Gender and age group differences in nutrition intake and dietary quality of Korean adults eating alone: based on Korean National Health and Nutrition Examination Survey Data, 2013–2016

BACKGROUND/OBJECTIVESThis study investigated gender and age differences in nutrient intake and dietary quality of people eating alone.SUBJECTS/METHODSFrom Korean National Health and Nutrition Examination Survey 2013–2016 data, 2,305 adults aged 20 years and older that ate meals alone were included in this study. Their energy and nutrients intakes, as well as their nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ) were analyzed. Food group consumption pattern, dietary variety score (DVS), dietary diversity score (DDS) were also analyzed. All data were compared among gender and age groups.RESULTSMen consumed more energy and nutrients than women, except for vitamin C, and the NARs showed similar gender differences. The INQs of 4 nutrients (calcium, vitamin A, vitamin C, and riboflavin) were lower than 1.0 in men, whereas only the calcium INQ was lower than 1.0 in women. Men had a lower DDS (3.6) than women (3.9) (P < 0.001) and had more ‘undesirable’ food group consumption patterns than women (P < 0.001). The intakes of calcium, vitamin A, and vitamin C were relatively low in the young-aged group (INQs less than 1.0). In the old-aged group, the MAR level was relatively low, and the INQs of calcium, riboflavin, and niacin were below 1.0. The old-aged group consumed more menu items, but their DVS was the lowest.CONCLUSIONSCompared to women, the dietary quality and food diversity among men were poorer. There were poorer quality and diversity patterns in the young-aged group compared to those of the older groups. An overall low intake of nutrients and the low nutrient density of meals were the main dietary problems among the old-aged group who eat alone. Therefore, men, particularly young- and old-aged, need to be prioritized in nutritional policies directed toward those who eat alone.     

Workplace foodservice meals are associated with higher nutritional quality among adult Korean workers: a nationwide cross-sectional study

BACKGROUND/OBJECTIVESAdequate nutritional intake is essential for good health and well-being. We aimed to compare the nutrient intake from homemade meals, meals sourced externally (“eating out”), and meals from workplace foodservices, as well as the potential association between foodservices used and nutritional quality among adult Korean workers.SUBJECTS/METHODSWe used data from the Korea National Health and Nutrition Examination Survey, a nationwide cross-sectional survey on the health and nutritional status of the Korean population. Data from 6,845 workers aged 20–64 years were included. A survey on dietary behavior and nutrition was conducted using the 24-h dietary recall method. Nutritional quality was examined using the index of nutritional quality (INQ) score. Higher INQ scores reflected poorer nutritional quality, with insufficient intake of a higher number of nutrients. Multivariate linear regression was used to identify the association between the foodservices used and INQ scores after adjusting for other covariates.RESULTSWe found that foodservice users exhibited a higher 1-day intake of total energy and macronutrients (all P < 0.05) and lower INQ scores (P < 0.01) than non-users. The INQ scores for total daily meals decreased with the frequency of foodservice use (P < 0.01). A significant association was observed between the non-use of foodservices and INQ scores (β = 0.29, P < 0.01) after adjusting for other covariates.CONCLUSIONSThe use of workplace foodservices contributed to higher dietary nutritional quality among workers. This study highlights the importance of expanding the scope of workplace foodservices to promote higher nutritional quality and healthy dietary habits among workers.     

Current status of foodservice nutrition management and effects of welfare facility support for the elderly in Cheongju City

