• Nutrition Research and Practice
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• v.10 no.5
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• pp.537-545
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• 2016

BACKGROUND/OBJECTIVES: Dietary sugar intake, particularly added sugar and sugar-sweetened beverages, has received worldwide attention recently. Investigation of dietary behaviors may facilitate understanding of dietary sugar intakes of children and adolescents. However, the relationship between dietary sugar intake and dietary behaviors in the Korean population has not been investigated. Thus, this study aimed to estimate dietary sugar intake and food sources according to sex as well as examine the relationship of dietary sugar intake with frequent snacking and dietary patterns among Korean children and adolescents. SUBJECTS/METHODS: We pooled data from five studies involving Korean children and adolescents conducted from 2002 to 2011. A total of 2,599 subjects aged 9-14 years were included in this study. Each subject completed more than 3 days of dietary records. RESULTS: Mean daily total sugar intake was 46.6 g for boys and 54.3 g for girls. Compared with boys, girls showed higher sugar intakes from fruits (7.5 g for boys and 8.8 g for girls; P = 0.0081) and processed foods (27.9 g for boys and 34.9 g for girls; P < 0.0001). On average, 95.4% of boys and 98.8% of girls consumed snacks during the study period, and total sugar intake showed a significantly increasing trend with increasing energy intake from snacks (P < 0.0001 for both sexes). Two dietary patterns were identified by cluster analysis: Traditional and Westernized patterns. Total sugar intake was higher in the Westernized pattern (56.2 g for boys and 57.2 g for girls) than in the Traditional pattern (46.5 g for boys and 46.3 g for girls). CONCLUSIONS: These results suggest that multilateral and practical development of a nutrition education and intervention program that considers dietary behaviors as well as absolute sugar intake is required to prevent excessive sugar intake in Korean children and adolescents.

• Nutrition Research and Practice
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• v.13 no.5
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• pp.434-443
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• 2019

BACKGROUND/OBJECTIVES: The intake of sugar has increased worldwide, and it is well established that childhood experiences and food preferences affect lifelong eating habits. To discourage sugar intake, nutrition education was imparted, and the effectiveness of the nutrition education program was investigated by considering the nutrient density and major dietary sources of sugar intake. SUBJECTS/METHODS: Twenty four-hour dietary recall and sugar intake frequency of 96 pre-school children (educated n = 47; non-educated n = 49) were collected on 3 consecutive days (1 weekend day, 2 weekdays) after 11 weeks of imparting nutrition education. Dietary intake of nutrients and total sugar were analyzed, and the intake frequency of sugar source foods were identified. All nutrition education programs were focused on a hands-on education program, and consisted of cooking lab, play, activity, animation, and visual materials. The difference between the two groups was verified by the Chi-square test or t-test. All statistical analysis was performed with significance level at P < 0.05. RESULTS: Compared to the non-educated group, the intakes of protein (P < 0.001), fiber (P < 0.01), potassium (P < 0.05), iron (P < 0.05), zinc (P < 0.05), and iodine (P < 0.001) were significantly higher, and the intakes of carbohydrate (P < 0.01) and total sugar (P < 0.05) were significantly lower in the educated group. The cumulative percent of sugar intake of top 20 sugar source foods in the educated group (82.80%) was lower than that of the non-educated group (85.75%). The contribution of beverages on total sugar intake was lower in the educated group. The average frequency of consuming sugary foods was significantly lower in the educated group (P < 0.05). CONCLUSIONS: Our results indicate that nutrition education on discouraging sugar intake is effective in reducing the amount of total sugar consumed, resulting higher nutrient density in the diets of pre-school children.

• Journal of Nutrition and Health
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• v.40 no.sup
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• pp.9-21
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• 2007

