1.Development and usability evaluation of a web-based healthy eating practice questionnaire for Korean preschool children: a child–parent dyad approach
Young-Hee HAN ; Dawon PARK ; Dahyeon KIM ; Saerom SHIN ; Eun Yeol WOO ; Hye-Kyung PARK ; Taisun HYUN
Nutrition Research and Practice 2026;20(1):132-144
BACKGROUND/OBJECTIVES:
The illustrated Healthy Eating Practice Questionnaire (HEPQ) was previously developed to assess food preferences, eating behaviors, hand/oral hygiene practices, and nutrition knowledge among Korean preschool children. Nevertheless, the lack of an integrated scoring system has limited its interpretability. This study developed a scoring system and a web-based platform with tailored feedback using a child-parent dyad approach.
SUBJECTS/METHODS:
The development process consisted of 5 phases: 1) questionnaire preparation for online use, 2) formulation of the scoring system, 3) determination of the cut-off values for three levels of healthy eating practices based on a child-parent survey, 4) technical development of the online platform, and 5) usability evaluation. A scoring system was established by standardizing the domain scores to a 100-point scale. One hundred child– parent pairs participated in the survey to calculate the Healthy Eating Practice Score (HEPS) and determine cut-off values for the HEPS levels. The validity of the cut-off values was examined by a comparison with the Nutrition Quotient for Preschoolers (NQ-P). A web-based platform was developed, and 47 child–parent pairs were used to assess its usability.
RESULTS:
Significant positive correlations were observed between child and parent HEPS across all domains. The HEPS-based classification showed good discriminative ability because higher HEPS levels were consistently associated with higher NQ-P scores in children and parents. The web-based HEPQ was easy to use and understand, and almost all participants (97.9% of children and 93.6% of parents) reported no difficulties using the platform.
CONCLUSION
The web-based HEPQ platform with an integrated scoring system provides a valid, user-friendly tool for assessing and interpreting healthy eating practices in preschool children. This platform supports parental engagement in children’s healthy eating practices and provides a practical tool for evaluating the effectiveness of nutrition education in early childcare settings.
2.Nutrient intake and food consumption of Korean preschool children:a comparison between a daycare meal group and non-daycare meal group using the data from the 2016–2019Korea National Health and Nutrition Examination Survey
Nutrition Research and Practice 2025;19(2):225-240
BACKGROUND/OBJECTIVES:
In Korea, childcare facilities providing food service for 100 or more children are required to employ dietitians, while those serving fewer than 100 children must register with the Center for Children's Foodservice Management to receive dietary guidance from its dietitians. This study compared the dietary intake of children who had daycare meals and those who did not to evaluate the impact of dietitian-managed nutritional services.
SUBJECTS/METHODS:
This study analyzed the 24-h recalls from 706 children aged 3–5 yrs using the data from the 2016–2019 Korea National Health and Nutrition Examination Survey.Among them, 578 children had daycare meals, while 128 did not. The differences in energy contributions from meals and snacks, nutrient intake, and the amount and number of servings of various food groups consumed by these two groups were investigated.
RESULTS
The daycare meal group (DMG) showed a significantly higher intake of protein, thiamin, niacin, sodium, potassium, and iron during lunch and higher protein and sodium consumption during snack times after adjusting for the energy intake compared to the non-daycare meal group (NDMG). On the other hand, the DMG consumed less sugar and fat during lunch and snack times and less vitamin C during snack times. The DMG also showed higher consumption of legumes and vegetables but lower consumption of sweets during lunch and in the total daily consumption. The overall dietary quality assessed by the mean adequacy ratio was significantly higher among the DMG than in the NDMG CONCLUSION: Children were provided with higher-quality meals in daycare settings than in other environments. These results underscore the importance of nutrition management by dietitians. These findings also highlight the need for nutrition education for caregivers, particularly increasing vegetable intake and reducing sugar-sweetened beverage consumption.
3.Nutrient intake and food consumption of Korean preschool children:a comparison between a daycare meal group and non-daycare meal group using the data from the 2016–2019Korea National Health and Nutrition Examination Survey
Nutrition Research and Practice 2025;19(2):225-240
BACKGROUND/OBJECTIVES:
In Korea, childcare facilities providing food service for 100 or more children are required to employ dietitians, while those serving fewer than 100 children must register with the Center for Children's Foodservice Management to receive dietary guidance from its dietitians. This study compared the dietary intake of children who had daycare meals and those who did not to evaluate the impact of dietitian-managed nutritional services.
SUBJECTS/METHODS:
This study analyzed the 24-h recalls from 706 children aged 3–5 yrs using the data from the 2016–2019 Korea National Health and Nutrition Examination Survey.Among them, 578 children had daycare meals, while 128 did not. The differences in energy contributions from meals and snacks, nutrient intake, and the amount and number of servings of various food groups consumed by these two groups were investigated.
