Purpose: This study examined the effects of nutritional education related to sugar in elementary school children on nutritional knowledge, attitude, and dietary behavior. Methods: A questionnaire survey on the knowledge, attitudes, and intake related to sugar was conducted on 572 students in grades 4–5, who were attending five elementary schools in Seoul and Gyeonggi-do. Results: Among the survey subjects, 270 (49.8%) were cognitive in education, and 302 (50.2%) were non-cognitive. The sugar-related knowledge score was 3.67 points in the cognitive education group, which was significantly higher than the 3.55 points in the non-cognitive group. The rate of checking the sugar content in the nutrition label was 31.2% in the cognitive education group, which was significantly higher than in the non-cognitive group, 15.4%. The cognitive education group had a higher intake frequency of unsweetened candy, jelly, and raw fruits, and higher sugar intake of unsweetened bread, white milk, and raw fruits than the non-cognitive group. In the case of the cognitive education group, the total knowledge score showed a positive correlation with the food behavior scores, and a negative correlation with the frequency of purchasing snacks after school, and the average sugar intake per day. In the cognitive education group only, the education of nutrition teachers was analyzed as a factor to reduce the total sugar intake. The cognitive group of sugar education tried to eat foods with a lower sugar content than the non-cognitive group, and nutrition education was an important factor affecting the sugar intake. Conclusion To reduce the sugar intake of elementary school students, it will be necessary to practice oriented-nutrition education by nutrition teachers continuously. In addition, it is important to develop and disseminate various types of nutrition education materials related to sugar that can be utilized easily by nutrition teachers.

To investigate the change of perception after weight management education in elementary, middle and high school students, a survey was conducted. Same questionnaire was administered twice, before and after weight management education, to 426 students at 9 schools in Seoul area. The mean height, weight and body mass index were 145.5+/-8.0cm, 40.0+/-8.3kg, 18.6+/-3.0 for elementary school students, 160.1+/-5.2cm, 50.2+/-7.3kg, 19.5+/-2.4 for middle school students, and 162.2+/-5.0cm, 52.2+/-6.4kg, 19.8+/-2.3 for high school students, respectively. Before education, their preferred weight and perceived healthy weight was 35.4kg and 37.0kg among elementary school students, 44.8kg and 46.5kg among middle school students, and 47.3kg and 48.9kg among high school students, respectively. Differences between their present body weight and their preferred weight and/or perceived healthy weight appeared to be 4.5kg and 2.9kg in elementary school students, 5.6kg and 4.0kg in middle school students, and 5.1kg and 3.3kg in high school students, respectively. After administering education, the differences decreased to 2.5kg and -0.2kg in elementary school students, 4.2kg and 2.7kg in middle school students, and 4.3kg and 2.0kg in high school students, respectively (p<0.01). And their perception on own body shape was investigated using 5 point scale ('too lean' to 'too fat', 1 to 5) before and after education. The mean values changed from 3.1 to 2.8 in elementary school students, from 3.3 to 3.0 in middle school students, and from 3.4 to 3.2 in high school students (p<0.01). Their satisfaction with own body weight was monitored using 5 point scale ('very satisfied' to 'very unsatisfied', 1 to 5), also. The mean values changed from 3.0 to 2.7 in elementary school students, from 3.6 to 3.2, in middle school students, and from 3.8 to 3.4 in high school students (p<0.01). In the evaluation of their nutrition knowledge about weight control using 10 item quiz, before and after education, the mean quiz score was changed from 6.3 to 7.0 in elementary school students, from 7.0 to 7.9 in middle school students, and from 7.5 to 8.1 in high school students (p<0.01). In summary, nutrition education on weight management improved the subject's perception on perceived healthy weight and own body shape, and satisfaction with present body weight. This result suggests that nutrition education program should incorporate strategies to change incorrect beliefs and knowledge regarding weight control. Onto this, weight control education for students should start from their early age, be repeated periodically and consistently, and focus on the harmful effects of excessive weight loss and information on the practical and scientific ways of weight management.
Body Mass Index ; Body Weight ; Education* ; Humans ; Surveys and Questionnaires ; Seoul* ; Weight Loss

