Diet-related behavioral modification for healthy eating and lifestyle is required to improve childhood obesity. The present study aimed to develop customized nutritional intervention protocol and education program to find barriers to adhere healthy diet and lifestyle for moderate to severe obese children and adolescents and their families. Theoretical framework approaches can be used to change behavior and achieve goals. Previous studies that described the relationship between behavioral modification and nutrition education theory were reviewed. The social cognitive theory and transtheoretical model were employed with behavioral changes to target a healthful diet and lifestyle. The nutrition care process (NCP) model was adopted to customize nutrition care for the participants. Customized nutritional intervention protocol was developed following as the four steps of the NCP. Firstly, nutrition status of the participants was assessed by the nutrition expert. Nutrition problems were described as “inadequate energy intake,” “overweight/obesity,” or “food and nutrition-related knowledge deficit.” All nutrition sessions were designed for nutrition intervention to give nutritional knowledge and a practical mission in real life for individual goal setting and self-control. Meal planning, portion control, healthy snack selection and cooking with fruits and vegetables were consisted of five components of the nutrition education session. During each session, the participants and their families were interviewed by a nutrition expert for monitoring and evaluating diet-related goal setting and achievement. A theoretical and evidence-based nutritional intervention was developed for the secondary to tertiary prevention of childhood obesity. This nutrition intervention protocol and program might be helpful for the further research on childhood obesity. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0002111
Adolescent ; Behavior Therapy ; Child ; Cooking ; Diet ; Eating ; Education ; Fruit ; Humans ; Information Services ; Life Style ; Meals ; Nutrition Assessment ; Nutritional Status ; Pediatric Obesity ; Self-Control ; Snacks ; Tertiary Prevention ; Vegetables

OBJECTIVES: Young athletes require adequate nutrition to maintain their athletic performance, growth and health. This study examined the status and needs of nutrition management and meal services for student athletes among the athlete's parents. METHODS: The subjects were parents of elementary, middle, and high school athletes (n=323) from 18 schools participating mainly in the Sports Food Truck. The questionnaire included general characteristics, status and needs on nutrition management and meal service for student athletes, and satisfaction with the Food Truck. The survey was done during 2018. The data were analyzed according to the school groups using a χ2-test or ANOVA. RESULTS: Approximately 45% of subjects had difficulty in the nutrition management of athletes, and 87.1% had not received nutrition education. Approximately 74% wanted nutrition education held for athletes, and mainly wanted topics on nutrition management for health and eating for athletic performance. The preferred methods were lectures and cooking activity. The responses on the necessity of nutrition education for athletes, desired education topics, and desired times for education differed significantly according to the school groups (p < 0.05). Most subjects also wanted nutrition information mainly through SNS. In the athlete's meal, breakfast and snacks were highlighted as the meal to supplement. Approximately 90.3% responded that providing a meal service is necessary. The subjects preferred snacks before/after exercise and dinner if a meal service was provided. They preferred Korean food, followed by snacks, and a dish meal. As the meal type, the subjects wanted the Food Truck and packed meal. The responses on necessity of a meal service (p < 0.05), preferred food (p < 0.001), and meal type (p < 0.001) in the meal service differed significantly according to the school groups. Approximately 43% were satisfied with the Food Truck and 50.8% responded as average. They made suggestions for the Food Truck in terms of foods, operations and frequency. CONCLUSIONS: Based on the study results, nutrition education and meal service may support nutrition for student athletes considering the needs of the parents according to the school groups.
Athletes ; Athletic Performance ; Breakfast ; Cooking ; Eating ; Education ; Humans ; Lectures ; Meals ; Motor Vehicles ; Needs Assessment ; Parents ; Snacks ; Sports