This study aimed to assess the total sugar intake for Korean and to identify major food sources contributing to those food components. Korean adults aged over 20 years old from the Korean National Health and Nutrition Examination Survey (KNHANES) 2001 and 2002 were selected. The data were analyzed to obtain nationally and seasonally representative information on the health and nutritional status of the Korean. Forty food groups were used in identifying food sources of total sugar and energy intake. Total sugar contents of foods in the KNHANES data sets were estimated by food code matching technique with Release 18 of the USDA National Nutrient Database for Standard Reference. Sample weighted means, standard errors, and population percentages were calculated using SAS and SUDAAN. The mean total sugar intake of the Korean was 60.3g in 2001, 40.9g in spring 2002, 45.7g in summer 2002, and 52.1g in fall 2002, which were 30-44% of intake of US people. Fresh fruit was identified as the most significant food source for total sugar intake in Korean population in all age groups and all seasons. The next major food sources following fresh fruits were candy/jelly/syrup/honey, coffee/coffee caream, vegetables, Kimchi, soft drinks, milk, fruit juice, cookie/cracker/cake, and vegetable juice/grain juice, which showed similar results through the seasons. While carbonated soft drink was the most significant food sources for total sugar or added sugar intakes for US people. The total sugar intakes were significantly higher in women, higher educational level, and residing in metropolitan area. As intake of total sugar increased, intakes of protein, fiber, calcium, phosphorus, iron, Vit A, B1, B2, C, niacin showed significantly increased, while high intakes of added sugars showed low intakes of some micronutrients in the US people. Percentages of people who consumed nutrients below EAR were less in higher total sugar intake group than in lower intake group. From these results, we can conclude that the food consumption habits including the total sugar intake of Korean people seems relatively good so far. More reliable database of total sugar and added sugar composition tables in public domain should be established in the future, and also more researches about total sugar and added sugar for Koreans should be continued.

• Nutrition Research and Practice
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• v.5 no.3
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• pp.236-245
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• 2011

This study investigated the correlation between consumption of sugar intake by fifth grade students in primary schools and development of Attention Deficit Hyperactivity Disorder (ADHD). A total of 107 students participated, and eight boys and one girl (8.4% of the total) categorized as high risk for ADHD according to diagnostic criteria. There were significant differences in the occupations and drinking habits of the respondents' fathers between the normal group and risk group. In a comparison of students' nutrition intake status with daily nutrition intake standards for Koreans, students consumed twice as much protein as the recommended level, whereas their calcium intake was only 60% of the recommended DRI (dietary reference intake). Regarding intake volume of vitamin C, the normal group posted 143.9% of the recommended DRI, whereas the risk group showed only 65.5% of the recommended DRI. In terms of simple sugar intake from snacks, students in the normal group consumed 58.4 g while the risk group consumed 50.2 g. These levels constituted 12.5% of their total daily volume of sugar intake from snacks, which is higher than the 10% standard recommended by the WHO. In conclusion, children who consumed less sugar from fruit snacks or whose vitamin C intake was less than RI was at increased risks for ADHD (P < 0.05). However, no significant association was observed between total volume of simple sugar intake from snacks and ADHD development.

• Journal of Nutrition and Health
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• v.45 no.1
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• pp.57-63
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• 2012

This study investigated the relationship between total sugar intake and obesity indices in 362 female university students. This study was conducted using an anthropometric checkup and 3-day dietary records. Subjects were categorized according to the total sugar intake as < 33.3 g (group I, n = 90), 33.3-56.1 g (group II, n = 91), 56.1-83.8 g (group III, n = 91), ${\geq}$ 83.8 g (group IV, n = 90). No significant differences in age, weight, height, body mass index (BMI), or the percentage of body fat were observed among the four groups. Based on BMI, 20.2% were overweight, and the percentage of body fat was > 30% in 67.1% of all students sampled. Energy intake in each groups was 1,164.7 kcal, 1,488.6 kcal, 1,590.0 kcal, and 1795.8 kcal, respectively (p < 0.001). Total sugar intake in the groups was 20.5 g, 44.6 g, 68.3 g, and 111.8 g, respectively (p < 0.001). Carbonated beverages were identified as the most significant food source for total sugar intake in female university students. The next major foods were ice cream, milk, coffee, fruit, sugar, cookies, bread, chocolate, corn syrup, rice, onion, maple syrup, pickle, and sweet potato. As intake of total sugar increased, intake of energy also increased significantly. Mean daily intakes of fat and calcium/1,000 kcal were significantly higher in group IV than those in the other groups. Mean daily intakes of vitamin C and vitamin E/1,000 kcal were significantly higher in group III than those in the other groups. The percentage of subjects who consumed nutrients below the estimated average requirement was less in the higher total sugar intake group than that in the lower intake group. The obesity indices (weight, BMI, % body fat) were not associated with total sugar intake in the subjects. We conclude that total sugar intake does not seem to influence obesity indices in female university students.

