• 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.

• Journal of Nutrition and Health
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• v.51 no.5
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• pp.433-444
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• 2018

Purpose: This study examined the status and needs of school-based nutritional education programs for reducing sugars intake in elementary schools. Methods: A total of 230 elementary nutrition teachers participated in this study through an online survey in July 2017. Results: Approximately one-third of the schools conducted nutrition education on reducing sugars intake as a main topic. The most frequent educated grade and education period were $4^{th}$ and $3^{rd}$ grade, and once a year. Most of the nutrition teachers answered that nutrition education related to reducing sugars intake for children was necessary. The nutrition teachers answered that first graders were the recipients in most need of nutrition education for reducing sugars but, realistically, third graders were the most suitable for nutrition education. The appropriate education topics were limited to the lower grades, such as sugars consumption related health problems, foods containing high sugars, and behaviors to reduce sugars intake; however, a wider variety of topics were selected for the upper grades. The experiment was considered to be an effective educational method for both the lower and upper grades. The most appropriate nutrition education media appeared to be a mock-up in the lower grades, and an experiment kit in the upper grades. Games and videos were highly considered to be effective media to educate students in reducing sugars consumption by voluntary participation in free time in the classroom in both the lower and upper grades. Conclusion: Nutrition education programs focusing on sugars intake reduction were conducted in some elementary schools, but the training time was short and the types of activities were limited. The perception and demand for nutrition education was very high. Therefore, the development and dissemination of elementary school-based nutritional education programs for sugars intake reduction is urgently needed. Moreover, to develop an effective nutrition education program, the education environment and demand in the field should be fully considered.

• Journal of Nutrition and Health
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• v.54 no.4
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• pp.355-372
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• 2021

Purpose: This study aimed to provide baseline data for establishing a sugar reduction policy at coffee shops by analyzing the factors that affect a coffee shop user's perception and behavioral intention of reducing sugar intake. Methods: An online survey was conducted involving 1,274 Daegu citizens aged 19-49 years, who had visited coffee shops within the last month. Results: When visiting a coffee shop, the purchase of sweet drinks was higher in the younger age group, and the addition of syrup or sugar was higher in the older age group. Of the total respondents, 42.1% were aware that some coffee shops accommodate reduced sugar requests, 57.9% perceived the need to reduce sugar in coffee shop beverages and 22.3% had purchased beverages intending to reduce their sugar intake. In addition, 59.7% knew about sugar nutrition labeling, and 68.8% perceived the need for nutrition labeling for sugar. When purchasing beverages, 35.6% checked the nutrition labeling, and 77.2% purchased alternative drinks when the sugar content was high. Guiding the choice of sweetness levels in coffee shop orders was seen to have the highest effectiveness and intention to reduce sugar intake. Moreover, the perceived need to reduce sugar intake had the most positive effect on the behavioral intention to reduce sugars in coffee shop beverages (β = 0.558, p < 0.001). Conclusion: Although the overall awareness and practice of reducing the sugar intake in coffee shop users were low, the behavioral intention to reduce sugars was positive, and this was most affected by the perception of the need to reduce sugars. Therefore, there is a need for differentiated education and promotion for each age group for recognizing the necessity and outlining methods for reducing sugar intake. Furthermore, coffee shops should reflect customer's sugar reduction needs.

• 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.

• Nutrition Research and Practice
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• v.12 no.4
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• pp.307-314
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• 2018