OBJECTIVES: Young athletes require adequate nutrition to maintain their athletic performance, growth and health. This study examined the status and needs of nutrition management and meal services for student athletes among the athlete's parents. METHODS: The subjects were parents of elementary, middle, and high school athletes (n=323) from 18 schools participating mainly in the Sports Food Truck. The questionnaire included general characteristics, status and needs on nutrition management and meal service for student athletes, and satisfaction with the Food Truck. The survey was done during 2018. The data were analyzed according to the school groups using a χ2-test or ANOVA. RESULTS: Approximately 45% of subjects had difficulty in the nutrition management of athletes, and 87.1% had not received nutrition education. Approximately 74% wanted nutrition education held for athletes, and mainly wanted topics on nutrition management for health and eating for athletic performance. The preferred methods were lectures and cooking activity. The responses on the necessity of nutrition education for athletes, desired education topics, and desired times for education differed significantly according to the school groups (p < 0.05). Most subjects also wanted nutrition information mainly through SNS. In the athlete's meal, breakfast and snacks were highlighted as the meal to supplement. Approximately 90.3% responded that providing a meal service is necessary. The subjects preferred snacks before/after exercise and dinner if a meal service was provided. They preferred Korean food, followed by snacks, and a dish meal. As the meal type, the subjects wanted the Food Truck and packed meal. The responses on necessity of a meal service (p < 0.05), preferred food (p < 0.001), and meal type (p < 0.001) in the meal service differed significantly according to the school groups. Approximately 43% were satisfied with the Food Truck and 50.8% responded as average. They made suggestions for the Food Truck in terms of foods, operations and frequency. CONCLUSIONS: Based on the study results, nutrition education and meal service may support nutrition for student athletes considering the needs of the parents according to the school groups.
Athletes ; Athletic Performance ; Breakfast ; Cooking ; Eating ; Education ; Humans ; Lectures ; Meals ; Motor Vehicles ; Needs Assessment ; Parents ; Snacks ; Sports

PURPOSE: Dyslipidemia is a major risk factor for cardiovascular disease. Pine needles (Pinus densiflora seib et Zucc) are a traditional medicine used to treat dyslipidemia in clinical settings. This study examined the potential effects of sulgidduk, a Korean traditional rice cake containing pine needle juice to protect against dyslipidemia induced by a high-fat/sugidduk diet in a rat model. METHODS: Twenty one male Sprague-Dawley rats were divided randomly into three groups: normal control (NC), Sulgidduk diet (SD), Sulgidduk diet containing pine needle juice (PSD). The blood lipid levels, production of lipid peroxide in the plasma and liver, total cholesterol and triglyceride in the liver and feces, antioxidant enzyme activities in plasma and erythrocytes were measured to assess the effects of PSD on dyslipidemia. RESULTS: A high-fat/Sulgidduk diet induced dyslipidemia, which was characterized by significantly altered lipid profiles in the plasma and liver. The food intake was similar in the three groups, but weight gain and food efficiency ratio (FER) were reduced significantly in the PSD group compared to those in the SD group. The level of total cholesterol, LDL-cholesterol and TBARS in the plasma showed tendencies to decrease in the PSD group compared to those in the SD group. The levels of high-fat/Sulgidduk diet-induced sterol regulatory element-binding protein 2 (SREBP2) gene expression were reduced significantly in the PSD group. The supplementation of PSD reduced the hepatic triglyceride and total cholesterol levels significantly, and enhanced the fecal excretion of triglyceride and hepatic antioxidant enzyme activities compared to the SD group. CONCLUSION: These results suggest that the addition of 0.4% pine needle juice to Sulgidduk may be an alternative snack to control dyslipidemia.
Animals ; Cardiovascular Diseases ; Cholesterol ; Diet ; Dyslipidemias ; Eating ; Erythrocytes ; Feces ; Gene Expression ; Humans ; Lipid Metabolism ; Liver ; Male ; Medicine, Traditional ; Models, Animal ; Needles ; Plasma ; Rats ; Rats, Sprague-Dawley ; Risk Factors ; Snacks ; Thiobarbituric Acid Reactive Substances ; Triglycerides ; Weight Gain

OBJECTIVES: Although the number of laboratory workers is constantly increasing every year, few studies have been conducted on the health and nutritional status of these research workers. This study determined the health status of laboratory workers by analyzing their anthropometric indices, dietary life, vitamin D status and blood clinical indices. METHODS: The subjects consisted of 100 female laboratory workers. This study investigated their diet, anthropometric indices, vitamin D status and blood clinical indices. The subjects were divided into two groups according to their duration of working in a laboratory (<1 year,≥1 year). RESULTS: The average age and body mass index (BMI) of subjects were 23.18 years and 21.51 kg/m2, respectively Those subjects with over 1 year employment (≥1 year) had a significantly higher waist-hip ratio than that of the subjects with the less than 1 year employment (<1 year). The mean serum vitamin D level of all the subjects was 10.04 ng/mL, which is close to a level of vitamin D deficiency. There was a significantly higher average intake of calories in the over 1 year employment group as compared to that of the less than 1 year employment group. The frequency of eating sweet snacks was significantly higher for the over 1 year employment group. The correlation analysis showed a significant positive correlation between the serum 25-(OH)-vitamin D level and the time of exposure to sunlight, while dietary intake of vitamin D did not show correlation with the serum 25-(OH)-vitamin D level. However, the serum 25-(OH)-vitamin D level was also negatively correlated with both the percentage of body fat and visceral fat. CONCLUSIONS: Laboratory workers are a very high risk group in terms of their nutritional status of vitamin D. Therefore, they need greater time of exposure to sunlight as well as increasing their dietary consumption of vitamin D. In addition, it is important for laboratory worker to practice regular and balanced dietary habits in order to maintain a healthy life.
Adipose Tissue ; Body Mass Index ; Diet ; Eating ; Employment ; Female ; Food Habits ; Humans ; Intra-Abdominal Fat ; Nutritional Status ; Snacks ; Sunlight ; Vitamin D Deficiency ; Vitamin D ; Vitamins ; Waist-Hip Ratio