BACKGROUND/OBJECTIVESSouth Korea is representative of countries experiencing rapid societal aging. This study aimed to understand the current status of foodservice nutrition management provided to welfare facilities for the elderly and to understand improvements after support from “the Center for Social Welfare Foodservice Management (CSWFM)” in Cheongju City.SUBJECTS/METHODSThe status of foodservice nutrition management was assessed by dietitians and hired by the CSWFM, who visited 40 welfare facilities (registered members of the CSWFM) for the elderly in Cheongju City. After visiting each facility three times from July to December 2019, the results of inspections on four areas, that is, ‘menu’, ‘meal provision’, ‘cooking’, and ‘distribution’ management for 2nd and 3rd visits (support visits) were compared with results obtained at initial visits.RESULTSBefore support as determined during 1st visits, compliance rates with ‘menu’, ‘meal provision’, ‘cooking’, and ‘distribution’ requirements were 72.1%, 75.5%, 58.3%, and 77.5%, respectively. The mean compliance rate for all 15 items on the questionnaire used was 70.8%. Items with low compliance rates were ‘Is the soup provided by foodservice at the recommended salinity?’ (compliance rate 37.5%) and ‘Is the foodservice cooking conducted by referring to a recipe?’ (42.5%). At the two support visits, mean compliance rates increased significantly (P < 0.01, P < 0.001), mean total score had significantly increased from 71.80 to 90.26 (P < 0.001), and mean soup salinity decreased significantly from 0.82% at 1st visits to 0.68% (P < 0.001) and 0.56% (P < 0.001) at the 1st and second follow-up visits.CONCLUSIONSThese results show that the status of nutrition management at welfare facilities for the elderly was much improved by CSWFM involvement, and indicate the CSWFM should continuously provide nutrition management support to facilities and that finances and opportunities for more welfare facilities for the elderly be expanded.     

Perception of sugar reduction,nutrition education,and frequency of snacking in children by the self-perceived sweet dietary habits of mothers in Busan

BACKGROUND/OBJECTIVESThe 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/METHODSA 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.RESULTSIn 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).CONCLUSIONSThese findings suggest that a perception of sugar reduction and practical nutrition education aimed at reducing the sugar intake are necessary to improve dietary habits.     

Do types of snacks,sleep hours,and eating places affect nutritional intakes and its adequacy in adolescents?

BACKGROUND/OBJECTIVESHigh-quality meal intake, including snacks, is necessary for optimal development during adolescence. The purpose of this study was to evaluate the nutritional intake of adolescents and the quality of their diet according to snack type, eating location, and sleep hours.SUBJECTS/METHODSA survey of middle school students living in Seoul and Gyeonggi province was conducted using questionnaires and the 24-h recall method to collect data on the 1-day dietary intake of the students from March to May, 2018. The data were analyzed using SPSS 23.0 and the CAN program.RESULTSThe average nutritional intake status among the respondents showed that the energy intake was lower than the recommended, showing 1,914.8 kcal for middle school boys and 1,752.7 kcal for girls. In terms of the nutritional intake status by gender, only the consumption of protein and niacin were significantly higher in boys than girls (P < 0.05). According to the sleep amounts, vitamin C intake was significantly higher in the sleep-deprived group than in the sleep-moderate or sleep-recommended group (P < 0.05), but the intake did not meet the recommendation in any group. The lower density nutrients found in the index of nutritional quality according to eating places were vitamin C, calcium, iron, and folic acid. School meals showed a higher nutritional density in protein, vitamin B₁, and niacin compared to convenience store meals (P < 0.05).CONCLUSIONSThis study suggested that sleep amount, and eating place affected the dietary quality of adolescents.     

Effects of multiple herb formula SEC-22 supplementation on dietary intake,picky eating behaviors,and growth indices in thin preschool children

BACKGROUND/OBJECTIVESThin children may have insufficient intake of energy and nutrients, resulting in reduced immune function and growth. This study aimed to identify the effects of multiple herb formula SEC-22 supplementation on growth, dietary changes, and picky eating behaviors in thin children.SUBJECTS/METHODSA double-blind, randomized clinical trial was conducted on 79 children aged 2-5 years with poor appetites, BMI percentile < 25, and without any illness. Subjects were given either SEC-22 (n = 35) or placebo (n = 44) for 2 months and followed for an additional 2 months. Three-day dietary records, questionnaires on picky eating behaviors, and anthropometric measures were collected.RESULTSEnergy, carbohydrate intake, and feeding difficulty improved in both groups during the intervention period. However, changes were maintained only in the SEC-22 group after 2 months of follow-up post-supplementation. ''Frequency of trying to feed'' was improved in the SEC-22 group compared to the placebo group after the first month of follow-up (P < 0.05). Intakes of potassium and thiamine were improved in the SEC-22 group compared to the placebo group after the first month of intervention (P < 0.05). ''Frequency of food reward'', eating amount, and intakes of carbohydrate, potassium, and vitamin C showed significant improvement compared to the placebo group after the second month of follow-up (P < 0.05).CONCLUSIONSThese results suggest that SEC-22 supplementation can improve parental feeding difficulty resulting from insufficient eating amount or picky eating as well as increase nutrient intake in thin children. Although these improvements were observable at least 2 months after supplementation, effects beyond this time frame need to be confirmed.     

