The Ministry of Agriculture, Food and Rural Affairs introduced the Agrifood Voucher in 2020. The Agrifood Voucher is the program that provides vouchers to purchase selected food items with dietary management education. This study aimed to explore value and meaning of dietary management based on the Agrifood Voucher. First, the Supplemental Nutrition Assistance Program of the United States and the Agrifood Voucher of Korea were reviewed. Second, various terms used for describing the purpose of food assistance programs were comparatively reviewed and 'food and nutrition security', together with the corresponding Korean term, was proposed to be the most appropriate term for the purpose. Subsequently, the value and meaning of dietary management based on the Agrifood Voucher were presented as enhancing food and nutrition security of the vulnerable. Diverse education programs should be developed and implemented to improve the dietary management capacity of the Agrifood Voucher recipients in order to properly realize the meaning and value of dietary management based on the Agrifood Voucher in the future.
BACKGROUND/OBJECTIVES: The purpose of this study was to investigate the association between socioeconomic status and chewing discomfort and identify the role of food insecurity in the association's causal pathway in a representative sample of Korean elders. MATERIALS/METHODS: We conducted cross-sectional analyses of the Korea National Health and Nutrition Examination Survey (2013-2015) data for elders aged ≥ 65 years. Socioeconomic status indicators used included household income and education level. Chewing discomfort was assessed according to the self-reported presence of chewing problems. Food security was surveyed using a questionnaire based on the US Household Food Security Survey Module. RESULTS: The odds ratios of chewing discomfort in the 1st and 2nd income quartiles were 1.55 (95% confidence interval [CI], 1.15-2.10) and 1.40 (95% CI, 1.03-1.90), respectively, compared to participants in the highest income quartile. Participants with the lowest education level were 1.89 (95% CI, 1.30-2.75) times more likely to have chewing discomfort than those without chewing discomfort. After including food security in the final model, the logistic coefficients were attenuated in the income and education quartiles. CONCLUSIONS: Low socioeconomic status was associated with chewing discomfort. In addition, the results confirm that food insecurity can mediate the association between socioeconomic inequalities and chewing discomfort among the elderly.
Hicks-Roof, Kristen;Xu, Jing;Fults, Amanda K.;Latortue, Krista Yoder
Nutrition Research and Practice
/
v.15
no.6
/
pp.789-797
/
2021
BACKGROUD/OBJECTIVES: Registered dietitian nutritionists (RDN) are providers of medical nutrition therapy (MNT) to address health and chronic disease. Traditionally, RDNs have provided care in healthcare facilities including hospitals and private care facilities. The purpose of this study was to determine how RDN individualized MNT in the home impacted nutrition, physical activity, and food security. SUBJECTS/METHODS: This is a secondary data analysis. The mean age of the participants (n = 1,007) was 51.6 years old with a mean body mass index (BMI) of 34.1 kg/m2. Individualized MNT visits were delivered by an RDN in the home setting from January to December 2019. Participants were referred by healthcare professionals or self-referred. Participants had MNT benefits covered by their health insurance plan (43.3% Medicaid; 39.8% private insurance; 7.9% Medicare, 9% other). Health outcomes related to nutrition care were measured. Outcomes included self-reported consumption of nutrition factors and physical activity. Our secondary outcome focused on food security. The changes in weight, BMI, physical activity, and nutrition factors were analyzed by a linear regression model or linear mixed model, adjusting for age, sex, baseline value, and number of appointments. Food security was summarized in a 2 by 2 contingency table. RESULTS: Baseline values had significantly negative impacts for all changes and number of appointments was significant in the changes for weight and BMI. Increases in physical activity were significant for both female and male participants, 10.4 and 12.6 minutes per day, respectively, while the changes in weight and BMI were not. Regarding dietary factors, the consumption total servings per day of vegetables (0.13) and water (3.35) significantly increased, while the consumption of total servings of whole grain (-0.27), fruit (-0.32), dairy (-0.80) and fish (-0.81) significantly decreased. About 24% (of overall population) and 45% (of Medicaid population) reported improvements in food security. CONCLUSIONS: This study found that home visits were a useful setting for MNT delivered by RDNs. There is a strong need for individualized counseling to meet the participants' needs and personal goals.