BACKGROUND/OBJECTIVES: Numerous researches have studied the association between sugar intake and obesity of children in many countries. This study was undertaken to investigate the association between beverage intake and obesity of children by reviewing a database for total sugar contents established in all foods and presented in a nutrition survey by the Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: Data of 1,520 children aged 6-11 years in the 6th KNHANES (2013-2015) were analyzed for this study. A database for total sugar intake comprises the total sugar contents of all foods included in the results of a nutrition survey using the 24-hour recall method of 6th KNHANES. Beverages were categorized into carbonated beverages, fruit & vegetable drinks, other drinks, tea, and coffee. RESULTS: The average daily beverage intake of all children was 131.75 g/day, and the average daily total sugar intake in beverages was 13.76 g/day. Carbonated beverages had the highest intake rate (58.85 g/day) and also ranked highest for sugar intake (6.36 g/day). After adjusting for confounding variables, the odds ratio for obesity in children with beverage intake of ${\geq}200mL/day$ significantly increased by 1.83 times (95% CI, 1.11-3.00) as compared to children with beverage intake of < 200 mL/day. Also, a significant increase was observed in the odds ratio for obesity in total children (2.41 times; 95% CI, 1.35-4.33) and boys (3.15 times; 95% CI, 1.53-6.49) with carbonated beverage intake of ${\geq}200mL/day$ when compared with children who consumed < 200 mL/day. CONCLUSION: A positive association is observed between beverage intake and obesity in Korean children. In particular, an intake of carbonated beverages has a positive correlation with childhood obesity in boys. This study can therefore be used as scientific evidence for reducing sugar, and for the continuous management and research on beverages.

• Journal of the Korean Dietetic Association
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• v.19 no.2
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• pp.112-123
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• 2013

HbA1c was recently adopted as a reliable indicator for screening diabetes. This study investigated the ability of nutrition consultation to prevent diabetes in overweight women (BMI 23 $kg/m^2$ or more) using HbA1c as an indicator. Twenty overweight and obese women (with $HbA1c{\geq}5.7$%) completed the 12-week nutritional study, with individual and personalized nutrition counseling performed every 2 weeks. The main study guidelines involved the following: 1) reducing the intake of high fat foods and alcohol, 2) consuming a large amount of vegetables, 3) reducing the intake of simple sugars and empty-calorie foods, and 4) increasing physical activity to ${\geq}30$ min/day. Anthropometric (height, weight, BMI, body muscle (kg), body fat (%), waist and hip circumference, blood pressure) and biochemical parameters (fasting blood sugar (FBS), HbA1c, lipid profiles, hs-CRP) were measured before and after the nutrition consultation. After 12 weeks, the HbA1c<5.7% group had significant decreases in BMI, WC, HC, WHR, HbA1c, hs-CRP and also dietary intake of energy (P<0.01), carbohydrates, lipids (P<0.01), proteins (P<0.01) and cholesterol was significantly decreased (P<0.05). In the HbA1c ${\geq}5.7$% group, HbA1c, TC, LDL, NON-HDL, hs-CRP and dietary intake of energy, carbohydrate, lipid, protein, and cholesterol significantly decreased (P<0.05). These results suggest that nutrition consultation effectively helps to prevent diabetes in overweight and obese women after applying HbA1c standards. Overall, the improvement in all markers measured suggest that HbA1c is a good indicator for blood glucose regulation, helping to prevent diabetes.

• Nutrition Research and Practice
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• v.13 no.2
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• pp.134-140
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• 2019

BACKGROUND/OBJECTIVES: Excessive sugar consumption may increase the risk for development of several diseases. Although average dietary sugar intake of Koreans is within the recommended level, an increasing trend has been found in all age groups. This study aimed to evaluate the population attributable fractions (PAF) to dietary sugar for disease and death in Korea, and to estimate the socioeconomic effects of a reduction in dietary sugar. MATERIALS/METHODS: The prevalence of sugar-sweetened beverages (SSB) overconsumption (${\geq}20g$ of sugar from beverages) was analyzed using the Korean National Health and Nutrition Examination Survey 2015. Disease-specific relative risks of excessive SSB consumption were obtained through reviewing previous studies. Using the prevalence of SSB overconsumption and each relative risk, PAFs for morbidity and mortality were calculated. Socioeconomic costs of diseases and death attributable to SSB overconsumption were estimated by using representative data on national medical expenditures, health insurance statistics, employment information, and previous reports. RESULTS: Disease-specific PAF to SSB consumption ranged from 3.11% for stroke to 9.05% for obesity and dental caries, respectively. Costs from disease caused by SSB overconsumption was estimated at 594 billion won in 2015. About 39 billion won was estimated to be from SSB consumption-related deaths, and a total of 633 billion won was predicted to have been saved through preventing SSB overconsumption. CONCLUSIONS: Sugars overconsumption causes considerable public burdens, although the cost estimates do not include any informal expenditure. Information on these socioeconomic effects helps both health professionals and policy makers to create and to implement programs for reducing sugar consumption.