Assessments of nutrient intake and metabolic profiles in Korean adolescents according to exercise regularity using data from the 2008 Korean National Health and Nutrition Examination Survey

The purpose of this study was to assess the metabolic profile and nutrient intake data in Korean adolescents according to exercise regularity using the forth Korean National Health and Nutrition Examination Survey from 2008 data. A total of 834 Korean adolescents (440 boys, 394 girls) aged 12 to 18 years were classified into exercising male (EM), non-exercising male (NM), exercising female (EF), and non-exercising female (NF) groups. EM exhibited significantly higher weight (P < 0.001), waist circumference (WC) (P < 0.01) and body mass index (BMI) (P < 0.001) than NM. EF showed significantly greater height (P < 0.01), weight (P<0.001), WC (P < 0.001), and BMI (P < 0.001) than NF. Although ratios of macronutrient intake were within the appropriate range in all groups, energy, riboflavin, vitamin C and calcium were assessed as in adequate by the nutritional adequacy ratio (NAR) in all groups. Moreover, EF and NF had inadequate intake of vitamin A and iron according to NAR, respectively. There were significant correlations between height and NAR protein (r = 0.249, P < 0.001), and mean adequacy ratio (MAR) (r = 0.177, P < 0.01), and between weight and NAR protein (r = 0.180, P < 0.01), and MAR(r = 0.136, P < 0.05) in EM. On the other hand, there were significant correlations between weight and NAR protein (r = 0.270, P < 0.01), WC and NAR protein (r = 0.271, P < 0.01), and BMI and NAR protein (r = 0.326, P < 0.01) in NM. There were significant correlations height and NAR Fe (r = 0.153, P < 0.05) in EF. However, there were no significant correlations between metabolic factors and nutritional adequacy in NF. Although we noted no significant differences in MAR between the groups, the exercising groups showed higher MAR values than the non-exercising groups. Therefore, practicing of ideal dietary behaviors appears to be induced through physical activity and regular exercise in Korean adolescents.     

Dietary Quality of Women of Reproductive Age in Low-Income Settings: A Cross-Sectional Study in Kyrgyzstan

Dietary diversity and adequate nutrient intake are essential for conducting a healthy life. However, women in low-income settings often face difficulties in ensuring dietary quality. This research assessed relationships between the dietary diversity, nutrient adequacy, and socio-economic factors among women of reproductive age (WRA) in Kyrgyzstan. A cross-sectional study was undertaken in four locations, including two rural and two urban areas in the north and south of Kyrgyzstan. A survey with pre-coded and open-ended questions was employed during the interviews of 423 WRAs aged 18–49. Data collection was conducted in March–May 2021. The average value body mass index (BMI) of WRA was 24.2 ± 4.6 kg/m². The dietary diversity score (DDS) was higher among rural women (common language effect size) cles = 0.67, adjusted p < 0.001) in the northern region (cles = 0.61, p < 0.05) who have cropland (cles = 0.60, p < 0.001) and a farm animal (cles = 0.60, p < 0.05). Mean nutrient adequacy ratio (NAR) was below 1 in most micronutrients, whereas thiamine, riboflavin, vitamins B6 and C, folic acid, calcium, and magnesium were even lower than 0.5. Women with a kitchen garden or a cropland had better NAR energy (cles = 0.57), NAR carbohydrate (cles = 0.60), NAR fiber (cles = 0.60), NAR vitamin B1 (cles = 0.53), and NAR folic acid (cles = 0.54). Respondents who receive remittances and a farm animal have better NARs for energy, carbohydrates, fiber, vitamin B1, folic acid, iron, zinc, and mean adequacy ratio for 16 nutrients (MAR 16) than those who do not. Education and income have a negative correlation with dietary quality. This study contributes to the limited literature on the quality of diets in Kyrgyzstan. Hidden hunger and undernutrition are a severe problem among WRA in low-income settings. Recommendations are including study programs in nutrition, teaching households farming practices, and raising awareness on adequate nutrition.     

