PURPOSE: School meal programs should be part of the educational process to promote good eating habits for students. The purpose of this study was to develop an evaluation scale for educational school meal programs and evaluate the achievement level of educational school meal programs using the developed scale. METHODS: The evaluation scale for educational school meal programs consisted of 23 items in eight categories and was developed using content validity ratio (CVR) analysis and analytic hierarchy process (AHP) by 15 related experts. The results of a survey on nutrition teachers or dietitians at 91 elementary, middle, and high schools in Gyeonggi province, South Korea were analyzed to evaluate the achievement levels of educational school meal programs. RESULTS: Overall, total average score was 45.7 out of 100, with significant differences among schools (p = 0.005). Elementary schools (51.9) showed a higher average score than middle (41.5) and high schools (37.1). The score for the category of regular nutrition and dietary education was the lowest (5.7 out of 33.7). In addition, school meal environment (5 out of 10), educational activities through school meal time (9.2 out of 19), and extra-curricular experiential activities (3.5 out of 10) also showed inadequate levels. CONCLUSION: The results show that the overall level of educational school meal programs is not adequate and needs to be improved, especially at middle and high schools. Government support polices need to be implemented to encourage educational activities related to school meal programs.
Eating ; Education ; Gyeonggi-do* ; Humans ; Korea* ; Meals* ; Nutritionists

PURPOSE: This study was conducted for analysis of menu pattern and food diversity of snack menus of child care centers in order to provide preliminary data for establishment of related guidelines for snack menus for child care centers. METHODS: Data from 630 snack menus (350 for morning snacks and 280 for afternoon snacks) of March, 2013 from 14 Child Care Information Centers in Seoul provided for child care centers were analyzed. In addition, the menu pattern and food diversity of morning snack menus were compared with those of afternoon snack menus. RESULTS: Differences in menu pattern and food diversity were observed between morning and afternoon snack menus. The majority of snack menus (66.8%) included two menu items and the numbers of menu items of afternoon snack menus were significantly larger than those of morning snack menus. The percentages of "Grains (G)" and "Grains (G) + Milk (D)" patterns were higher in snack menu (G: 18.9%, G+D: 17.1%). Approximately one third of snack menus were composed of only one food group. In addition, 45.6 % of all snack menus comprised milk and only 23.0% included fruits. CONCLUSION: These results demonstrated the need for improvement in food composition and diversity of snack menus provided by Child Care Information Centers for child care centers. Therefore, to ensure children's intake of nutritionally balanced snacks, it will be necessary to establish more detailed guidelines for the menu pattern and food composition in snack menus for child care centers.
Child ; Child Care* ; Fruit ; Humans ; Information Centers* ; Milk ; Seoul ; Snacks*

Thrombomodulin (TM) is thrombin receptor present on the luminal surface of endothelial cells. Because the thrombin-TM complex acts as an anticoagulant, the functional variants or deficiency of TM may lead to increment of thrombotic tendency. In this study, we screened the genetic variants of the TM gene in patients with myocardial infarction (MI) and analyzed the genotype to elucidate the effects of genetic variations of TM gene on the development of the MI. We screened a promoter region and coding sequence of the TM gene using single strand conformation polymorphism-heteroduplex analysis and identified three common genetic variants: those were TM G-33A, TM Ala455Val, and TM C1922T. The genotype frequencies were investigated in the patients with MI (n=234) and control subjects (n=291) by the method of allele-specific oligomer hybridization. The frequencies of mutant genotypes (TM -33A, TM 455Val, and TM 1922T) were higher in patient group compared to the control subjects in males while there were no significant differences in females. In the multiple logistic regression analysis, TM 455Val and TM 1922T alleles were independent risk factors for MI (OR[95% CI: 1.799[1.125-2.878] p=0.014 and 5.624[1.019-31.025], p=0.048, respectively) in males. However, the genetic variations were not independent risk factors for MI in females. There were significant linkage disequilibriums among three genetic variants. These linkage disequilibriums explain the similar effects of three genetic variants on the development of MI. To investigate the effect of the TM G-33A mutation on TM promoter activity, the two TM promoter constructs (pTM-355 and pTM-125, bearing TM -33G or TM -33A) containing of firefly luciferase gene were transfected into HepG2, BAE, and CHO cells. The promoter activities were higher in the promoter constructs with TM -33G compared to the constructs with TM -33A in pTM-355. These results suggest the possibility of the positive predisposing effect of TM -33A allele on MI in males. The functional study for TM Ala455Val and TM C1922T should be followed to elucidate the genotype effects of these mutations on the development of MI. In this study, we identified three genetic variants of TM gene and showed the significant associations between genetic variants and MI in males. These results proposed that TM gene is an attractive candidate for genetic risk factor for MI in Koreans.
Alleles ; Animals ; CHO Cells ; Clinical Coding ; Cricetinae ; Endothelial Cells ; Female ; Fireflies ; Genetic Variation ; Genotype ; Humans ; Linkage Disequilibrium ; Logistic Models ; Luciferases ; Male ; Myocardial Infarction* ; Phenobarbital ; Promoter Regions, Genetic ; Receptors, Thrombin ; Risk Factors* ; Thrombomodulin

