• Nutrition Research and Practice
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• v.14 no.6
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• pp.679-690
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• 2020

BACKGROUND/OBJECTIVES: Concerns about regional disparities in heathy eating and nutritional status among South Korean adults are increasing. This study aims to identify the magnitude of regional disparities in diet and nutritional status among Korean adults who completed the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: The participants were a nationally representative sample of Korean adults aged 19 years and older from the 2017 KNHANES (n = 6,126). We employed the svy commands in STATA to accommodate the complex survey design. The relative concentration index (RCI), absolute concentration index (ACI) and index of disparity were used to measure regional nutritional inequalities. RESULTS: Overweight and obese adults were more prevalent among the poor than among the rich in urban areas (RCI = -0.041; P < 0.05), while overweight and obese adults were more prevalent among the rich than among the poor in rural areas of South Korea (RCI = 0.084; P < 0.05). Economic inequality in fruit and vegetable intake ≥ 500 g per day was greater in rural areas than in urban areas in both relative size (RCI = 0.228 vs. 0.091, difference in equality = 0.137; P < 0.05) and absolute size (ACI = 0.055 vs. 0.023, difference in equality = 0.032; P < 0.05). CONCLUSIONS: This study provides useful information identifying opposite directions in the relative concentration curves between urban and rural areas. Adult overweight/obesity was more prevalent among the poor in urban areas, while adult overweight/obesity was more prevalent among the rich in rural areas. Public health nutrition systems should be implemented to identify nutritional inequalities that should be targeted across regions in South Korea.

• Korean Journal of Community Nutrition
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• v.21 no.5
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• pp.405-414
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• 2016

Objectives: The associations between the eating behavior and energy and macronutrient intake from meals and snacks consumed during different times of the day across the menstrual cycle were investigated in 74 healthy female college students. Methods: A 9-day food record was collected during the last 3 days before menstrual onset (phase 1) and the first 3 days after menstrual onset (phase 2) and from the 4th to the 6th day after menstrual onset (phase 3), respectively. Anthropometry was assessed and eating behaviors were measured using the Dutch Eating Behavior Questionnaire (DEBQ). Results: External eating was the most prevalent type of eating behavior, followed by restrained eating and emotional eating. Restrained eating was positively associated with energy, carbohydrate and lipid intake at the breakfast and midmorning snack during phase 3. However, emotional eating was also positively related to energy and macronutrient intake at the dinner and after-dinner snack during phase 1 and phase 3, with higher level detected in the phase 1. The association of emotional eating with the snack consumption was highest in phase 1. External eating was positively associated with energy and macronutrient intakes at the dinner and after-dinner snack across the three phases, the highest level being phase 1. In addition, restrained eating was positively associated with the weight, body mass index(BMI), fat mass, waist and hip girth of the subjects. Conclusions: Eating behaviors varied with regard to meals and snacks consumed during different times of the day across the three menstrual phases. Dinner and afterdinner snack consumption in premenstrual phase could be considered as a time when women are more prone to overconsumption and uncontrolled eating.

• Clinical Nutrition Research
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• v.12 no.2
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• pp.116-125
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• 2023

The present study sought to examine the association between an infant's anthropometric outcomes with maternal Dietary Inflammatory Index (DII) and Alternate Healthy Eating Index for Pregnancy (AHEI-P) scores during the third trimester of pregnancy. This prospective cohort study was applying 130 pregnant women, at the pregnancy training center in west Tehran, Iran (November 2020 to July 2021). The maternal dietary intake, and body mass index (BMI), and social economic level were evaluated. The data about birth weight, birth height, head circumference, and, gestational age at birth were extracted from each child's health records. The ultimate sample included 122 (93.8%) pairs of women/newborn children. The participants, mean age was 28.13 ± 4.66 years with gestational age between 28 to 40 weeks and the mean of BMI was 24.62 ± 3.51. Our outcomes, after adjustment for confounding factors, suggested that those newborn infants in the highest quartile of maternal DII score had a significantly lower weight (p < 0.001) and height (p = 0.05), in comparison to those in the lowest quartile, but not head circumference (p = 0.18). Moreover, after adjustment for confounding factors, results suggested that those newborn infants in the First quartile of maternal AHEI-P score had a significantly lower weight (p = 0.018) and, in comparison to those in the higher quartile. It appears that newborn infants with lower maternal DII and higher AHEI-P scores may have a better anthropometric outcome. Further longitudinal and in-depth qualitative and quantitative studies, with a longer-term follow-up, is warranted to support the integrity of our outcomes.

• Nutrition Research and Practice
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• v.12 no.2
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• pp.135-142
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• 2018

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.