The voluntary addition of vitamins and minerals to the appropriate foods may help reduce the risks associated with low intakes of these micronutrients, yet the potential of excessive intake, particularly for persons consuming very large amount of foods needs to be addressed. Using the Flynn's model to estimate the level of each vitamins and minerals that can be added safely to foods, maximum levels of fortification to conventional foods per 100 kcal portion were estimated. Critical factors in the Flynn's model included tolerable upper intake level (UL), each micronutrient intake at the 95th percentile, the proportion of fortified foods in the diets of individuals, the proportion of foods to which micronutrients could be practically added, and a range of estimates for fractions of foods which might be actually fortified in each nutrient. Food vehicles included all foods except for fresh foods and alcoholic beverages, in general. With fortification of 50% of all potentially fortifiable foods, micrornutrients could be added safely to foods at levels per 100 kcal 1) >100% Recommended Intake (RI) for vitamin B12, 2) 1,200% RI for vitamin B1 and niacin, 3) 1,000% RI for vitamins B2 and B6, 4) 400% RI for vitamin E, 5) 30% RI for calcium, 6) 20% RI for folic acid, iron and zinc, 7) 10% RI for manganese, 8) no fortification for magnesium, phosphorous and vitamin A, and 8) further consideration of vitamin D, copper and selenium due to insufficient evidence. Results of this study suggests a wide range of vitamins and minerals that can be added safely to foods in current diets of Koreans.
Alcoholic Beverages ; Calcium ; Copper ; Diet ; Folic Acid ; Food, Fortified ; Humans ; Iron ; Magnesium ; Manganese ; Micronutrients ; Minerals* ; Niacin ; Selenium ; Thiamine ; Vitamin A ; Vitamin B 12 ; Vitamin D ; Vitamin E ; Vitamins* ; Zinc

Abdominal obesity (AO) is a strong risk factor for type 2 diabetes and cardiovascular disease, which has shown a remarkable increase in Korea. This study aimed to identify prevalence of AO and related risk factors in Korean adults. A total of 5,132 men and women aged 20 - 85 years old from the 2001 Korean National Health and Nutrition Examination Survey were included in the analyses. AO was defined as waist circumference >= 90 cm in men and >= 85 cm in women as proposed by Korean Society of Obesity. Multiple logistic regression was carried out to identify risk factors for AO. Three models were specified: (i) demographic and socioeconomic factors (model 1: age, education, poverty income ratio, employment), (ii) lifestyle factors and covariates (model 2: physical activity, cigarette smoking, alcohol consumption, dietary quality, type 2 diabetes, co-morbidity) and (iii) demographic, socioeconomic and lifestyle factors (model 3). The prevalence of AO was 24.1% in men, 23.5% in women. High poverty income ratio in men and low education attainment in women were risk factors for AO in model 1. There was a significant association of AO with alcohol consumption, physical inactivity and dietary quality in men, alcohol consumption and cigarette smoking in women. These factors except alcohol consumption in men became insignificant in model 3. This findings underscore the importance of developing AO prevention programs in Korea that target the at risk groups identified in this study. A program focusing on low income men or less educated women would be more efficient.
Adult* ; Aged, 80 and over ; Alcohol Drinking ; Cardiovascular Diseases ; Education ; Female ; Humans ; Korea ; Life Style ; Logistic Models ; Male ; Motor Activity ; Nutrition Surveys* ; Obesity ; Obesity, Abdominal* ; Poverty ; Prevalence* ; Risk Factors ; Smoking ; Social Class ; Socioeconomic Factors ; Waist Circumference

This study aimed at investigating the perception and action plans of the school breakfast program (SBP) proposed by nutrition teachers and dietitians at elementary, middle, and high schools in Gyeongbuk province. The survey was carried via questionnaires throughout April to May 2010. Two hundred ten questionnaires were returned (52.5%) and out of the total, 194 were used for analysis. Of the respondents, 73% disagreed and 27% agreed to the implementation of SBP, although most respondents agreed to the importance of eating breakfast in children. The percentage of disagreement was higher among subjects with working experience of 15 years and more, age of 40 years and more, and those who were employed at elementary schools. The primary reasons of disagreement were 'eating breakfast with family is better' and 'it increases the cost of school foodservice'. The respondents preferred students' optional participation (62.9%) over universal participation (37.1%) of SBP. Action plans of SBP, which were proposed by nutrition teachers and dietitians, included direct operating system by the school, food delivery schedule prior to the day of serving, 2-3 hours of preparation time, serving food 50 minutes before the start of classes, and convenient style menu served at the school cafeteria. Efforts to lessen foodservice employees' workload as well as support from school principals and the Office of Education were suggested as prerequisites for a successful SBP implementation.
Appointments and Schedules ; Breakfast ; Child ; Collodion ; Eating ; Humans ; Surveys and Questionnaires