RESULTS
The daycare meal group (DMG) showed a significantly higher intake of protein, thiamin, niacin, sodium, potassium, and iron during lunch and higher protein and sodium consumption during snack times after adjusting for the energy intake compared to the non-daycare meal group (NDMG). On the other hand, the DMG consumed less sugar and fat during lunch and snack times and less vitamin C during snack times. The DMG also showed higher consumption of legumes and vegetables but lower consumption of sweets during lunch and in the total daily consumption. The overall dietary quality assessed by the mean adequacy ratio was significantly higher among the DMG than in the NDMG CONCLUSION: Children were provided with higher-quality meals in daycare settings than in other environments. These results underscore the importance of nutrition management by dietitians. These findings also highlight the need for nutrition education for caregivers, particularly increasing vegetable intake and reducing sugar-sweetened beverage consumption.
4.Nutrient intake and food consumption of Korean preschool children:a comparison between a daycare meal group and non-daycare meal group using the data from the 2016–2019Korea National Health and Nutrition Examination Survey
Nutrition Research and Practice 2025;19(2):225-240
BACKGROUND/OBJECTIVES:
In Korea, childcare facilities providing food service for 100 or more children are required to employ dietitians, while those serving fewer than 100 children must register with the Center for Children's Foodservice Management to receive dietary guidance from its dietitians. This study compared the dietary intake of children who had daycare meals and those who did not to evaluate the impact of dietitian-managed nutritional services.
SUBJECTS/METHODS:
This study analyzed the 24-h recalls from 706 children aged 3–5 yrs using the data from the 2016–2019 Korea National Health and Nutrition Examination Survey.Among them, 578 children had daycare meals, while 128 did not. The differences in energy contributions from meals and snacks, nutrient intake, and the amount and number of servings of various food groups consumed by these two groups were investigated.
RESULTS
The daycare meal group (DMG) showed a significantly higher intake of protein, thiamin, niacin, sodium, potassium, and iron during lunch and higher protein and sodium consumption during snack times after adjusting for the energy intake compared to the non-daycare meal group (NDMG). On the other hand, the DMG consumed less sugar and fat during lunch and snack times and less vitamin C during snack times. The DMG also showed higher consumption of legumes and vegetables but lower consumption of sweets during lunch and in the total daily consumption. The overall dietary quality assessed by the mean adequacy ratio was significantly higher among the DMG than in the NDMG CONCLUSION: Children were provided with higher-quality meals in daycare settings than in other environments. These results underscore the importance of nutrition management by dietitians. These findings also highlight the need for nutrition education for caregivers, particularly increasing vegetable intake and reducing sugar-sweetened beverage consumption.
5.Nutrient intake and food consumption of Korean preschool children:a comparison between a daycare meal group and non-daycare meal group using the data from the 2016–2019Korea National Health and Nutrition Examination Survey
Nutrition Research and Practice 2025;19(2):225-240
BACKGROUND/OBJECTIVES:
In Korea, childcare facilities providing food service for 100 or more children are required to employ dietitians, while those serving fewer than 100 children must register with the Center for Children's Foodservice Management to receive dietary guidance from its dietitians. This study compared the dietary intake of children who had daycare meals and those who did not to evaluate the impact of dietitian-managed nutritional services.
SUBJECTS/METHODS:
This study analyzed the 24-h recalls from 706 children aged 3–5 yrs using the data from the 2016–2019 Korea National Health and Nutrition Examination Survey.Among them, 578 children had daycare meals, while 128 did not. The differences in energy contributions from meals and snacks, nutrient intake, and the amount and number of servings of various food groups consumed by these two groups were investigated.
RESULTS
The daycare meal group (DMG) showed a significantly higher intake of protein, thiamin, niacin, sodium, potassium, and iron during lunch and higher protein and sodium consumption during snack times after adjusting for the energy intake compared to the non-daycare meal group (NDMG). On the other hand, the DMG consumed less sugar and fat during lunch and snack times and less vitamin C during snack times. The DMG also showed higher consumption of legumes and vegetables but lower consumption of sweets during lunch and in the total daily consumption. The overall dietary quality assessed by the mean adequacy ratio was significantly higher among the DMG than in the NDMG CONCLUSION: Children were provided with higher-quality meals in daycare settings than in other environments. These results underscore the importance of nutrition management by dietitians. These findings also highlight the need for nutrition education for caregivers, particularly increasing vegetable intake and reducing sugar-sweetened beverage consumption.