Intermittent Fasting Alleviates Risk Markers in a Murine Model of Ulcerative Colitis by Modulating the Gut Microbiome and Metabolome

Clinical trials have demonstrated the health benefits of intermittent fasting (IF). However, the potential mechanism of IF in alleviating dextran sulfate sodium (DSS)-induced colitis is not fully understood. The present study was mainly designed to explore the dynamic changes in the gut microbiota and metabolome after short-term (2 weeks) or long-term (20 weeks) IF and therefore clarify the potential mechanisms by which IF ameliorates DSS-induced colitis in a murine model. Thirty-two C57BL/6 male mice were equally divided into four groups and underwent IF intervention for 2 weeks (SIF group, n = 8), 20 weeks (LIF group, n = 8), or were allowed free access to food for 2 weeks (SAL group, n = 8) or 20 weeks (LAL group, n = 8). The thirty-two C57BL/6 male mice were accepted for the diet intervention of 2 weeks of IF or fed ad libitum. Colitis was induced by drinking 2% DSS for 7 days. Our findings showed that short-term IF prominently elevates the abundance of Bacteroides, Muibaculum and Akkermansia (p < 0.001, p < 0.001, p < 0.001, respectively), and decreased the abundance of Ruminiclostridium (p < 0.05). Long-term IF, however, decreased the abundance of Akkermansia and obviously increased the abundance of Lactobacillus (p < 0.05, p < 0.001, respectively). Metabolites mainly associated with nucleoside, carbohydrate, amino acid, bile acid, fatty acid, polyol, steroid and amine metabolism were identified in the faeces using untargeted GC/MS. In particular, inosine was extremely enriched after short-term IF and long-term IF (p < 0.01, p < 0.01, respectively); butyrate, 2-methyl butyric acid and valeric acid were significantly decreased after short-term IF (p < 0.001, p < 0.001, p < 0.01, respectively); and 2-methyl butyric acid was significantly increased after long-term IF (p < 0.001). The abundance of lithocholic acid (LCA), one of the secondary bile acids, increased significantly after short-term and long-term IF based on UPLC–MS/MS (p < 0.001, p < 0.5, respectively). Of note, IF markedly mitigated DSS-induced acute colitis symptoms and down-regulated pro-inflammatory cytokines IL-1α, IL-6, keratinocyte-derived chemokine (KC) and G-CSF levels in the serum (p < 0.01, p < 0.001, p < 0.05, p < 0.001, respectively). Furthermore, a correlation analysis indicated that the disease activity index (DAI) score and serum levels of IL-1α, IL-6, KC, and G-CSF were negatively correlated with the relative abundance of Akkermansia and the faecal metabolites LCA and inosine. This study confirmed that IF altered microbiota and reprogramed metabolism, which was a promising development in the attempt to prevent DSS-induced colitis. Moreover, our findings provide new insights regarding the correlations among the mucosal barrier dysfunction, metabolome, and microbiome.     

Relationship Between Protein Intake in Each Traditional Meal and Physical Activity: Cross-sectional Study