• Journal of Nutrition and Health
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• v.55 no.5
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• pp.558-571
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• 2022

Purpose: The purpose of this study was to analyze the dietary intake of Korean adults with atopic dermatitis (AD) to determine whether the risk of developing AD was related to their diet. Methods: Among the participants in the 7th National Health and Nutrition Survey (2016 to 2018), 10,571 adults aged 19-64 were divided into AD (AD group, n = 366) and control groups (non-AD group, n = 10,205) to compare and analyze their nutrient intake status and Korean Healthy Eating Index (KHEI) score. Depending on the prevalence of AD, the nutrient intake, nutrient intake per 1,000 kcal, acceptable macronutrient distribution range, and KHEI score were tested for significance by correcting for age, sex, body mass index, education, marriage, occupation, residence area, physical activity, and energy intake variables that were derived for confounding factors. Results: The acceptable macronutrient distribution range for protein was lower in the AD group than in the non-AD group. Comparing the nutrient intake per 1,000 kcal, the intakes of protein, phosphorus, iron, and potassium of the AD group were significantly lower than those of the non-AD group. In the KHEI, the scores of total vegetables, vegetables excluding kimchi and pickles, meat, fish, eggs, and legumes of the AD group were significantly lower than those of the non-AD group. In addition, as these food intake scores increased, the risk of AD significantly decreased. Conclusion: In conclusion, adult AD patients had low intakes of vegetables, meat, fish, eggs, and legumes, and it was confirmed that high intakes of these foods may be associated with low AD risk. Therefore, we suggest that an adequate intake of vegetables and foods containing protein would be necessary for the management and treatment of AD in adults.

• Journal of Nutrition and Health
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• v.57 no.1
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• pp.88-104
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• 2024

Purpose: High-sensitivity C-reactive protein (hs-CRP) is primarily synthesized in the liver upon stimulation of infectious disease cytokines, such as interleukin-6 (IL-6), and is used as a biological marker of systemic inflammation. Previous studies reported that hs-CRP is closely related to diet and abdominal obesity. Furthermore, a dietary score favoring the consumption of vegetables, fruits, and whole grains over meat and saturated fat reduced inflammation and decreased the prevalence of obesity and abdominal obesity. Nevertheless, no studies have examined whether hs-CRP mediates the relationship between dietary scores and abdominal obesity, and research on the Korean Healthy Eating Index (KHEI) is lacking. Therefore, the present study examined the association between the KHEI and abdominal obesity and the mediating effect of hs-CRP. Methods: In total, 17,770 adults aged ≥19 years were included in the study using the Korea National Health and Nutrition Examination Survey 2015-2018. KHEI was developed to assess the overall diet quality of Korean adults. Multivariable linear and logistic regression analyses assessed the relationship between KHEI, hs-CRP, and abdominal obesity. The mediation analysis with the bootstrapping method was performed using SAS MACRO. Results: Among women, the odds ratio (OR) of abdominal obesity prevalence was lower in the highest KHEI compared to the lowest KHEI after adjusting for age, body mass index, educational level, income level, occupational status, marital status, household type, region type, alcohol consumption, smoking status, physical activity, total energy intake, and hsCRP (OR 0.744, 95% confidence interval 0.598-0.926). The association between KHEI and abdominal obesity was partially mediated via hs-CRP, and the mediated proportion was 68.7% in men and 38.1% in women. Conclusion: A substantial relationship was observed between the KHEI and abdominal obesity among females. Moreover, according to the KHEI, abdominal obesity may be mediated partially by hs-CRP.

• Journal of the Korean Society of Food Culture
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• v.29 no.6
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• pp.648-658
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• 2014

The aim of this study was to investigate the relationships between eating habits and health among adolescents in Shanghai and Heze, China. A cross-sectional study was conducted in 2013 on 2,089 adolescents; 1,089 students were from Shanghai and 999 students from Heze region. Eating habits, weight, height, and nutritional knowledge were assessed using a self-administered questionnaire. Eating habits score was classified into two categories: healthy eating habits and unhealthy eating habits, based on "Korean Youth Risk Behavior Web-based Survey", for statistical data analysis. Associations between eating habits, BMI, and nutritional knowledge were examined using a general linear model with adjustment of potential confounding factors such as region, gender, age, parents' education level, and pocket money. Statistical analyses were performed using the SAS (version 9.3) program. Proportions of healthy eating habits group were 90.0% for breakfast (3-7 times/wk), 29.1% for fruit (${\geq}once/d$), 12.5% for vegetable (${\geq}3times/d$), 7.3% for milk (${\geq}2times/d$), 90.0% for fast food (<3 times/wk) consumption, respectively. The average BMI score was 20.1 (Shanghai 20.5 Heze 19.6), which is in the range of normal weight. Rates of obesity and overweight were 16.5% and 8.3% in Shanghai and Heze, respectively. There were significant negative correlations between intake frequencies of breakfast, fast food, biscuits, sugar, chocolate, and BMI score. Eating habits and nutritional knowledge score showed a significant positive correlation. These results showed better eating habits regarding eating regularity and consumption of fruits and soft drinks in Chinese adolescents compared with Korean adolescents, although cultural differences were not fully considered. This study demonstrated significant associations of BMI and nutritional knowledge with dietary behavior in Chinese adolescents in two regions of China. Further studies on Chinese adolescents from other regions in China should be considered.