This study aims to develop an index of food security in order to assess food security status in Korea and to evaluate reliability and validity of the index. The index of food security was developed based on the US Household Food Security Survey Module (US-HFSS). After the US-HFSS was translated and back-translated, it was evaluated and modified by a focus interview for experts. The developed Korean Household Food Security Survey Module (K-HFSS) was tested by cognitive interviews and a pretest for general community population to assess its application for Korean population. For the reliability and validity of K-HFSS, the survey was conducted with 300 adults aged 40 years or more living in a rural community and 212 infants and toddlers living in an urban community. The reliability was assessed by Cronbach' alpha and the validity was evaluated by content validity, construct validity, and criterion-related validity. The questionnaire items of K-HFSS were partly modified, accounting for Korean social and cultural backgrounds and adapted by general community population. The reliability was relatively high, showing Cronbach' alpha coefficients ranged from 0.80 (for adults) to 0.87 (for infants and toddlers). The content and construct validities were all acceptable. The result of criterion-related validity showed that food security status was significantly related to the household income level. In conclusion, the K-HFSS would be used as a reliable and valid instrument to assess food security status in parts of the Korean population.
Although food insecurity might be associated with poor dietary intake, this relationship has not been researched in Korea. This study examined the association of food security with dietary intake from the third Korea National Health and Nutrition Examination Survey. Food security was measured by a self-reported hunger measure on the dietary situation of subjects' households in the previous year and approximately 2/3 of the subjects lived in food-insecure households. Dietary intake was based on a 24-hour dietary recall. Food insecurity was significantly associated with low nutrients intake and nutrients intake compared to dietary reference intakes (DRI) was also lower among subjects in food-insecure households. Overall diet quality based on dietary diversity score (DDS) was worse in food-insecure subjects. Food security should be considered an important issue to public health because dietary change due to food insecurity may affect health status.
BACKGROUND/OBJECTIVES: Relocation to new environments can have a negative impact on health by altering body weight and dietary patterns. This study attempted to elucidate changes in body weight, food security, and their current food and nutrient consumption in adult North Korean refugees (NKR) living in South Korea (SK). SUBJECTS/METHODS: This study analyzed data on 149 adult NKR from a North Korean refugee health in SK cohort at four time points (leaving North Korea, entering SK, first examination, and second examination). Body weight was self-reported at the two earlier time points and directly measured at the two later time points. Food security, diet-related behaviors (dietary habits and food consumption), and sociodemographic information were obtained using a self-administered questionnaire. Nutrient intake information was obtained by one-day 24-hour recall. Statistical analyses were performed with SPSS ver 23.0. RESULTS: Body weight increased during relocation by an average of 4 kg, although diversified patterns were observed during the settlement period in SK. Approximately 39.6% of subjects maintained their body weight between the first and second examinations, whereas 38.6% gained and 22.1% lost at least 3% of their body weight at the first examination by the second examination. Food security status improved from 12.1% food secure proportion to 61.7%. NKR showed generally good food and nutrient consumption (index of nutrient quality: 0.77-1.93). The body weight loss group showed the most irregular meal consumption pattern (P < 0.05), and eating-out was infrequent in all three groups. Consumption frequencies of food groups did not differ by group, except in the fish group (P = 0.036). CONCLUSION: This study observed considerable body weight adjustment during the settlement period in SK after initial weight gain, whereas food security consistently improved. More detailed understanding of this process is needed to assist healthy settlement for NKR in SK.
In order to provide basic data for the means to improve food situation and nutritional status of those supported by the National Basic Livelihood Security System (NBLSS), we examined household food insecurity and nutritional status of children under the support of NBLSS. This study included 209 children aged 3-12 years (99 boys and 110 girls) and their caretakers. We measured house food insecurity using Radimer/cornell Scale, children's body sizes and nutrient intake by semi-quantitative food frequency questionnaire, and caretakers' nutritional management skills. Only 9.6% of the households were in food secured (FS) while 8.1% were in household food insecured, but without hunger (HFI), 42.1% were in adult food insecured with hunger (AFI), and 40.2% were in child hungry (CH). Important predictors of food security were nutritional management skills of the caretakers as well as their education, but neither income nor food expenditure of the households. Mean energy intake of the children was 86.0% of the Korean Recommended Dietary Allowance (RDA). Intakes of protein, phosphorous, vitamin A and B$_1$ were relatively high ranging from 112.3% to 124.4% of the RDAs while those of calcium, iron, niacin, vitamin C were low showing 74.8-83.3% of the RDAs. Height, weight and weight/height ratio were close to the reference levels. Lower nutrient intakes of children were observed as the households were more food insecured. However, nutrient intakes and body sizes of children did not differ as a function of household socioeconomic status representing by income, food expenditure and caretakers' education. Results of this study suggest the importance of food security and nutritional management skills for the children's nutrient intakes. Concerning this matter, a need for nutrition education in the program for NBLSS was discussed.
