• 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.

• Korean Journal of Community Nutrition
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• v.14 no.6
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• pp.831-845
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• 2009

Hypertension and obesity are important modifiable risk factors for cardiovascular disease, the leading cause of death in Korea. Therefore, we assessed the association between dietary pattern and obesity in hypertensive patients to formulate health promotion strategies for the older population. Dietary information was collected from hypertensive patients visiting community health education and information center by using 24 hour recall method. The 2005 DRIs for Koreans was used to evaluate the dietary adequacy. When subjects were categorized by body mass index (BMI) as normal, overweight and obese, no significant difference in energy intake was found among groups. Dietary intakes of folate, and vitamin C in obese hypertensive patients were significantly lower than in normal weight patients (p < 0.05). When we compare the nutritional status by waist circumferences, dietary intakes of zinc, vitamin A, thiamin, vitamin C and folate were significantly lower in the obese group. Vegetable intake was significantly lower in the obese group according to BMI as well as waist circumference. Energy intake from carbohydrate was significantly higher in obese hypertensive patients (p < 0.05). Obese hypertensive patients had a higher risk of nutritional inadequacy compared to normal weight patients. Our results indicated the need for developing interventions that encourage greater consumption of vegetables while cutting down salt intake with wise selection of staple foods, for obese hypertensive patients.

• Korean Journal of Community Nutrition
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• v.24 no.2
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• pp.152-162
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• 2019

Objectives: The purpose of this study was to investigate the food, nutrient intake, and diet quality of postmenopausal women at high risk of osteoporosis (OP) and cardiovascular disease (CVD) compared with those of control subjects. Methods: A total of 1,131 post-menopausal women aged over 45 years, who took the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES), were included for analysis. These participants were classified into the following groups: the OP group, with a risk of OP (n=135); the CVD group, with a risk of CVD (n=373); the OP+CVD group, with a risk of OP and CVD concurrently (n=218); and the control group (n=405) according to bone mineral density (BMD) and CVD risk. Anthropometric measurements, blood profiles, dietary intake, and dietary quality indices were measured and compared among the four groups. Results: Waist circumference, total body fat percentage, blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and LDL-cholesterol were higher, and HDL-cholesterol and BMD were lower in the OP+CVD group than in the control group. In the food frequency questionnaire, the OP+CVD group had significantly higher frequencies of grain (except for multi-grain) and lower frequencies of fruit and dairy product. The frequency of consumption of red meat, processed meat, and carbonated beverages was higher in OP+CVD group. In nutrient density analysis, proteins and vitamin $B_2$ levels were significantly lower in the OP+CVD group than in the control group. The nutritional quality index (INQ) values of calcium were in the order of 0.63, 0.58, 0.56, and 0.55 in each group, and it was urgent to improve the dietary intake for calcium in postmenopausal women. In addition, vitamin $B_2$ was inadequately consumed by all groups. Conclusions: These results suggest that it is necessary to increase the intake of vitamin $B_2$ and calcium and decrease the frequency of intake of red meat, processed meat, and carbonated beverages in postmenopausal women with the risk of OP and CVD.

• Korean Journal of Community Nutrition
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• v.26 no.4
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• pp.280-295
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• 2021

Objectives: This study aimed to examine the characteristics of patients according to their nutritional status as assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 at the Samsung Medical Center were included. We categorized patients into malnourished and normal according to the five nutritional screening tools 1 month after surgery and compared their characteristics. We also calculated the Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each pair of screening tools. Results: We observed 86.24% malnutrition based on the PG-SGA and 85.82% based on the NUTRISCORE among gastric cancer patients in our study. When we applied NRI or CONUT, however, the malnutrition levels were less than 30%. Patients with malnutrition as assessed by the PG-SGA, NUTRISCORE, or NRI had lower intakes of energy and protein compared to normal patients. When NRI, PNI, or CONUT were used to identify malnutrition, lower levels of albumin, hemoglobin, total lymphocyte count, total cholesterol, and longer postoperative hospital stays were observed among patients with malnutrition compared to those without malnutrition. We found relatively high agreement between PG-SGA and NUTRISCORE; sensitivity was 90.86% and AUC was 0.78. When we compared NRI and PNI, sensitivity was 99.64% and AUC was 0.97. AUC ranged from 0.50 to 0.67 for comparisons between CONUT and each of the other nutritional screening tools. Conclusions: Our study suggests that PG-SGA and NRI have a relatively high agreement with the NUTRISCORE and PNI, respectively. Further cohort studies are needed to examine whether the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