• Journal of Nutrition and Health
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• v.47 no.4
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• pp.268-276
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• 2014

Purpose: The aim of this study is to estimate total sugar intake and identify major food sources of total sugar intake in the diet of the Korean population. Methods: Dietary intake data of 33,745 subjects aged one year and over from the KNHANES 2008-2011 were used in the analysis. Information on dietary intake was obtained by one day 24-hour recall method in KNHANES. A database for total sugar content of foods reported in the KNHANES was established using Release 25 of the U.S. Department of Agriculture National Nutrient Database for Standard Reference, a total sugar database from the Ministry of Food and Drug Safety, and information from nutrition labeling of processed foods. With this database, total sugar intake of each subject was estimated from dietary intake data using SAS. Results: Mean total sugar intake of Koreans was 61.4 g/person/day, corresponding to 12.8% of total daily energy intake. More than half of this amount (35.0 g/day, 7.1% of daily energy intake) was from processed foods. The top five processed food sources of total sugar intake for Koreans were granulated sugar, carbonated beverages, coffee, breads, and fruit and vegetable drinks. Compared to other age groups, total sugar intake of adolescents and young adults was much higher (12 to 18 yrs, 69.6 g/day and 19 to 29 yrs, 68.4 g/day) with higher beverage intake that beverage-driven sugar amounted up to 25% of total sugar intake. Conclusion: This study revealed that more elaborated and customized measures are needed for control of sugar intake of different subpopulation groups, even though current total sugar intake of Koreans was within the range (10-20% of daily energy intake) recommended by Dietary Reference Intakes for Koreans. In addition, development of a more reliable database on total sugar and added sugar content of foods commonly consumed by Koreans is warranted.

• 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 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.

• The Korean Journal of Food And Nutrition
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• v.30 no.5
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• pp.923-934
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• 2017

The purpose of this study was to provide the basic information for developing sugar related nutrition education programs for children in child-care facilities and their parents. The results showed that the total score of parent's dietary attitudes towards sugar-rich foods was 17.94 and the total score of parent's nutritional knowledge was 3.67. A positive relationship was observed among items of parent's dietary attitudes (p<0.01), and some correlations were also observed between the total score of parent's nutritional knowledge and the total score of parent's dietary attitudes (p<0.05 or p<0.01). The total average score of children's eating behaviors for sugar-rich foods was 23.98, and the item with the highest score was 'I often eat candy, chocolate and jelly'. For children, food that received the highest preference was chocolate, and soft drinks received the lowest preference. The most frequently consumed food item was candy or caramel, and the least frequently consumed food item was soft drinks. There were positive correlation among the total score of children's eating behaviors, food preferences, and food intake frequency (p<0.01). When parent's tried to reduce the sugar intake, children's total score of eating behaviors (p<0.001) and food intake frequency (p<0.001) for sugar-rich food was lower. We conclude that parent's dietary attitudes may influence children's eating behaviors, food preferences, and food intake frequency for sugar-rich foods.

• Journal of Nutrition and Health
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• v.28 no.7
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• pp.644-652
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• 1995

The purpose of this study was to examine the relationship between sugar intake and behavioral problems in Korean school children. The subjects were 280 school children lived in Soung Nam city. Nutrient and sugar intakes were measured by 24-hour recall method and food frequency method through personal interview. Hyperactivity scores of children were measured by teacher and mother using conners Rating Scale-Revised. The average daily total sugar intake for the total sample was 63.0$\pm$37.4g(Range : 10g-220g). The result of stepwise multiple regression analysis using the sugar intake as dependent variable showed that energy, participation of school lunch program, Vit B2, protein, education of fathers, niacin, calcium are significant explanatory variables, explaining 44.8% of variation. As a result of the Conners scale test by teacher, 4% of children were Attention Deficit Hyperactivity Disorder(ADHD) children. A result of the Conners scale test by mother, 8% of children were ADHD children. The result of simple regression analysis had not shown significant relationship between sugar intake and ADHD scores. But the result of the Conners test by teacher, sugar intake(69.9$\pm$37.1g) of ADHD children were significantly higher than sugar intake(62.9$\pm$37.7g) of normal children(p<0.01).