• Nutrition Research and Practice
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• v.17 no.4
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• pp.717-734
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• 2023

BACKGROUND/OBJECTIVES: This study aimed to identify preschool children's eating behaviors associated with early childhood obesity and its multi-level, socio-ecological determinants. SUBJECTS/METHODS: In a cross-sectional study of 364 mothers of preschool children aged 3-5 years, these children's healthy eating behaviors were assessed using a validated preschool nutrition quotient (NQ-P) questionnaire. The children's overweight or obesity statuses were determined based on body mass index percentiles from the 2017 Korean National Growth Chart. The associations between the NQ-P score and risk of overweight or obesity were examined using multivariable logistic regression. The associations of individual, maternal, physical, and media environmental factors with the NQ-P score were also examined using multivariable linear regression. RESULTS: Preschool children with greater NQ-P scores were at a significantly lower risk of overweight or obesity (P < 0.01). The NQ-P score had a significantly positive association with maternal body mass index and an inverse association with household income (all P < 0.05). Maternal parenting and feeding practices exhibited associations with the NQ-P score. Positive associations were observed with "warm," "structured," and "autonomy-supportive" parenting as well as monitoring feeding practices (all P < 0.05). In addition, the NQ-P score had a significantly positive association with the childcare center's anti-obesogenic environment, such as the provision of nutritional and physical-activity support and vicinity of the built food environment to the home, including access to good-quality food, fruits and vegetables, and low-fat foods (all P < 0.05). Regarding media environments, the NQ-P score demonstrated more significant associations with viewing and eating and/or cooking content displayed on online video platforms (all P < 0.05) than with that on television. CONCLUSIONS: Our findings confirm the significance of healthy eating behaviors in early-childhood-obesity prevention and underscore the importance of multilevel maternal, physical, and media environmental interventions that effectively guide eating behaviors in preschool children.

• Nutrition Research and Practice
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• v.17 no.2
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• pp.269-283
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• 2023

BACKGROUND/OBJECTIVES: This study aimed to examine the food security status of urban poor adolescents and its association with diet quality. SUBJECTS/METHODS: A cross-sectional survey was conducted among 188 adolescents aged 13-18 yrs living in Kuala Lumpur, Malaysia. Household food insecurity and dietary intake data were collected using the Radimer/Cornell hunger and food insecurity instrument and 2-day 24-h dietary recalls, respectively. Diet quality was determined using the Malaysian Healthy Eating Index (HEI). Weight and height were measured and body mass index-for-age, as well as height-for-age z scores were calculated. RESULTS: The present study revealed that 47.9% of the adolescents experienced household food insecurity, 24.5% experienced individual food insecurity, 18.6% household food security, and 9.0% child hunger. The mean score of diet quality was 56.83 ± 10.09, with a significantly lower HEI score among food insecure adolescents (household food insecure, individual food insecure, and child hunger) than household food secure adolescents (P = 0.001). The differences between food secure and food insecure households were found to be significant for energy (P = 0.001) and nutrients including proteins (P = 0.006), carbohydrates (P = 0.005), dietary fiber (P = 0.001), folate (P < 0.001), and vitamin C (P = 0.006). The multiple linear regression showed that adolescents who experienced food insecurity (β = -0.328; P = 0.003) were found to be significantly associated with poor diet quality (F = 2.726; P < 0.01), wherein 13.3% of the variation in the diet quality was explained by the food security status. CONCLUSIONS: Experiencing food insecurity contributed to poor diet quality among urban poor adolescents. Further longitudinal studies are needed to comprehensively understand this association to improve food insecurity and diet quality among urban poor communities.

• Korean Journal of Community Nutrition
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• v.21 no.1
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• pp.102-111
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• 2016

Objectives: The intention of this study was to find out the impact of mother's body mass index, eating habits, nutrition status and sociodemographic factors on the body mass index of the children. Methods: The study used original data of Korea National Health and Nutrition Examination Survey (2010-2011) and had 957 children in the ages of 1-5 years and 957 mothers of these children, a total 1,914 as subjects. The weights (body mass indexes) of the children, subjects under 5th percentile were classified into a underweight group, 5~84th percentile into a normal weight group, 85-94th percentile into an overweight group and more than 95th percentile into an obesity group based on the 2007 Korean children and adolescents growth chart. Results: We observed that when the body mass index of a mother increased by 1, the possibility that her child would belong to the overweight group increased by 6.5% (95% confidence interval: 1.01~1.13), and the possibility that the child would belong to the obesity group increased by 95% (confidence interval: 1.01~1.18). With regard to the number of deficient nutrients which were ingested according to estimated average requirements (EAR) amid nutrients ingested by the mother increased by 1, the possibility that the child would belong to the obesity group increased by 16.6% (95% confidence interval: 1.01~1.35). In case the birth weight of child increased by 1kg, the odds ratio that the child would belong to the obesity group was 2.022 (95% confidence interval: 1.08~3.77). Conclusions: We conclude that the body mass index, eating habits and nutrition status of the mother had significant effects on the body mass index of the child. Therefore, it is critical to recognize the importance of this observation and provide practical training for eating habits and nutrient intakes in order to achieve healthy growth and prevention of obesity among children.