• Journal of Nutrition and Health
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• v.28 no.11
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• pp.1117-1128
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• 1995

This study investigated whether social and psychological factors were related to nutritional status of the elderly. Food habits, social contacts and psychological the test score were collected from 86 institutionalized elderly women aged 65-96 in Chon-buk area. Social health status was measured by score of social contacts with others. Depression, self-esteem and locus of control were measured to evaluate psychological health status by using Zung DSI(Depression Status Intentory), Rosenberg SES(Self-esteem scale) and Rotter's vs external control, respectively. Social contacts of the total subjects were lowered, and in the group of over 85, contacts with relatives were significantly decreased compare to under 85 years of age groups. Psychological health status such as depression and self-esteem were also lowered, but locus of control showed internal control that indicates positive attitude to eating behavior. Most of the nutrients intake were positively correlated to self-esteem scores(p<0.05), but not to nutritional risk index score. Intake of vitamin C was related to social health status as well as psychological health status. Increasing the number of contact with relatives, intakes of carbohydrates, fiber, vit B1, vit C, Ca and P were elevated(p<0.05). As the score of self-esteem increased, intakes of fiber, Fe, vit B1, niacin, vit C, and vit A were increased. It is suggested that social activity and health education programs will be needed to improve the nutritional status of the institutionalized elderly.

• Korean Journal of Community Nutrition
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• v.16 no.6
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• pp.706-715
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• 2011

This study aims to identify the dietary patterns relevant to obesity of Korean women among low income classes. Adults 20-64 years were used as study subjects from the data of 2005 Korea National Health and Nutrition Examination Survey. We compared obese and normal-weight women in terms of their nutrients intake, diet quality and food patterns. Diet quality was assessed by using the Nutritional Adequacy Ratio (NAR) and Index of Nutritional Quality (INQ). Our results showed higher prevalence of obesity among lower socioeconomic status women. In men, there were no significant associations with socioeconomic status and prevalence of obesity. Higher risk of nutritional inadequacy was observed among obese women compared to normal weight women. Obese women showed significantly lower INQ for nutrients such as Ca, Fe, Vitamin A, Thiamin, Riboflavin and Vitamin C compared to other women. They consumed significantly higher amount of rice (p < 0.05) and lower amount of vegetables (p < 0.01). By contrast, obese men from low income classes showed higher intake of those nutrients. Obese men also consumed significantly higher amount of meats than normal weight men. Therefore, this study suggests that gender-specific approaches based on economic situation should be considered in developing the intervention program for managing obesity for low income classes.

• Korean Journal of Community Nutrition
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• v.27 no.3
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• pp.205-222
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• 2022

Objectives: This study examined the characteristics of patients according to nutritional status assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 were included. The patients were categorized into malnutrition and normal status according to five nutritional screening tools one month after surgery. The Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each two screening tools were calculated. Results: Malnutrition was observed in 86.24% of patients based on the PG-SGA and 85.82% based on the NUTRISCORE. When NRI or CONUT were applied, the proportions of malnutrition were < 30%. Patients with malnutrition had lower intakes of energy and protein than normal patients when assessed using the PG-SGA, NUTRISCORE, or NRI. Lower levels of albumin, hemoglobin, total lymphocyte count, and total cholesterol and longer postoperative hospital stays were observed among patients with malnutrition compared to normal patients when NRI, PNI, or CONUT were applied. Relatively high agreement for NUTRISCORE relative to PG-SGA was found; the sensitivity was 90.86%, and the AUC was 0.78. When NRI, PNI, and CONUT were compared, the sensitivities were 23.72% for PNI relative to NRI, 44.53% for CONUT relative to NRI, and 90.91% for CONUT relative to PNI. The AUCs were 0.95 for NRI relative to PNI and 0.91 for CONUT relative to PNI. Conclusions: NUTRISCORE had a high sensitivity compared to PG-SGA, and CONUT had a high sensitivity compared to PNI. NRI had a high specificity compared to PNI. This relatively high sensitivity and specificity resulted in 77.00% agreement between PNI and CONUT and 77.94% agreement between NRI and PNI. Further cohort studies will be needed to determine if the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

• Journal of Nutrition and Health
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• v.45 no.3
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• pp.240-251
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• 2012