BACKGROUND: Recently, new plasmid-mediated extended-spectrum beta-lactamases have been reported. These are not derived from TEM or SHV enzymes but are related to cephalosporins of Enterobacteriaceae (AmpCenzymes), that confer to all cephalosporins including cefoxitin. METHODS: Fifteen clinical isolates of cefoxitin-resistant Klebsiella pneumoniae were charaterized. Antimicroilutin method. Crude beta-lactamases were prepared by sonication and isoelectric focusing of the enzyme preparations was performed in polyacrylamide gel. The transmissibility of resistance was tested by mating to E. coli J53. We performed PCR and hybridization for further characterization of the AmpC-type beta-lactamse. RESULTS: Seven strains were found to have the plasmid-mediated AmpC type beta-lactamase as a pI of 8.0 and this was confirmed to be cmy-1 beta-lactamase by PCR and hybridization analysis. These strains were resistant to ampicillin and piperacillin with MICs above 128microgram/ml. Cefoxitin resistance could be transferred from 4 strains via a large plasmi with molecular sizes approximately 77 or 130 kb. The molecular weight of CMY-1 enzyme is approximately 38kDa. We analyzed the OMP of six cefoxitin-resistance K. pneumoniae. Two of six strains were lacking a major OMP of approximately 40 kDa, but four of them showed another 39 kDa sized band just below the 40 kDa major OMP, which were thought to be a modified 40 kDa OMP. CONCLUSION: With these results, we conclude that resistance to cefoxitin in K. pneumoniae isolated from Korean patients is either associated with the productin of CMY-a, a plasmid-mediated AmpC type beta-lactamase, of altered expressin of an outer membrane protein.
Ampicillin ; beta-Lactamases* ; beta-Lactams ; Cefoxitin ; Cephalosporins ; Enterobacteriaceae ; Humans ; Isoelectric Focusing ; Klebsiella pneumoniae* ; Klebsiella* ; Membrane Proteins ; Molecular Weight ; Piperacillin ; Pneumonia ; Polymerase Chain Reaction ; Sonication

