BACKGROUND/OBJECTIVES: Cardiovascular diseases (CVDs) are the leading cause of death in Koreans, and eating habits, including diet quality, are among the etiologies of these diseases. Recently, various studies on regional health disparities have been conducted. However, there are limited studies on their relationship with nutritional factors. This study aimed to identify the magnitude of regional disparities in diet quality and prevalence of CVD in Korean adults. SUBJECTS/METHODS: This study included 17,646 participants aged ≥ 20 years from the 7 th (2013–2016) Korean National Health and Nutrition Examination Survey. Participants were classified into four groups based on their residential areas: City 1, City 2, City 3, and noncity. Demographic characteristics, health-related factors, body mass index (BMI), metabolic syndrome index, diet quality, and CVD prevalence were evaluated. RESULTS: In terms of demographic characteristics, age (P < 0.001), marital status (P < 0.001), educational level (P < 0.001), and income (P < 0.001) were lower in the non-city category. Health-related factors such as monthly drinking rate (P < 0.01) and mental stress (P < 0.05) were the highest in City 1 and lowest in the non-city group. Conversely, the current smoking rate (P < 0.05), BMI (P< 0.05), and prevalence of metabolic syndrome (P < 0.001) were the highest in the non-city group (P < 0.05). The non-city group also had the highest prevalence of CVDs (35.6%). This group had the lowest diet quality index (68.36 ± 0.22, P < 0.01), caused by low intake of fruit and calcium, a lack of sodium moderation, and an overall imbalance in the macronutrient and fatty acid ratio. When the diet quality index was increased by 1, the odds ratio for the prevalence of CVDs was reduced by 0.991 (P < 0.001), but this was not the case in all regions. CONCLUSIONS This study provides useful information and data in identifying and resolving the regional health disparities related to CVD prevalence and implementation of public health nutrition systems.

Background: As the coronavirus disease 2019 (COVID-19) has continued for a couple of years, the long-term effects of the pandemic and the subsequent school curriculum modification on the mental health of children and parents need to be investigated. To clarify the changes that can occur during one school year and to predict the risk factors for vulnerable groups, this study identified parameters relative to children’s screen time, their problematic behavior, and parental depression. Methods: A total of 186 participants were analyzed who were parents of elementary schoolchildren in South Korea. These parents were required to complete a web-based questionnaire twice. The questionnaires were conducted in June 2020 and September 2021. Participants’ general demographics including family income, children’s screen time, sleep patterns, problematic behavior, and parental depression were assessed via the parental questionnaire that included various measurement tools. Results: Children’s body mass index (BMI) increased significantly in 2021 (18.94 ± 3.75 vs. 18.14 ± 3.30, P < 0.001). Smartphone frequency of use per week (5.35 vs. 4.54, P < 0.001) and screen time per day (3.52 vs. 3.16, P < 0.001) significantly increased during the period of the COVID-19 pandemic. The television screen time (2.88 vs. 3.26, P < 0.001), frequency of viewing (3.77 vs. 4.77, P < 0.001), and children’s problematic behaviors significantly decreased (9.15 vs. 11.85,P < 0.001). A lower income household was a key predictor of increased smartphone frequency (B = 1.840, 95% confidence interval [CI], 0.923–2.757, P < 0.001) and smartphone screen time (B = 1.992, 95% CI, 1.458–2.525, P < 0.001). The results showed that the lower income household (B = 5.624, 95% CI, 2.927–8.320, P < 0.001) and a child’s psychiatric treatment history (B = 7.579, 95% CI, 5.666–9.492, P < 0.001) was the most significant predictor of problematic behaviors of children and parental depression (B = 3.476, 95% CI, 1.628–5.325, P < 0.001; B = 3.138, 95% CI, 1.827–4.450, P < 0.001). Conclusion This study suggested that children’s smartphone screen time and BMI increased during COVID-19 because of the school curriculum modification following school closures in South Korea. The increased children’s problematic behaviors and parental depression were predicted by lower-income households and the previous psychiatric history of children. These results indicate that multiple social support systems to the vulnerable group are needed during the ongoing pandemic and that a modified school setting is required.