BackgroundProtein intake plays an important role in the synthesis and maintenance of skeletal muscles for the prevention of health risks. It is also widely known that physical activity influences muscle function. However, no large-scale studies have examined the relationship between daily dietary habits, especially the timing of protein intake, and daily physical activity.ObjectiveThe purpose of this cross-sectional study was to investigate how protein intake and composition (involving the 3 major nutrients protein, fat, and carbohydrate) in the 3 traditional meals (breakfast, lunch, and dinner) are associated with physical activity.MethodsUsing daily dietary data accumulated in the smartphone food log app “Asken” and a web-based cross-sectional survey involving Asken users (N=8458), we analyzed nutrient intake and composition, as well as daily activity levels. As very few individuals skipped breakfast (1102/19,319 responses, 5.7%), we analyzed data for 3 meals per day.ResultsSpearman rank correlation analysis revealed that breakfast and lunch protein intakes had higher positive correlations with daily physical activity among the 3 major macronutrients (P<.001). These findings were confirmed by multivariate logistic regression analysis with confounding factors. Moreover, participants with higher protein intake and composition at breakfast or lunch tended to exhibit significantly greater physical activity than those with higher protein intake at dinner (P<.001).ConclusionsAmong the 3 macronutrients, protein intake during breakfast and lunch was closely associated with daily physical activity.     

Nutrient intakes of infants with atopic dermatitis and relationship with feeding type

BACKGROUND/OBJECTIVESThe prevalence of atopic dermatitis in infants is increasing worldwide. However, the nutrient intake status of infants with atopic dermatitis has not been studied properly. This study was conducted to compare the nutrient intake status of infants in the weaning period with atopic dermatitis by feeding type.MATERIALS/METHODSFeeding types, nutrient intake status and growth status of 98 infants with atopic dermatitis from age 6 to 12 months were investigated. Feeding types were surveyed using questionnaires, and daily intakes were recorded by mothers using the 24-hour recall method. Growth and iron status were also measured.RESULTSThe result showed that breastfed infants consumed less energy and 13 nutrients compared to formula-fed or mixed-fed infants (p < 0.001). The breastfed group showed a significantly lower intake rate to the Dietary Reference Intakes for Koreans than the other two groups (p < 0.001). In addition, they consumed less than 75% of the recommended intakes in all nutrients, except for protein and vitamin A, and in particular, iron intake was very low, showing just 18.7% of the recommended intake. There was no significant difference in growth by feeding type, but breastfed infants showed a significantly higher rate of iron deficiency anemia (p < 0.001).CONCLUSIONSContinuous management programs should be prepared for breastfed infants with atopic dermatitis, who are in a period when rapid growth takes place and proper nutrient intake is essential.     

Development of nutrient-based nutritional standards for foodservice at shelters during disasters in the Republic of Korea

BACKGROUND/OBJECTIVESIn times of disaster, simplified and minimized nutritional standards are necessary for a quick response to provide nutritious relief food. This study aimed to develop nutrient-based nutritional standards for foodservice at shelters during disasters in the Republic of Korea (South Korea).SUBJECTS/METHODSThe standards were developed in 2 phases. First, nutrients to be included in the standards were selected. Initial candidates were selected considering 3 aspects: preceding standards, insufficient intake during disasters, and inadequate intake among South Koreans. Final selection was made by excluding nutrients for 3 reasons: nutrients for which there is no deficiency concern in South Korea, nutrients whose intake data were not available, or nutrients whose values presented by Dietary Reference Intakes for Koreans are difficult to achieve based on the current diet among South Koreans. Second, the reference values of energy and the selected nutrients were calculated. The reference values for the entire population who were 1-year-old and over were calculated by multiplying the estimated energy requirements or the recommended nutrient intake and the proportion of each age and sex group. Respective reference values were also calculated for 4 different age groups (1–5, 6–11, 12–64, and ≥ 65-year-old).RESULTSThe standards for the entire population were 2,000 kcal for energy, 55 g for protein, 650 µg retinol activity equivalents for vitamin A, 95 mg for vitamin C, 1.1 mg for thiamin, 1.3 mg for riboflavin, 14 mg niacin equivalents for niacin, 350 µg dietary folate equivalents for folic acid, 750 mg for calcium, and 11 mg for iron. Four additional standards corresponding to each age group were developed.CONCLUSIONSThe nutritional standards during disasters were developed for South Korea, including energy and 9 nutrients with reference values for the entire population and 4 different age groups. The standards will contribute to maintaining the health of disaster evacuees in South Korea.     

