uncommon clinic entity in pediatrics that may be congenital or acquired in childhood. Acquired noncaustic ES is very rare, and clinical features of affected patients are unknown. Purpose: We aimed to evaluate the clinical findings, and outcomes of patients with acquired noncaustic ES to aid physicians in the early referral of patients to gastroenterologists. Methods: The medical data of patients with acquired noncaustic ES who were followed in our gastroenterology clinic between January 2009 and December 2019 were reviewed. Results: Acquired noncaustic ES was found in 12 of the 4,950 patients (0.24%) who underwent endoscopy during the study period. The main symptoms were dysphagia (58.3%), vomiting (33.3%), and chronic anemia (8.3%). Chronic malnutrition and underweight were found in 66.6% of the patients. The most common etiological factors were radiotherapy, peptic reflux, and achalasia (16.6%, each), while chemotherapy, squamous-cell carcinoma (SC) of the esophagus, eosinophilic esophagitis (EoE), esophageal web, epidermolysis bullosa, and esophageal diverticulum (8.2%, each) were the other etiological factors. Patients with EoE underwent endoscopic bougie dilation in addition to steroid use and elimination diet. Patients with epidermolysis bullosa and esophageal web underwent bougie dilation. Patients with peptic reflux-related ES were initially put on antireflux therapy, but during follow-up, one patient required esophageal replacement with colonic interposition. Patients with radiotherapy-related ES recovered with medical therapy. The patient with initially underwent surgical gastrostomy and tumoral mass excision. The patient then received chemotherapy and radiotherapy and underwent jejunal interposition. Patients with achalasia underwent surgical esophagomyotomy. Conclusion: The presence of solid dysphagia, malnutrition, and an associated disease may alert physicians to the presence of ES.

• Journal of the Korean Society of Food Culture
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• v.25 no.2
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• pp.170-178
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• 2010

We conducted this study to determine the factors associated with childhood obesity. The subjects were 170 preschool children in Busan. Data were collected by using questionnaires which asked for information about socioeconomic status, parental perception of their child's weight status and dietary/physical activity behavior. BMI was calculated for each child and their classification was determined, according to their age and sex, as follows: "overweight" at or above the 85th percentile, "normal" for the 15th-85th percentile, and with a BMI below the 15th percentile the children were deemed as underweight. Classification according to BMI percentile showed that 23.5% ($18.25{\pm}1.33\;kg/m^2$) of the children were overweight, 62.9% ($15.51{\pm}0.76\;kg/m^2$) normal, and 13.5% ($13.23{\pm}2.86\;kg/m^2$) were underweight. Socioeconomic status, as represented by the parents' level of education, the occupation of the father and the household income, did not affect the results. However, mothers working outside the household was a factor that was more likely to affect the weight status (p<0.05). Among mothers whose children were overweight, 30% underestimated their children's weight status (believing them to be of normal weight when they were overweight), and 25% failed to recognize the necessity of weight control for their overweight children. While sedentary activity and total daily activity levels were not related to BMI, the level of physically active leisure activity was inversely correlated with BMI (p<0.05). Although there were no differences in total energy intake, dietary behavior was significantly related to weight status. Overweight children had poor eating tendancies: they eat faster (in less than 15 minutes), overeat, and eat late at night. Based on our findings where hereby recommended the following interventions to help limit weight problems in Korean pre-schoolers: early promotion of active leisure behavior and healthy eating habits, along with attempting to correct parental misperception of healthy weight status for children.