BACKGROUND/OBJECTIVES: School meals are not just meals consumed at school, they are part of the culture, education, and life experience at school. Nevertheless, few studies have revealed the influence of school meals on students' school lives. The purpose of this study was to investigate the effect of satisfaction with the school meal program on students' school happiness. SUBJECTS/METHODS: A survey conducted in December 2015 asked 2,336 students (1,062 elementary school students, 880 middle school students, and 394 high school students) about their satisfaction with the school meal program and their school happiness. Multiple regression analyses were used to examine the relation between the students' school meal satisfaction and their happiness level. RESULTS: The average level of satisfaction with school meals of elementary school students was 4.1 out of 5 points, comparatively higher than that of middle and high school students, with a significant difference between school levels (P < 0.001). In addition, school happiness, as well as overall happiness, of elementary school students was higher than that of middle and high school students (P < 0.001). The school meal operation factor (0.232, P < 0.001) had the most influence on students' school happiness, followed by the school meal environment factor (0.219, P < 0.001) and school meal quality factor (0.136, P < 0.001). Overall satisfaction (0.097, P = 0.001) and school meal hygiene factor (0.095, P = 0.001) also had significant influences on students' school happiness. CONCLUSIONS: Students' satisfaction with the school meal program was related to their school happiness. Therefore, plans to enhance students' satisfaction with a school meal program needs to be implemented, with emphasis on placing a priority on school meal operation and school environment factors, in order to improve students' level of happiness.
Education ; Happiness* ; Humans ; Hygiene ; Korea* ; Life Change Events ; Meals*

BACKGROUND/OBJECTIVES: This study investigated the importance and performance level of sodium reduction practices in school meal service by school nutrition teachers and dietitians, and compared them according to school level and placement of the school nutrition teacher. SUBJECTS/METHODS: An online survey was conducted with 608 nutrition teachers and dietitians in schools in the Republic of Korea from September 28 to November 12, 2021 (response rate: 57%). The questionnaire comprised 11 items related to sodium reduction practices (purchasing, food preparation and serving, and education). The importance and performance level of each item was rated on a 5-point scale. The mean differences were analyzed using t-tests or one-way analyses of variance and Duncan’s post-hoc tests. An importance-performance analysis was performed on sodium reduction practices. RESULTS: Participating in sodium reduction education, sodium reduction education for cooks, and sodium reduction education for students were assessed to have high importance but low performance. Overall, the higher the school level, the lower was the importance level of sodium reduction practices. The performance in kindergartens and elementary schools was higher than that in middle and high schools. The importance in the purchasing category perceived by dietitians was lower as compared to nutrition teachers. In addition, the performance in the purchasing, food preparation and serving, and education categories perceived by dietitians was lower than those of nutrition teachers. CONCLUSION Sodium reduction education for nutrition teachers and dietitians, cooks, and students should prioritize practicing sodium reduction in school meal service. Specific guidelines for managing sodium reduction at all stages—purchasing, food preparation, and serving—should also be developed. The results could be used as basic data to reduce the sodium content in school meals.

PURPOSE: The purpose of this study was to investigate the current status of dietary education carried out by dieticians or nutrition teachers at elementary, middle, and high schools in Gyeonggi province. We compared dietary education status not only among school level but also between dieticians and nutrition teachers. METHODS: The survey using self-administered questionnaires was conducted by dieticians or nutrition teachers at 91 schools (43 elementary schools, 33 middle schools, and 15 high schools) in Gyeonggi province in December, 2015. The questionnaire consisted of questions regarding general characteristics of respondents, current status of dietary education, opinion about dietary education methods, and cooperation level of persons concerned. RESULTS: The placement rate of nutrition teachers was 50.5% overall. Only 36 out of 91 schools conducted regular dietary education, and the percentage of schools conducting regular dietary education was significantly different according to school level with the lowest percentage in high schools, equivalent to 20% (p = 0.003). The average annual dietary education time was 12.4 hours, and it was very low in high schools (5.1 hours) and in schools without a nutrition teacher (1.6 hours). The levels of cooperation and support from principals, teachers, parents, and students were significantly lower in high schools than elementary and middle schools (all p < 0.001) and in schools without a nutrition teacher than schools with a nutrition teacher (all p < 0.05). CONCLUSION: The results show that the level of dietary education is not enough and needs to be improved, especially at middle and high schools and at schools without a nutrition teacher. Government support polices need to be implemented to encourage dietary educational activities.
Education* ; Gyeonggi-do* ; Humans ; Nutritionists ; Parents ; Surveys and Questionnaires