Comparison of sodium content of workplace and homemade meals through chemical analysis and salinity measurements

BACKGROUND/OBJECTIVES

Most Koreans consume nearly 70-80% of the total sodium through their dishes. The use of a salinometer to measure salinity is recommended to help individuals control their sodium intake. The purpose of this study was to compare sodium content through chemical analysis and salinity measurement in foods served by industry foodservice operations and homemade meals.

MATERIALS/METHODS

Workplace and homemade meals consumed by employees in 15 cafeterias located in 8 districts in Daegu were collected and the sodium content was measured through chemical analysis and salinity measurements and then compared. The foods were categorized into 9 types of menus with 103 workplace meals and 337 homemade meals.

RESULTS

Workplace meals did not differ significantly in terms of sodium content per 100 g of food but had higher sodium content via chemical analysis in roasted foods per portion. Homemade meals had higher broth salt content and higher salt content by chemical analysis per 100 g of roasted foods and hard-boiled foods. One-dish workplace meals had higher salinity (P < 0.05), while homemade broths and stews had higher sodium content (P < 0.05 and P < 0.01, respectively). The sodium content per 100 g of foods was higher in one-dish workplace meals (P < 0.05) and in homemade broths and stews (P < 0.01 and P < 0.05, respectively).

CONCLUSIONS

The use of a salinometer may be recommended to estimate the sodium content in foods and control one''s sodium intake within the daily intake target as a way to promote cooking bland foods at home. However, estimated and actual measured values may differ.     

Nutrition knowledge,outcome expectations,self-efficacy,and eating behaviors by calcium intake level in Korean female college students

BACKGROUND/OBJECTIVES

Calcium is important but deficient in diets of young adult women. This study aimed to examine if cognitive factors and eating behaviors differ according to calcium intake based on the Social Cognitive Theory.

SUBJECTS/METHODS

Subjects were female college students in Seoul, Korea. Three hundred students completed the questionnaire regarding calcium intake, nutrition knowledge, outcome expectations, self-efficacy and eating behaviors. Data on 240 students were analyzed using t-test or χ²-test. Subjects were categorized into two groups, high calcium intake (HC, ≥ 650 mg/day) and low calcium intake (LC, < 650 mg/day), according to recommended intakes of calcium for women aged 19-29 years.

RESULTS

The LC group constituted 77.9% of total subjects. Nutrition knowledge was not different according to calcium intake. Three out of 12 outcome expectations items were significantly different between the HC and LC groups. Subjects in the HC group agreed more strongly with the practical benefits of consuming calcium-rich foods, including ''taste'' (P < 0.01) and ''going well with other snacks'' (P < 0.05), compared to those in the LC group. Negative expectations of ''indigestion'' were stronger in the LC group than HC group (P < 0.001). Among self-efficacy items, perceived ability of ''eating dairy foods for snacks'' (P < 0.001), ''eating dairy foods every day'' (P < 0.01), and ''eating calcium-rich side dishes at meals'' (P < 0.05) differed significantly between the HC and LC groups. Eating behaviors including more frequent consumption of dairy foods, fruits or fruit juice (P < 0.001), anchovy, seaweeds, green vegetables, protein-rich foods (P < 0.05), and less frequent consumption of sweets or soft drinks (P < 0.01) were significantly related to calcium intake.

CONCLUSIONS

This study found that outcome expectations, self-efficacy in consuming calcium-rich foods, and eating behaviors are important in explaining calcium intake. Nutrition education needs to address practical benefits, reduce negative expectations of calcium-rich foods, increase self-efficacy, and modify eating behaviors contributing to calcium intake.     