Assessment regarding the nutritional status of Parkinson's disease (PD) patients is important because their nutritional status influences the outcome of disease. The purpose of this study investigated the dietary habits, dietary quality, and quality of life for Korean PD patients according to their nutritional status. Seventy PD patients were recruited from K University Hospital (KMC IRB#0918-07) from February 2010 to October 2011. To diagnose PD, the United Kingdom Parkinson's Society Brain Bank standards were used by a neurology physician. The participants were interviewed and assessed using various tools, including a general questionnaire, anthropometrics, questionnaires for dietary habits, dietary diversity score (DVS), dietary variety score (DVS), diet quality index-international (DQI-I), beck depression inventory (BDI), the Korean version of mini mental state examination (K-MMSE), and 36-item short-form health survey (SF-36). The results of the study were as follows: 1) Most of the PD patients (69.0%) were at risk of malnutrition, and 8.5% and 22.5% of the subjects were malnourished and well-nourished, respectively. 2) Clinical symptoms (swallowing and chewing difficulties) were obvious, and the quality of diet (DDS, DVS, DQI-I) was low in the malnourished group (p < 0.01). 3) The malnourished group had significantly lower scores regarding SF-36 (quality of life) as well as that of cognitive function (p < 0.05). 4) The nutritional status of PD patients was significantly correlated with their depression (p < 0.05) and quality of life (p < 0.01). These results indicate that appropriate nutritional management will improve the nutritional status and quality of life as well as the cognitive function in Parkinson's disease patients.

• Korean Journal of Community Nutrition
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• v.27 no.3
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• pp.223-244
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• 2022

Objectives: This study was designed to investigate the relationship between metabolic risk factors, Index of Nutrition Quality, and the dietary quality index score of Korean adults. Methods: The subjects were 18,652 Korean adults aged 19 years or older (7,899 males, 10,753 females) who participated in the 2016-2019 Korea National Health and Nutrition Examination Survey. Subjects were divided into normal, pre-metabolic syndrome, and metabolic syndrome (MetS) groups according to the number of their metabolic risk factors. Data were analyzed using the SPSS program. Results: About 44.7% of men in the MetS group were at least college graduates (P < 0.001), whereas 52.0% of women in the MetS group were middle school graduates or lower (P < 0.001). The frequency of fruit and dairy products intake tended to decrease as the number of metabolic risk factors increased in both men and women (P for trend < 0.001). As the number of metabolic risk factors decreased, the frequency of grain intake tended to decrease in men (P for trend < 0.001) while the frequency of intake of red meat (P for trend = 0.001), poultry (P for trend < 0.001), and eggs (P for trend < 0.001) decreased in women. The total scores of Diet Quality Index-International (DQI-I) (men P < 0.001, women P < 0.01) and Korean Healthy Eating Index (KHEI) (men and women P < 0.001) were significantly lower in the MetS group compared to the other groups, and the total score of DQI-I and KHEI tended to decrease as the number of metabolic risk factors increased. Conclusions: Dietary quality evaluation using various indices can provide more information on the dietary problems related to metabolic risk factors. Nutrients and foods that have been confirmed to be related to metabolic risk factors can be used to develop dietary guidelines for the nutritional management of metabolic diseases.

• Journal of Gastric Cancer
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• v.22 no.2
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• pp.145-155
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• 2022

Purpose: Weight loss and deterioration in body composition are observed in patients with gastric cancer (GC) following gastrectomy. This study aimed to investigate the impact of residual stomach volume (RSV) on the nutritional status and body composition of patients with GC treated with distal gastrectomy. Materials and Methods: In total, 227 patients who underwent minimally invasive distal gastrectomy with Billroth 1 anastomosis for stage I GC between February 2015 and May 2018 were enrolled. Clinicodemographic and laboratory data were collected from the GC registry. The RSV, abdominal muscle area, and subcutaneous/visceral fat areas were measured using computed tomography data. Results: A larger RSV was associated with a lower decrease in the nutritional risk index (P=0.004) and hemoglobin level (P=0.003) during the first 3 months after surgery, and better recovery at 12 months. A larger RSV demonstrated an advantage in the preservation of abdominal muscle area (P=0.02) and visceral fat (P=0.04) after surgery, as well as less reduction in weight (P=0.02) and body mass index (P=0.03). Conclusions: Larger RSV was associated with improved nutritional status and better preservation of muscle and fat after distal gastrectomy.