This study was conducted to develop a construct model regarding the daily activities, emotional security provided by food, enjoyment of food, level of satisfaction with delivered food, and the quality of life of homebound seniors who benefitted from meal delivery programs. The data were analyzed by SAS 9.2 and the Structural Equation Model (SEM), which was created by Analysis of Moment Structure (AMOS) 5.0 packages. The reliability of the data was confirmed by an exploratory factor analysis and through a Cronbach's alpha coefficient, and the measurement model proved to be appropriate by a confirmatory factor analysis of the measurement model in conjunction with AMOS. The results of the correlations between all the variables showed significant positive correlations (P < 0.05). The path analysis demonstrated that the daily activities (P < 0.01) and the emotional security created by food (P < 0.05) had positive correlations with the foodservice satisfaction (P < 0.05), while the daily activities (P < 0.05), the sense of emotional security made by food (P < 0.05), and food enjoyment (P < 0.05) also presented significant positive correlations with the quality of life. However, the food service satisfaction was shown to directly, but not significantly, affect the quality of life. This revealed that the current meal delivery programs needed to be improved in several directions.
BACKGROUND/OBJECTIVES: This cross-sectional study assessed household food security status and determined its association with diet quality and weight status among indigenous women from the Mah Meri tribe in Peninsular Malaysia. SUBJECTS/METHODS: The Radimer/Cornell Hunger and Food Insecurity Instrument and the Malaysian Healthy Eating Index (HEI) were used to assess household food security status and diet quality, respectively. Information on socio-demographic characteristics and 24-hour dietary recall data were collected through face-to-face interview, and anthropometric measurements including weight, height, and body mass index (BMI) were obtained from 222 women. RESULTS: Majority of households (82.9%) experienced different levels of food insecurity: 29.3% household food insecurity, 23.4% individual food insecurity, and 30.2% fell into the child hunger group. The food-secure group had significantly fewer children and smaller household sizes than the food-insecure groups (P < 0.05). The mean household income, income per capita, and food expenditure significantly decreased as food insecurity worsened (P < 0.001). The food-secure group had significantly higher Malaysian HEI scores for grains and cereals (P < 0.01), as well as for meat, poultry, and eggs (P < 0.001), than the food-insecure groups. The child-hunger group had significantly higher fat (P < 0.05) and sodium (P < 0.001) scores than the food-secure and household food-insecure groups. Compared to the individual food-insecure and child-hunger groups, multivariate analysis of covariance showed that the food-secure group was significantly associated with a higher Malaysian HEI score while the household food-insecure group was significantly associated with a higher BMI after controlling for age (P < 0.025). CONCLUSIONS: The majority of indigenous households faced food insecurity. Food insecurity at the individual and child levels was associated with lower quality of diet, while food insecurity at the household level was associated with higher body weight. Therefore, a substantial effort by all stakeholders is warranted to improve food insecurity among poorer households. The results suggest a pressing need for nutritional interventions to improve dietary intake among low income households.
This study evaluated the satisfaction and healthy eating index of nutrition-plus program providing nutritional supplements to pregnancy, lactating women, infant and children. This program was carried out at Public Healthcare Center, Seodaemun-gu in Seoul from February 2014 to June 2014. The subject selected among applicants for low income family financing of the government included 159 subjects. There was no statistically significant difference for degree of satisfaction with supplementary food by age, but the degree tends to get higher at lower age. Degree of satisfaction with supplementary food by the duration for participation was shown higher as the duration gets longer. For questions of 'Do you check nutrition label?' and 'Do you preserve food as described at food label?' in healthy eating index evaluation, the scores appeared higher at younger age group as they check the nutrition label more. Also as the duration for participation gets longer, the scores appeared higher which can be interpreted as effect of nutrition education from Nutrition-Plus. Frequency of having breakfast gets lower at higher age of subjects. And it gets higher as the duration for participation gets longer even though that there's no difference between '3 to 4 months' and '5 to 8 months' of the duration of participation. For evaluation of food security in recent 1 year, 86.8% of subjects responded 'Food sufficiency' and 'Enough but not always the kinds of food we want', and there is no difference by age and the duration of participation. As a result of this research, it is shown that the subjects of nutrition support project are relatively satisfied with the support. And healthy eating index gets improved as the duration of participation gets longer which can be considered as effect of nutrition education. It seems to be necessary to keep nutrition education as well as food support so to perform food life education on appropriate purchase and consumption of food.
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