Objectives: This study determines the effects of comorbidity of mood disorder and alcohol use disorder on suicide behavior. Methods: We converted data from the electronic medical records of one university hospital into a common data model and utilized it in our analysis. We selected 9551 patients with diagnosis codes of mood disorders or alcohol use disorders and divided them into three groups: mood disorder (MD) only, alcohol use disorder (AUD) only, and comorbidity of mood disorder and alcohol use disorder (MD+AUD). The mood disorder group was also subgrouped with depressive (DD) or bipolar affective disorder (BD) groups, and the comorbidity group was classified in the same way. Then, we applied logistic regression analysis to assess the risk of suicide attempts between the diagnostic groups. Subgroup analysis according to age also was conducted. Results: The MD+AUD group had 2.7 (odd ratio [OR]=2.70, 95% confidence intervals [CI]=1.91– 3.81, p<0.0001) and the DD+AUD group had 2.78 (OR=2.78, 95% CI=1.95–3.98, p<0.0001) times higher risk of suicide attempts than the MD only and DD only group, respectively. Furthermore, according to the age subgroup, the risk of suicide attempts was the highest (OR=5.17, 95% CI=2.35–11.40, p<0.0001) in the DD+AUD group for those aged 40–59. There were no significant results in BD. Conclusion The results showed that the comorbidity of mood disorder and alcohol use disorder could increase suicide risk. This study suggested that alcohol use behavior needs to be assessed as well as mood symptoms for suicide prevention.

Objectives: This study determines the effects of comorbidity of mood disorder and alcohol use disorder on suicide behavior. Methods: We converted data from the electronic medical records of one university hospital into a common data model and utilized it in our analysis. We selected 9551 patients with diagnosis codes of mood disorders or alcohol use disorders and divided them into three groups: mood disorder (MD) only, alcohol use disorder (AUD) only, and comorbidity of mood disorder and alcohol use disorder (MD+AUD). The mood disorder group was also subgrouped with depressive (DD) or bipolar affective disorder (BD) groups, and the comorbidity group was classified in the same way. Then, we applied logistic regression analysis to assess the risk of suicide attempts between the diagnostic groups. Subgroup analysis according to age also was conducted. Results: The MD+AUD group had 2.7 (odd ratio [OR]=2.70, 95% confidence intervals [CI]=1.91– 3.81, p<0.0001) and the DD+AUD group had 2.78 (OR=2.78, 95% CI=1.95–3.98, p<0.0001) times higher risk of suicide attempts than the MD only and DD only group, respectively. Furthermore, according to the age subgroup, the risk of suicide attempts was the highest (OR=5.17, 95% CI=2.35–11.40, p<0.0001) in the DD+AUD group for those aged 40–59. There were no significant results in BD. Conclusion The results showed that the comorbidity of mood disorder and alcohol use disorder could increase suicide risk. This study suggested that alcohol use behavior needs to be assessed as well as mood symptoms for suicide prevention.

Objectives: The aim of this study was to compare the nutritional intake and Diet Quality Index-International (DQI-I) of gynecological cancer survivors and normal women. Methods: This study compared the anthropometric indices, dietary behavior, nutritional intake, and DQI-I in women with previous history of breast or uterine cancer [Gynecological cancer survivors group (GCSG, n=126)] and normal women [Normal control group (NCG, n=7,011)] using the 2013~2016 Korea National Health and Nutrition Examination Survey data. Results: Body mass index and waist circumference were lower in the GCSG compared the NCG. The frequency of skipping breakfast and eating out was higher in the NCG compared to GCSG. Energy and fat intake were significantly higher in the NCG than in the GCSG, whereas intake of all minerals and vitamins (excluding thiamine), and dietary fiber intake were higher in GCSG. It was observed that the fatty acid intake of the GCSG was significantly lower than that of the NCG. The diet quality evaluation using DQI-I results showed that GCSG was higher in the “within-group” diet variety and adequacy of vegetable group than the NCG, whereas the intake level of the fruit group was higher in NCG. Besides, protein, calcium, and vitamin C intake were higher in the GCSG than in the NCG. The GCSG showed higher levels of total fat and saturated fat moderation than the NCG, whereas cholesterol moderation showed the opposite results. The results of DQI-I comparison according to the cancer survival years showed that the overall score and scores related to diet adequacy and balance were higher in the below 5-year group, whereas the over 5-year group scored higher in terms of moderation of diet. Conclusions The results of this study suggest that a chronic disease based management approach is needed in cancer survivors. The study provides important data which can help in the preparation of guidelines for long-term lifestyle and diet management, in these patients.