It was well received that well grounded behavioral theories were important in the development of effective nutrition education programs, but there are only a few programs available for Korean women. The objective of this study was to develop nutrition education programs for childbearing-aged women in Korea. Based on the findings of the needs assessment for the program and theoretical backgrounds, we developed behaviorally oriented tailored nutrition education program including motivation (MT), modifying (MD) and maintenance (MA) stages. The key concepts of the stages were motivation promotion for MT, increasing behavioral capabilities for MD, and strengthening self-management and building favorable environmental condition for MA. The education program was intended to be need in individual nutrition counseling, but it could be well used for group education by developing materials using the relevant contents. The primary users of the program were nutrition educators, however it could be also used by clients as needed. The introductory chapter provided dietary assessment tools and nutrition education tips. MT chapter included subjects such as nutritional status screening, costs of inappropriate nutrition and weight management, benefits of eating right, and activities for motivation promotion. MD stage chapter dealt with topics of healthy weight, knowledges and skills for better eating habits and physical activity status, and activities related to setting tailored behavioral objectives. MA stage focused on facilitating self management skills and building helping relationships. Each stage underlined activities using various educational tools in order to promote active participation of the client (s). For better use of this program, it was recommended to conduct program validation study.
Counseling ; Eating ; Education* ; Female ; Humans ; Korea* ; Mass Screening ; Motivation ; Motor Activity ; Needs Assessment ; Nutritional Status ; Self Care

This study aimed to identify risk factors for type 2 diabetes (T2D) in Korea, a rapidly changing country. Data of 5,132 adults aged 20-85 were used from the 2001 Korean Health and Nutrition Examination Survey. Multiple logistic regression was carried out to identify risk factors for T2D. Three models were specified: (i) socioeconomic and demographic factors (model 1: age, gender, education, poverty income ratio, employment), (ii) behavioral risk factors and covariates (model 2: obesity, physical activity, smoking, alcohol drinking, dietary quality, family history of T2D, co-morbidity) and (iii) socioeconomic, demographic, and behavioral factors (model 3). The prevalence of T2D was 7.4%. Less education (OR 1.41, 95% CI 1.08-1.84), age (OR 2.19, 95% CI 1.56-3.08 in 40-59 yrs, OR 4.05, 95% CI 2.76-5.95 in 60 yrs + comparing to 20-39 yrs) and abdominal obesity (OR 2.24, 95% CI 1.79-2.82) were risk factors for T2D even after controlling for other factors simultaneously. There was a significant association of T2D with ever smoking (OR 1.34, 95% CI 1.06-1.67). The relationship of age with T2D was modified by gender in model 1 and the relationship of smoking with T2D was modified by obesity in model 2. Less educated, older, obese or ever smokers were more likely to have T2D. Gender mediated the relationship of age, and obesity mediated the relationship of smoking, with T2D. Intervention programs for T2D in Korea should take the interactions among risk factors into account.
Adult ; Aged ; Alcohol Drinking ; Demography ; Humans ; Korea ; Logistic Models ; Motor Activity ; Nutrition Surveys ; Obesity ; Obesity, Abdominal ; Poverty ; Prevalence ; Risk Factors ; Smoke ; Smoking

This study examined the status of current nutrition labelling and claims for the processed foods that were purchased in the supermarket. They were assessed in the aspects of frequency and content of nutrition labelling and claims. The results are summarized as follows; The percentage of products contain the nutrition labelling or claims of processed foods of investigation were 18.7% and 18.8% respectively. In the nutrition labelling method, the format separated by expression contents with 'only liability indication nutrient' or 'liability indication nutrients plus discretion indication nutrients' were 44.7% and 43.4% respectively. In the case of type and title, 'table' and 'nutrition composition' were used most frequently, 83.9% and 83.2% respectively. And in the case of expression unit, 'per 100 g or 100 ml' was higher (56.8%) than others. Nutrition claims were divided into 'nutrition content claim' and 'comparative claim', in the former the most claim was 'containing' and in the other 'more or plus' used most frequently. 'Nutrient function claim' was 13.4% and 'Implied nutrient claim' was 7.3% of all the claims. Results of the evaluation of current nutrition labeling system, nutrition labelling was less advanced and variable in content and format and also the information was not easy for consumers to understand and use them. To support achievement of the nutrition label, there must be program and initiatives for better understanding and communication and guidances on food labelling and nutrition for food manufactures.
Food Labeling

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

The original version of this article contained errors in Tables. The contents of Table 4, 5, and 6 should be corrected.