Missed opportunities for hypertension screening: a cross-sectional study,India

ObjectiveTo assess missed opportunities for hypertension screening at health facilities in India and describe systematic differences in these missed opportunities across states and sociodemographic groups.MethodsWe used nationally representative survey data from the 2017–2018 Longitudinal Ageing Study in India to estimate the proportion of adults aged 45 years or older identified with hypertension and who had not been diagnosed with hypertension despite having visited a health facility during the previous 12 months. We estimated age–sex adjusted proportions of missed opportunities to diagnose hypertension, as well as actual and potential proportions of diagnosis, by sociodemographic characteristics and for each state.FindingsAmong those identified as having hypertension, 22.6% (95% confidence interval, CI: 21.3 to 23.8) had not been diagnosed despite having recently visited a health facility. If these opportunities had been realized, the prevalence of diagnosed hypertension would have increased from 54.8% (95% CI: 53.5 to 56.1) to 77.3% (95% CI: 76.2 to 78.5). Missed opportunities for diagnosis were more common among individuals who were poorer (P = 0.001), less educated (P < 0.001), male (P < 0.001), rural (P < 0.001), Hindu (P = 0.001), living alone (P = 0.028) and working (P < 0.001). Missed opportunities for diagnosis were more common at private than at public health facilities (P < 0.001) and varied widely across states (P < 0.001).ConclusionOpportunistic screening for hypertension has the potential to significantly increase detection of the condition and reduce sociodemographic and geographic inequalities in its diagnosis. Such screening could be a first step towards more effective and equitable hypertension treatment and control.     

Evaluation of dietary behaviors of preschool children in Seoul and Gyeonggi-do associated with the level of parents' health consciousness: using nutrition quotient for preschoolers (NQ-P)

BACKGROUND/OBJECTIVESThis study aimed to assess the dietary behaviors of preschool children using the nutrition quotient for preschoolers (NQ-P) and analyzed the difference in the scores of the children''s dietary behaviors in regards to the parents'' health consciousness.SUBJECTS/METHODSThe subjects were 257 children aged 3–5 years and their parents residing in Seoul and Gyeonggi-do, South Korea. The questionnaire is composed of demographic characteristics, the NQ-P questions, and health consciousness. All data were statistically analyzed by SPSS program (ver. 25.0) and the statistical differences in variables were evaluated by χ² test, Fisher''s exact test, t-test, 1-way analysis of variance and Tukey''s multiple comparison test.RESULTSThere was a significant difference on the intake frequency of processed meat by region and fast foods by age, region, and weight status (P < 0.05). There was also a significant difference in not moving around while eating by weight status and parents'' effort to have healthy eating habits by sex (P < 0.05). The mean score of NQ-P of the total subjects was 59.47, which was within the medium-low grade. The mean score of balance was 61.62, and the boys were significantly higher than girls (P < 0.05). As the age of children increased, the mean score of the moderation was significantly decreased (P < 0.05). The scores of NQ-P (P < 0.05), balance (P < 0.01), and environment (P < 0.05) were significantly higher in the high group of parents'' health consciousness than the low group.CONCLUSIONSAccording to the results of the evaluation by NQ-P, the dietary behaviors of preschoolers residing in Seoul and Gyeonggi-do need to be improved. For improving their eating behavior and nutritional health status, parents and children need customized nutrition education programs based on sex, age, region and weight status of preschool children as well as the degree of parents'' health consciousness.     

The association between meal regularity and weight loss among women in commercial weight loss programs

BACKGROUND/OBJECTIVESWhile many obesity studies have pointed out the importance of meal regularity, few have conducted empirical analyses using data from food diaries. We examined the association between meal regularity (i.e., meal time regularity [MTR] and calorie intake regularity [CIR]) and weight loss.SUBJECTS/METHODSWe collected food diary data from 637 women who had participated in commercial weight loss programs for 28–168 days (4–24 weeks). This study defined “meal regularity” in terms of two concepts: MTR and CIR. MTR refers to how regularly people eat their meals (i.e., at certain times each day), whereas CIR refers to how regularly people consume a certain amount of calories at each meal. We conducted multiple regression analyses.RESULTSMTR (model 1: β = −2,576.526, P < 0.001; model 2: β = −1511.447, P < 0.05; model 3: β = −1,721.428, P < 0.05) and CIR (model 1: β = −1,231.551, P < 0.01; model 2: β = −2,082.353, P < 0.001; model 3: β = −1,343.490, P < 0.01) turned out to be significant determinants of the amount of weight loss in breakfast, lunch, and dinner contexts. While meal regularity (i.e., MTR and CIR) was significantly associated with weight loss, daily calorie intake from meals was not significantly associated with the amount of weight loss (model 1: β = 0.13, P > 0.05; model 2: β = 0.11, P > 0.05; model 3: β = 0.14, P > 0.05). Subjects who consumed an equal amount of calories per meal throughout the day lost more weight than those who did not (model 4: β = −3,675.51, P < 0.001).CONCLUSIONSEating each meal (i.e., breakfast, lunch, and dinner) at a certain time every day may increase weight loss success. Also, consuming the same amount of calories at each meal may help weight loss success.     