OBJECTIVES: This study examined the relationship between the presence of allergic rhinitis and the nutritional intake levels of Korean infants. METHODS: The study involved a total of 1,214 infant subjects aged 1~5 months from the 2013~2016 KNHNES (Korea National Health and Nutrition Examination Survey). The Subjects were classified into two groups based on the presence of allergic rhinitis: Non-allergic rhinitis infants (NARI, n=1,088) and allergic rhinitis infants (ARI, n=126). The general characteristics and family history of allergies, nutrient intake status, nutrient supplement intake, and breast milk and baby food start period data of the two groups were compared. All statistical analyses accounted for the complex sampling design effect and sampling weights. RESULTS: The mean age was 0.5 years old in the ARI group compared to the NARI group. In the residence, the rate of urban was higher in ARI. The family history revealed a significant difference between the two groups, particularly those of mothers rather than fathers. The nutrient intake levels were high in energy, phosphorus, sodium, potassium, iron, riboflavin, niacin, and polyunsaturated fatty acids. Breastfeeding was significantly higher in the ARI group than in the NARI group. The baby food start period was 0.3 months earlier in NARI group than in ARI group. The height, body weight, and birth weight were higher in ARI group than NARI group. The result of Odds ratio analysis showed that excess energy, protein, calcium, phosphorus, iron, riboflavin, and niacin intake increases the risk of allergic rhinitis. CONCLUSIONS: These results can be used as data to develop nutrition guidelines for allergic rhinitis infants.
Birth Weight ; Body Height ; Breast Feeding ; Calcium ; Fathers ; Fatty Acids, Unsaturated ; Humans ; Hypersensitivity ; Infant ; Iron ; Korea ; Milk, Human ; Mothers ; Niacin ; Nutrition Policy ; Nutrition Surveys ; Odds Ratio ; Phosphorus ; Potassium ; Rhinitis ; Rhinitis, Allergic ; Riboflavin ; Sodium ; Weights and Measures

This study was conducted to compare the nutrient intake, physical characteristics, and health status according to daily fruits and vegetables intake of adolescents using the Korean national health and nutrition examination survey for the sixth period (2013∼2015). Subjects were 1,096 adolescents aged 13∼18 years. The average daily intake of fruits and vegetables was 518.49±4.94 g. The two groups (insufficient, sufficient) were divided by fruits and vegetables intake (<500 g/day, ≥500 g/day) and the ratio of the insufficient group was 75.9% while that of the adequate group was 24.1%. The mean of intake of energy, calcium, phosphorus, sodium, potassium, iron, thiamin, niacin, vitamin C and dietary fiber differed significantly between the insufficient and sufficient groups (P<0.01, P<0.001). However, there was no significant difference in physical characteristics between groups. The self-perceived health status was better in the sufficient group (P<0.05), while the insufficient group was aware of more stress in their daily life (P<0.05). The serum triglyceride was significantly higher in the sufficient group (P<0.05), while the total cholesterol was lower (P<0.05). As the characteristics of fruits and vegetables are different, it will be necessary to determine standards for consumption of each type. It is also necessary to consider whether a fruits and vegetables intake of 500 g would be a reasonable standard for adolescents. Nevertheless, the results of this study indicate efforts to increase fruits and vegetables intake by young people are necessary.
Adolescent* ; Ascorbic Acid ; Calcium ; Cholesterol ; Dietary Fiber ; Fruit* ; Humans ; Iron ; Niacin ; Nutrition Surveys* ; Phosphorus ; Potassium ; Sodium ; Triglycerides ; Vegetables*