OBJECTIVES: This study examined the association of the sleep quality and patterns with the dietary behavior, including snack and beverage consumption, taste preferences, as well as lifestyle of university students. METHODS: The subjects were 406 university students in Cheongju, Korea, and the data were collected using a self-administered questionnaire. They were divided into two groups according to the Pittsburgh Sleep Quality Index (PSQI): good-quality sleepers (PSQI score ≤ 5) and poor-quality sleepers (PSQI score > 5). The data were analyzed using a χ2-test, independent t-test, and analysis of covariance using the SPSS 25.0 program. RESULTS: Fifty-two percent of university students were categorized as poor-quality sleepers by the PSQI. Students classified as poor-quality sleepers had delayed bedtimes, and a shorter duration in bed and total sleep hours than the good-quality sleepers did. Poor-quality sleepers were more prevalent among those who were female, having irregular mealtimes, or frequent late night meals. They also consumed fast food frequently, such as fried chicken and hamburgers, and noodles when adjusted for gender. In addition, drinks with caffeine over milk were dominant among poor-quality sleepers. Furthermore, the preferences for spicy and salty tastes and longer smartphone usage were more prevalent in those with poor-sleep quality. CONCLUSIONS: These results showed that more than 50% of university students reported disturbed sleep and poor quality sleep was associated with less desirable snack consumption and taste preference, more smartphone usage, and others. Therefore, nutrition education program along with lifestyle changes promoting sufficient sleep are encouraged to provide for university students, particularly those who have poor sleep quality.
Beverages ; Caffeine ; Chickens ; Chungcheongbuk-do ; Education ; Fast Foods ; Female ; Food Habits ; Humans ; Korea ; Life Style ; Meals ; Milk ; Smartphone ; Snacks

OBJECTIVES: The study was performed to examine the dietary behaviors and life stress of middle school students in the Gyeonggi area. METHODS: A total of 580 middle school students (295males, 285 females) in the Gyeonggi area participated in the study between July and August in 2011. The study was a questionnaire-based survey that included dietary habits, dietary behaviors, and life stress. RESULTS: For dietary habits, the score for drinking milk was higher in male students than in female students, whereas the score for eating fruits was higher in female students compared to male students. There were significant differences in foods eaten and preferred under stress between male and female students. Male students showed significantly less changes in the number of meals, amount of meal intake, number of snacks, snack intake, frequency of overeating, and appetite during stress than female students. Life stress score of students largely came from academic factors, and female students showed higher stress levels in personal and surrounding environment factors than male students. Life stress score was significantly lower in students with high and moderate levels of dietary habits than in students with a low level of dietary habits. Total score for dietary habits and scores for eating adequate amounts of foods for each meal, considering a combination of food groups at each meal and eating green and orange vegetables, were significantly negatively correlated with life stress score. Life stress score was significantly negatively correlated with meal regularity and positively with the level of overeating. CONCLUSIONS: This study may provide basic information on dietary habits and life stress according to gender and the relationship between dietary behaviors and life stress of middle school students, and it suggests gender-based nutrition education programs to solve undesirable dietary habits and dietary behaviors in students with higher stress.
Appetite ; Citrus sinensis ; Drinking ; Eating ; Education ; Female ; Food Habits ; Fruit ; Gyeonggi-do ; Humans ; Hyperphagia ; Male ; Meals ; Milk ; Snacks ; Stress, Psychological ; Vegetables