This study was conducted to characterize well-being menus and to examine the service frequency and profitability of those served in the contract-managed workplace foodservice. In-depth interviews were conducted with six persons who were in charge of menu management in the headquarters of six different foodservice management companies during March, 2007. In addition, 122 set menus consisting of 777 menu items, which were on one month menus served during January to April, 2007, were collected from three workplace operations managed by three different foodservice management companies. As a result of the in-depth interviews, four categories of well-being menu items were extracted: 'medicinal, functional menu item', 'environmentally- friendly menu item', 'natural food menu item', and 'harmful components-limiting menu item'. Accordingly, a well-being menu item was defined as 'a menu item with increased nutrition value or decreased health risk by changing food material or cooking method'. When the menu items (n=777) were analyzed by applying the definition and categories, approximately 14% of the items were identified as well-being menu items and most of them were either medicinal, functional (65%) or natural food menu items (33%). Approximately 59% of the 122 set menus included at least one well-being menu item, and therefore they were named the well-being set menus. These well-being set menus, however, were not significantly different from the rest set menus in terms of profitability as measured by the contribution margin. The results of this study could be useful for foodservice management companies to develop and plan well-being menus targeting workplace foodservice operations.
Cooking ; Fees and Charges ; Humans ; Nutritive Value

This study aimed to evaluate the effectiveness of the foodservice management support program focusing on menu management in community child centers. The support program provided reference menus, staff training, and field consulting to 10 community child centers in the Jeollanam-do province for one month, August in 2010. One month menus were developed, based on children's preference for menu items, foodservice personnel's preference for food materials, and availability of local specialty foods, and offered as reference menus. In addition, staff training and field consulting focusing on menu management were conducted before and during the pilot period, respectively. To evaluate the support program, menus, foodservice personnel's knowledge level and perceived performance in foodservice management, and children's level of satisfaction for foodservice were analyzed before and after the support program. As a result of analysis of 222 and 210 menus of before and after the support program, respectively, the number of dishes per meal increased from five to six on average, and the proportion of meals including five food groups, which were grain, meat, vegetable, fruit, and milk and dairy product, rose from 2% to 24%. Foodservice personnel's knowledge level regarding foodservice management increased significantly (p = 0.007), however, their perceived performance in foodservice management did not show any significant changes. Children were more satisfied with 'food' (p = 0.001), 'sanitation' (p = 0.001), and 'environment' (p < 0.008) of foodservice in community child centers after the support program. In conclusion, the foodservice management support program focusing on menu management in this study was effective for improving menu quality of and children's satisfaction with foodservice in community child centers.
Edible Grain ; Child ; Dairy Products ; Fruit ; Humans ; Korea ; Meals ; Meat ; Milk ; Vegetables

The purpose of this study was to investigate school dietitians' satisfaction with and needs for School Meal Service Support Centers. A web-based on-line survey was conducted with 1,102 nutrition teachers or school dietitians using four School Meal Service Support Centers during the summer of 2011. The data from 578 respondents (52.5%), consisting of 165 (44.4%), 334 (53.4%), 41 (67.2%), and 38 (86.4%) dietitians using Seoul, Gyeonggi, Suncheon and Gyeongju centers, respectively, were analyzed. The main reason for using the centers was subsidies from local governments. The dietitians using the metropolitan centers, which were Seoul and Gyeonggi centers, tended to buy agricultural products through the centers only, and those using local centers, which were Suncehon and Gyeongju centers, bought those products from the private suppliers as well as from the centers. The dietitians' overall level of satisfaction with the centers was not high showing 3.3 out of 5 points; it was significantly associated with the operating system and services of the centers such as system efficiency, delivery accuracy, communication, and information provision rather than the agricultural products provided by the centers. The dietitians preferred joint operation of the centers by local governments and producers' groups. They wanted School Meal Service Support Centers to be evaluated every year. It was suggested that efforts should be made to improve the operation system and service of School Meal Service Support Centers for improving dietitians' satisfaction with the centers. In addition, an evaluation system for School Meal Service Support Centers should be implemented soon based on school dietitians' needs.
Surveys and Questionnaires ; Humans ; Joints ; Meals