This study was conducted to examine the interrelations among snack preference, purchasing behavior and intake of fifth and sixth grade students in elementary schools in Gyeongnam province. Frequency of snack intake was the highest in those who reported 'once a day' (45.6%) snack habit. Longer-time television viewers also showed higher frequency of snack intake than shorter-time viewers. Thirty-three percent of students purchased snacks by themselves and the frequency of snack purchasing had a significant positive relationship with TV watching time (p < 0.01). The main reason, place and time of eating snacks were 'hunger' (79.2%), their home environment (50.9%) and 'after school hours' (89.7%). The favorite snack was 'ice cream' and, this snack habit was significantly different by gender of the child (p < 0.01) and TV watching time (p < 0.01). 'Milk and dairy products' scored highest (3.47) in snack intake frequency among longer-time TV viewers (> 2hr) compared to shorter-time TV viewers and this difference was statistically significant (p < 0.001). The snack preference score was correlated positively (r = 0.454) with the intake frequency for snack and its explanation power (R2) was 20.5%. With regard to snack purchase behaviors, the scores of 'checking the expiration date' and 'comparing the price with similar products' were high (in what group?). Female students (p < 0.001) and shorter-time TV viewers (< 2hr) (p < 0.01) had a more reasonable purchasing behavior. The total score of preference was significantly higher (p < 0.05) in shorter-timeTV viewers (< 2hr). In the correlation between snack purchasing behaviors and intake frequency, attractiveness (r = 0.208, p < 0.001) and preference (r = 0.330, p < 0.001) showed significant positive correlations. The result of regression analysis, preference only was selected (R2= 0.108).
Child ; Eating ; Female ; Humans ; Snacks* ; Television

This study was conducted to develop a dietary life education textbook and teaching manual for creative activities of elementary school students in middle grade. First, we extracted dietary life related contents from textbooks for third and fourth grade and created systematization of contents involving educational objectives, goals, contents and activities. The development of textbook and teaching manual were based on systematization of contents. The textbook was composed of five major chapters, which were 'nutrition', 'cooking', 'environment and hygiene', 'food' and 'dietary culture'. Each major chapter having six to seven smaller chapters, adding up to a total of 34 smaller chapters. The textbook was in activity format so that can be readily and directly used in actual classes. The textbook had fun characters and various activities (particularly a lot of cooking activities) to deliver the main theme of each chapter. The teaching manual was composed of background, goal, teaching plan and teaching point. The smaller chapters had learning goal, teaching-learning resources, important points, teaching-learning process and reference material. In evaluation after operating the model school, the developed textbooks were suited for students' needs and cognitive level. This textbook can be utilized at creative activities consisting of ten to fifteen students.
Cooking ; Humans ; Learning

This study was conducted to provide basic data for development of a dietary education textbook and guidebook by investigating and analyzing eating behavior, nutrition knowledge and educational needs in elementary school students. Most of the subjects were eating three meals a day (71.5%) and breakfast (75.3%). The percentage of students who consumed proper amount of meals (49.2%) was low. The percentage of students consuming salty food and fatty foods was 28.6% and 42.1%, respectively. The consumption of meat, fish, egg, bean and tofu was high, while the consumption of vegetables, fruits and seaweed was low. The percentage of students consuming processed food was high, but the percentage reading nutrition labels (34.9%) and hazard analysis critical control point (HACCP) mark (26.9%) when buying processed foods was very low. Total scores of eating behavior and nutrition knowledge were significantly higher in female students than in male students (p < 0.05-p < 0.001). The desirable frequency of the education was once a week (60.5%). The most preferred educational method was 'experiment and cooking practice' (40.1%). The students wanted dietary information as 'cooking' (39.0%). As a result of this study, many problems were found in the eating behavior of students and nutritional knowledge was observed to be low as well. On the other hand, the demand for dietary education was very high. The findings of this study suggested the need for developing dietary education programs in order to encourage proper eating habits of students.
Breakfast ; Cooking ; Eating ; Feeding Behavior ; Female ; Fruit ; Hand ; Humans ; Male ; Meals ; Meat ; Ovum ; Seaweed ; Soy Foods ; Vegetables