OBJECTIVES: Snacks contribute to the diet quality in youth, which is often poor. Although the US Department of Agriculture (USDA) has guidelines for healthy snacks, this is lost in translation when youth are choosing snacks. To develop a userfriendly app to help identify healthy snacks based on the US Department of Agriculture guidelines and evaluate the app's feasibility, usability, satisfaction, and acceptability. METHODS: The ‘Snackability’ app was developed following the ADDIE (analysis, design, development, implementation, and evaluation) model. The app was pilot tested for 2 weeks among college-age students (18–24 years) using questionnaires and focus groups. Based on the feedback received, the app was improved, and pilot-tested again. RESULTS: The app had a simple score (−1 to 11) and feedback (the higher the score, the healthier the snack is). The 1st pilot test among 12 students showed that the app's feasibility and usability were >50% (p < 0.05). Participants reported that the app was a good way to help individuals select and consume healthy snacks and suggested improving the search process and including average score reports, a ‘consumed history’ tab, gamification, notifications, and the option to add snacks not found. These were incorporated into the 2nd version of the app, which was pilot tested among 8 students. Feasibility, usability, and acceptability of the 2nd version were >50% (p < 0.05). Additional suggestions were to include images for serving size, snack alternatives, and barcode scanning, which were incorporated into the 3rd version. CONCLUSIONS: Snackability app was feasible, usable, satisfactory, and acceptable, and several features were improved as suggested by participants.
Adolescent ; Agriculture ; Diet ; Focus Groups ; Humans ; Serving Size ; Smartphone ; Snacks ; United States Department of Agriculture

PURPOSE: This study aimed to explore the environmental factors affecting childhood obesity using photovoice from the perspectives of students, parents, and teachers in the community. METHODS: Six school students, seven parents, and seven school teachers completed an assignment requiring them to take 24 pictures and participate in group discussions. After training session, the participants were asked to take pictures associated with food and physical activity environments related to childhood obesity at home, school, and within their communities for two weeks and to submit the pictures with records. Each group had four sessions for discussion. RESULTS: School cafeteria, convenience stores near schools, instant food and fast food joints, food delivery, and high-calorie snacks comprised the food environmental factors. Lack of physical activity classes at school, commuting by car, barriers to physical activity, and use of smart-phone were environmental factors that inhibited physical activity. CONCLUSION: To reduce childhood obesity, the creation of a supportive environment for encouraging the consumption of healthy foods and enhancing physical activity should be considered. Modifications of and improvement to the obesogenic environment might be a good strategy to prevent and reduce childhood obesity.
Child ; Fast Foods ; Humans ; Joints ; Motor Activity ; Obesity ; Parents ; Pediatric Obesity ; Snacks ; Transportation ; Voice

PURPOSE: This study examined the relationship among the use of food-related content (FRC), dietary behaviors, and dietary self-efficacy to demonstrate the need for nutrition education to help adolescents build healthy eating habits and provide evidence for developing nutrition education programs for adolescents. METHODS: Three hundred and eighty-one high school students in Seoul and Gyeonggi areas participated in the study. The subjects were divided into three groups (low, medium, and high) according to the level of use of the FRC, and their general characteristics, dietary behaviors, and dietary self-efficacy were analyzed. Correlation analysis was performed between FRC usage, dietary behaviors, and dietary self-efficacy, and the mediating effects of dietary self-efficacy on the relationship between the level of the use of FRC and dietary behaviors were estimated. RESULTS: A higher level of FRC usage was associated with an increased daily cost of eating out and snacking, but no difference was observed in the BMI range. The subjects in a group with a high level of FRC usage ate convenience store or instant foods instead of homemade meals (p = 0.033), had a late-night meal or snack (p = 0.024), and turned to emotional eating under stress (p < 0.001) more than those in the low level group. In addition, the high level group checked the nutrition facts label more carefully when purchasing processed foods (p = 0.016) and exercised at least 30 minutes daily, not considering physical education classes (p = 0.057). The higher level of FRC use, the lower the dietary self-efficacy, whereby the subscales ‘environmental stimulus control efficacy’ and ‘affective factor control efficacy’ showed complete mediating effects. CONCLUSION: Given that FRC has been increased recently, adolescents are in need of support to help them control and enhance their dietary self-efficacy as well as develop healthy dietary behaviors through proper nutrition education programs.
Adolescent ; Eating ; Education ; Gyeonggi-do ; Humans ; Meals ; Negotiating ; Physical Education and Training ; Seoul ; Snacks