Psychosocial factors and eating behaviors according to the stages of change in nutrition management among elementary and middle school athletes

BACKGROUND/OBJECTIVESThis study examined the differences in psychosocial factors and eating behaviors by the stages of change (SOC) in nutrition management among elementary and middle school athletes.SUBJECTS/METHODSSubjects were young athletes recruited from the athletic clubs of 10 organizations. Subjects responded to a survey questionnaire, and data on 167 athletes were analyzed. Subjects were grouped into the pre-action or action stage in nutrition management. The χ² test, t-test, analysis of covariance, and correlation analysis were used in data analysis.RESULTSAthletes in the action stage (62.3%) compared to the pre-action stage, showed a higher self-efficacy (P < 0.01), and felt more confidence in performing specific eating behaviors (P < 0.05 to P < 0.01). Those in the action stage had more favorable beliefs regarding nutrition (P < 0.001) and agreed less strongly on the specific misconceptions/disadvantages of nutrition (P < 0.01) than those in the pre-action stage. Eating behaviors (P < 0.001) and subscales of the eating behaviors (P < 0.05 to P < 0.01) also differed significantly by the SOC group. Place of eating dinner (P < 0.05) and the person who prepares dinner (P < 0.05) showed significant differences by the SOC group. The relationship of self-efficacy, beliefs regarding nutrition, and eating behaviors to the SOC differed by sports type. Beliefs for football athletes, self-efficacy, and beliefs for baseball athletes were correlated significantly with the SOC, whereas all 3 variables were related to the SOC for handball and other athletes.CONCLUSIONSThis study showed differences in psychosocial factors and eating behaviors between the pre-action and action stages. Nutrition education should include strategies to help young athletes modify their beliefs, mainly misconceptions/disadvantages of nutrition, increase self-efficacy, and adopt specific and desirable eating behaviors. Nutrition education might employ different strategies considering the sports type that student-athletes participate.     

Dietary Diversity and Nutrient Intake of Han and Dongxiang Smallholder Farmers in Poverty Areas of Northwest China

This study aimed to evaluate the status of dietary diversity and nutrient intake among Han and Dongxiang smallholder farmers in poor rural areas of northwest China. In this cross-sectional study, dietary intake was assessed in 499 smallholder farmers aged 18–75 years from two nationally designated impoverished counties in Gansu Province, China, using three consecutive 24 h dietary recalls. The dietary diversity score (DDS) and nutrient adequacy ratio (NAR) were adopted to assess dietary diversity and micronutrient adequacy, respectively. The mean DDS (range from 1 to 9) in participants was relatively low (3.81 ± 1.01). Consumption of grains was excessive, while consumption of vegetables, fruits, meat, beans, eggs, fish, and dairy was inadequate. The NAR values were higher in Han Chinese, with the exceptions of vitamin C, potassium, pyridoxine, and selenium (p < 0.05). For each nutrient, the high DDS group had a higher mean NAR (p < 0.05), except for pyridoxine. High household monthly income, being Han Chinese, high DDS, and being aged over 45 years were positively associated with mean adequacy ratio (MAR) of 14 micronutrients evaluated. Lack of dietary diversity and insufficient intake of essential micronutrients are public health concerns in northwest China. Nutrition education and other proper methods to address these issues are needed.     

Dietary sugar intake and dietary behaviors in Korea: a pooled study of 2,599 children and adolescents aged 9-14 years

BACKGROUND/OBJECTIVESDietary 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/METHODSWe 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.RESULTSMean 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).CONCLUSIONSThese 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.