• Journal of Community Nutrition
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• v.4 no.2
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• pp.118-129
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• 2002

Nutrition is important in the management of diabetes mellitus, however, there are few little education materials specifically designed for older adults. The objective of this study was to develop nutrition education materials for prevention and management of diabetes moll for older adults. Materials developed were a booklet and four leaflets. The contents of materials were based on lesson plans. After several revisions of the draft of materials, illustrations and icons appropriate to the contents were designed using illustrator 9.0 and Photoshop 6.0. The booklet was composed of five chapters and 40 pages. The first chapter began with an introduction about diabetes and diabetes management by diet, exercise and medication. The second chapter dealt with ideal body weight, calculation of adequate caloric intake and food exchange list. The third chapter provided information for meal planning and sample menus. The fourth chapter focused on practical tips on nutritional care of diabetes, by providing tips on reducing sugars, fat and salt, and suggestions on eating for special occasions. The fifth chapter dealt with information in case of low blood sugars, exercise and foot care. The topics of the four leaflets were “Diabetes, what is it and care”, “Food exchange list and meal planning”, “Healthy eating for diabetes”, “Special care for diabetes low blood sugars, exercise and foot care” Each leaflet was composed of six sections and was printed in large paper (B4 size) for older adults. The draft of educational materials were re-viewed by four nutrition professionals and finally pilot-tested with ten adults aged 50 and older. The characteristics of the developed materials are as follows, i) messages are delivered using simple, specific information, ⅱ) messages focused on practical applicable tips, ⅲ) various pictures, illustrations and artwork were created and inserted to enhance understanding and interest, ⅳ) sections including risk factor assessment, calculation of ideal body weight and meal planning were designed to induce the user's participation, ⅴ) sample menus and food pictures were inserted in the booklet, vi) characteristics of older adults and transformed characteristics are diversely used to help the user feel familiarity. These materials are self-explanatory and can be used by older adults. These materials also can be used widely in nutrition education at public health centers or senior centers.

• Journal of Nutrition and Health
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• v.47 no.5
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• pp.330-341
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• 2014

Purpose: The purpose of this study was to evaluate dietary habits, food intakes, nutrient intakes, and diet quality of non-alcoholic fatty liver disease in a health screening and promotion center. Methods: The total number of study subjects was 10,111 adults, where 3087 subjects (30.5%) were diagnosed as NAFLD. The dietary intakes were obtained using a food frequency questionnaire. They were then compared with the dietary reference intakes could be used in the future for development of diet and nutrition guidelines s (KDRIs). Results: Mean age of subjects in the normal group was $52.9{\pm}10.3yrs$ and body mass index (BMI) was $22.4{\pm}2.6kg/m^2$, and those of the NAFLD group were $55.1{\pm}9.2yrs$ and $25.4{\pm}2.9kg/m^2$. BMI, blood pressure of the NAFLD group were significantly higher than those of the normal group. The rates of skipping breakfast, overeating, and eating out were significantly could be used in the future for development of diet and nutrition guidelines er in the NAFLD group (p < 0.05, p < 0.000, p < 0.000 respectively). The speed of eating was fast in the NAFLD group (p < 0.000). The NAFLD group consumed significantly higher amounts of grains, meats, fish, seaweeds, kimchies, sugars, sweets, coffee, teas, and oils compared to the normal group (p < 0.05). Meanwhile, intakes of starch products, fruits, milk, and milk products were significantly lower in the NAFLD group compared with those of the normal group (p < 0.05). Riboflavin, calcium, and dietary fiber nutrient adequacy ratio (NAR) of the NAFLD group were significantly lower than those of the normal group. The Korean's dietary diversity score (KDDS) of the NAFLD group was lower than that of the normal group. Conclusion: In conclusion, we suggest that diet guidelines, such as increasing the intake of calcium and dietary fiber, reducing the intake of energy, fat, and simple carbohydrates, are necessary to improvement of NAFLD. The results could be used in the future for development of diet and nutrition guidelines for NAFLD.