• 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.

• Nutrition Research and Practice
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• v.10 no.5
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• pp.546-554
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• 2016

BACKGROUND/OBJECTIVES: The aim of this study was to investigate the perception of sugar reduction, nutrition education, and frequency of snacking in children according to the self-perceived dietary preferences for sweet taste by mothers in Busan. SUBJECTS/METHODS: A total of 277 mothers were surveyed, and their perceptions of sugar reduction and the frequency of snacking in children were assessed using a questionnaire. The subjects were classified into either a sweet (n = 91) or an unsweet (n = 186) group according to their self-perceived preferences for a sweet taste. RESULTS: In the sweet group, the results for sweet products were sweetened ice (86.8%), confectionery (74.7%), processed milk (73.6%), carbonated beverages (71.4%), and fermented milk (53.9%). In the unsweet group, the results were sweetened ice (88.7%), carbonated beverages (78.5%), processed milk (75.8%), confectionery (69.4%), and fermented milk (50.5%). The necessity of sugar intake reduction was high in both groups (sweet = 89.0%, unsweet = 82.8%). Beverage purchases after identifying the nutrition labeling was significantly lower in the sweet group than in the unsweet group (P < 0.05). The reasons for the beverage purchases instead of water were "habitually" (50.5%) and "like sweet taste" (25.3%) in the sweet group (P < 0.01). Snacking in children was significantly higher in the sweet group based on the increased frequencies of carbonated drinks (P < 0.01), fast food (P < 0.001), candy and chocolate (P < 0.05), crackers (P < 0.01), ramen (P < 0.01), and fish paste/hotdogs (P < 0.01). The frequency of purchase education after identifying the nutrition labeling was significantly lower in the sweet group than in the unsweet group (P < 0.01). CONCLUSIONS: These findings suggest that a perception of sugar reduction and practical nutrition education aimed at reducing the sugar intake are necessary to improve dietary habits.

• Journal of Nutrition and Health
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• v.48 no.3
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• pp.248-257
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• 2015

Purpose: The aim of this study was to estimate total sugar intake and sugar intake-related dietary habit and nutrient intake of middle school students. Methods: Subjects included 1,184 middle school students (476 males and 708 females) residing in Jeju. This research analyzed daily dietary intakes of subjects using the 24 hour recall method and surveyed the dietary habit related to total sugar intake using questionnaires. Descriptive analysis, chi-square test, t-test, and ANOVA, using the SAS program were used for analysis of data. Results: The average daily total sugar intake was 60.3 g (male 50.5 g, female 66.9 g). Total sugar intake per meal was 6.5 g (10.8%) from breakfast, 9.0 g (14.9%) from lunch, 11.8 g (19.6%) from dinner, and 33.0 g (54.7%) from snacks. Food groups that contribute to the majority of total sugar intake were grains and their products (23.0 g), milk (11.0 g), fruits and their products (7.3 g), sugars and sweets (6.1 g), and vegetables and their products (5.8 g). In terms of total sugar intakes by cooking methods, desserts showed a greater amount than main and side dishes, and indicated in order of amount as follows: bread and cookies (11.5 g), dairy products (7.5 g), ice cakes (6.2 g), beverages (5.3 g), and fruits (4.5 g). Total sugar consumption was high for rice and side dishes such as noodles (10.2 g), fried foods (2.9 g), stir-fried foods (2.0 g), and cooked rice with seasoning (1.7 g). The daily intake of natural sugar, added sugar, and natural and added sugar was 18.3 g, 35.8 g, and 6.2 g, respectively. The high sugar intake group, which was over 20% of the energy from total sugar intakes, consumed significantly less Fe, Zn, vitamin B6, niacin, and vitamin E than the low sugar intake group, which was below 20%. Conclusion: Total sugar intake of second graders of middle schools on Jeju Island was 60.3 g/day, mostly obtained from snacks (54.7%). Therefore, nutritional education for proper selection of better snacks and for reduction of dietary sugar intake is needed for middle school students.

• Journal of Nutrition and Health
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• v.48 no.1
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• pp.81-93
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• 2015

Purpose: The aim of this study was to estimate total sugar intake and sugar intake-related dietary habit and nutrient intake of elementary school students. Methods: Subjects included 701 elementary school students (351 boys and 350 girls) residing in Jeju. The research analyzed a sample and was carried out using the 24 hour recall method and one day consumption of total sugar. Results: The average daily total sugar intake was 55.3 g (male 53.1 g, female 57.6 g). Total sugar intake per meal was 6.3 g (11.4%) from breakfast, 6.9 g (12.5%) from lunch, and 7.2 g (13.0%) from dinner, 34.9 g (63.1%). Major food groups of total sugar were milks (17.04 g), grains and their products (12.79 g), fruits and their products (9.40 g), and sugars and sweets (7.30 g). In analysis of the amount of total sugar consumption from several recipes, much was taken in from dessert and snacks such as dairy products (15.08 g), bread and snacks (6.4 g), beverages (5.5 g), fruits (5.1 g), and ice cakes (4.8 g). Total sugar consumption was high for rices and side dishes such as noodles (5.1 g), stir-fried foods (2.3 g), fried foods (1.4 g), cooked rice with seasoning (1.4 g), and hard-boiled foods (1.1 g). In comparison of total sugar consumption for sugar sources, daily intake of natural sugar, added sugar, and natural and added sugar were 25.8 g, 23.3 g, and 6.2 g, respectively. High sugar intake group, which was over 20% of the energy from total sugar intakes, consumed significantly less Fe, Zn, and niacin than the low sugar intake group, which was below 20%. Conclusion: Total sugar intake of fifth graders of elementary schools on Jeju Island was 55.4 g/day, and it was usually intake from snacks. Therefore, elementary school students need nutritional education for proper selection of better snacks and for reduction of dietary sugar intake.

• Journal of the Korean Dietetic Association
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• v.22 no.3
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• pp.179-192
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• 2016

The purpose of this study was to evaluate a nutrition education program designed to reduce sugar intake in preschool children. The nutritional knowledge, dietary attitude, dietary behavior, and food intake with a sweet taste in preschool children were tested before and after 4 weeks of nutrition education from March 8 to April 1, 2016. The preschool children were recruited in Dobong-gu, Seoul. The subjects were divided into two groups; educated (N=59) and non-educated group (N=40). Statistical analyseis were performed using SPSS 22. The nutritional knowledge about sweet tasting food was significantly increased (P<0.01) in the educated group and significantly decreased (P<0.01) in the non-educated group. The dietary attitude toward sweet tasting food was significantly decreased (P<0.05) in the educated group but not significantly changed in the non-educated group. The dietary behavior toward sweet tasting food was significantly decreased (P<0.05) in the educated group and significantly decreased (P<0.01) in the non-educated group. The major food sources of sugar intake were not significantly changed in either groups. The major food sources of sugar intake in the 5 years old children were yogurt products>sweetened breads>cookies/biscuits>chocolate>cereals>beverages>sweetened milk>sweet spicy chicken>Tteokbokki. Although there are some limitations in this study, due to the short length of the nutrition education and lack of active participation by the parents, the results suggest that effective nutrition education on sweet tasting food can bring about changes in nutritional knowledge as well as dietary attitude.

• 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.

• Korean Journal of Community Nutrition
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• v.26 no.3
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• pp.167-176
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• 2021

Objectives: This study was conducted to identify the awareness and practice of reducing sugar in school meals and the status of nutrition education regarding sugar reduction. Methods: An online survey was conducted on 101 nutrition teachers (dietitians) working at elementary, middle, and high schools in Daegu. Results: School nutrition teachers in Daegu recognized the need for efforts to reduce the sugar intake in the Korean diet, and it was found that elementary nutrition teachers were more aware of the implementation of the sugar reduction policy at the national level than middle and high school nutrition teachers (P = 0.002). Among the policies to reduce sugar intake at the national level, there was a high need for the promotion of self-control and limiting the sales of food with high sugar content in schools and their vicinity. The degree of practice for reducing sugar in school meals was found to be higher in the preparation, purchase, and cooking stage compared to the serving stage (P < 0.05). There was a high need for changing the preferences of the subjects for a sweet taste as a means of reducing the sugar in school meals. Thirty-six percent of nutrition teachers conducted sugar reduction education, and sending out school newsletters was the highest type of nutrition education at 80.6%. Conclusions: To effectively promote reduced sugar intake in school meals, it is necessary to change the preference of the subjects for sweetness and to conduct continuous education that can improve the awareness of people for reducing their sugar intake. For this, it is necessary to set aside time for nutrition education and to prepare an institutional framework for providing this education.

• Korean Journal of Community Nutrition
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• v.28 no.4
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• pp.269-281
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• 2023

Objectives: This study aimed to examine the frequency of convenience food consumption at convenience stores (CVS) and the CVS usage patterns of middle and high school students as well as to understand students' attitude toward sodium and sugar reduction. Methods: We used an online questionnaire for data collection. The questionnaire comprised five distinct categories: general characteristics, CVS usage, frequency of consumption according to convenience food menus at CVS, attitude toward sodium and sugar reduction, and adherence to dietary guidelines. Results: A total of 75 students from Seoul (14 middle school students and 61 high school students) participated in the study. Most respondents visit CVS 3-5 times a week. CVS are predominantly used during weekdays, mostly during lunch, and dinner. The students mostly checked the caloric content and expiration date as food labeling information. The participants were aware of the need to reduce their sugar and sodium intake. Among frequent CVS convenience food consumers, there was an increased consideration of the need to reduce their sugar and sodium consumption, despite their actual selection of foods with high sugar and sodium content. Additionally, they did not check the sugar and sodium levels indicated in food labeling. Further, the dietary action guide from the Ministry of Health and Welfare were poorly followed by most students. Conclusions: There is a need for nutrition education specifically addressing the sugar and sodium content of the convenience foods predominantly consumed by students. Additionally, educating students with frequent convenience food consumption to actively check the sugar and sodium information on food labels could help promote healthier food choices.

• 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 Society of Food Science and Nutrition
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• v.44 no.12
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• pp.1865-1872
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• 2015

This study attempted to investigate consumer perceptions and attitudes towards reducing sugar intake by providing data to develop guidelines for the government and food-related industries to encourage Korean consumers to maintain appropriate levels of sugar intake. A survey was conducted on 238 adult consumers regarding their purchasing power for products with high sugar content in Seoul and Bundang, Gyeonggi area from September 1~30, 2013. Nutritional information on sugary products had a greater impact than media and others' recommendations on consumer awareness regarding need to reduce sugar intake. External factors such as health and weight control were stronger reasons for consuming reduced amounts of sugar or sugar-free products than internal factors such as sweetness. However, internal factors-such as taste-did not have a greater effect on consuming reduced amounts of sugar or sugar-free products than environmental factors-such as absence of purchase channels. Consumers indicated higher acceptance for 50% reduction in sweetness of existing commercial products. Regarding methods of lowering sugar intake, sugar replacement and reducing sugar consumption both generally and at home were preferred. In addition, consumers were likely to pay 10~14% more for sugar-reduced products than for existing products. Overall, consumers expressed positive attitudes towards reducing sugar intake in the future, although those in their twenties tended to be more passive than other age groups.