6.Nutrient intake and food consumption of Korean preschool children:a comparison between a daycare meal group and non-daycare meal group using the data from the 2016–2019Korea National Health and Nutrition Examination Survey
Nutrition Research and Practice 2025;19(2):225-240
BACKGROUND/OBJECTIVES:
In Korea, childcare facilities providing food service for 100 or more children are required to employ dietitians, while those serving fewer than 100 children must register with the Center for Children's Foodservice Management to receive dietary guidance from its dietitians. This study compared the dietary intake of children who had daycare meals and those who did not to evaluate the impact of dietitian-managed nutritional services.
SUBJECTS/METHODS:
This study analyzed the 24-h recalls from 706 children aged 3–5 yrs using the data from the 2016–2019 Korea National Health and Nutrition Examination Survey.Among them, 578 children had daycare meals, while 128 did not. The differences in energy contributions from meals and snacks, nutrient intake, and the amount and number of servings of various food groups consumed by these two groups were investigated.
RESULTS
The daycare meal group (DMG) showed a significantly higher intake of protein, thiamin, niacin, sodium, potassium, and iron during lunch and higher protein and sodium consumption during snack times after adjusting for the energy intake compared to the non-daycare meal group (NDMG). On the other hand, the DMG consumed less sugar and fat during lunch and snack times and less vitamin C during snack times. The DMG also showed higher consumption of legumes and vegetables but lower consumption of sweets during lunch and in the total daily consumption. The overall dietary quality assessed by the mean adequacy ratio was significantly higher among the DMG than in the NDMG CONCLUSION: Children were provided with higher-quality meals in daycare settings than in other environments. These results underscore the importance of nutrition management by dietitians. These findings also highlight the need for nutrition education for caregivers, particularly increasing vegetable intake and reducing sugar-sweetened beverage consumption.
7.Development and validation of an illustrated questionnaire on healthy eating practices among Korean preschool children
Dawon PARK ; Bo-Jeong GONG ; Dahyeon KIM ; Young-Hee HAN ; Saerom SHIN ; Eun Yeol WOO ; Hye-Kyung PARK ; Taisun HYUN
Nutrition Research and Practice 2025;19(6):985-1001
BACKGROUND/OBJECTIVES:
An illustrated questionnaire, the Healthy Eating Practice Questionnaire (HEPQ), was developed and validated to assess healthy eating practices among Korean preschool children.
SUBJECTS/METHODS:
The development process consisted of 4 phases: (1) item generation based on a literature review and focus group interviews, (2) item refinement through expert consultation, (3) illustration design, and (4) validation. One hundred and eighty-seven child–parent pairs and 24 teachers participated in the validation study. The reliability was examined using test–retest analysis, and the validity was assessed by comparing the children’s self-reports with those of their parents and teachers. The level of agreement was determined using the percentage agreement, kappa statistics, and intraclass correlation coefficient (ICC).
RESULTS:
The final 30-item questionnaire consisted of 4 domains: food preferences, eating behaviors, hand/oral hygiene practices, and nutrition knowledge. Most items showed a percentage agreement above 60% and kappa coefficients exceeding 0.5 in test–retest analysis, indicating acceptable consistency. The child–caregiver agreement was moderate to substantial, with kappa values generally above 0.4. The domain-level ICCs indicated good reliability (ICC = 0.49–0.83) and validity (ICC = 0.33–0.77) across all domains and subgroups.The comparisons by age showed that 4-yr-olds provided valid and reliable responses comparable to 5-yr-olds. The parents and teachers confirmed that the illustrated format was easy for the children to understand and complete independently.
CONCLUSION
The HEPQ showed satisfactory reliability and validity for assessing healthy eating practices among preschool children. The illustrated format enhances comprehension and engagement, supporting its applicability for research and nutrition education in daycare settings.
8.Nutritional content and healthiness in sweet and salty snacks and beverages popular in South Korea and the United States assessed by nutrition labels: a cross-sectional comparative study
Bo Jeong GONG ; Segovia LUCAS ; Diewo CAMARA ; Pauline E. JOLLY ; Chandrika PIYATHILAKE ; Taisun HYUN
Korean Journal of Community Nutrition 2024;29(6):467-479
Objectives:
This study investigated the nutritional differences between sweet and salty snacks and beverages in South Korea (Korea) and the United States (US). Nutritional content and healthiness were determined using back- and front-of-package nutrition labeling (FoPNL) systems.
Methods:
Three snack and three beverage categories popular in Korea and the US were selected. Statistical data were used to determine the top 10–15 best-selling products in each category in each country. The selected products included chips (n = 15), cookies (n = 10), chocolate (n = 13), carbonated drinks (n = 10), fruit juices/drinks (n = 10, 5/5), and energy drinks (n = 10). The study excluded products that were artificially sweetened. Nutritional information and percentages of fruit and vegetable content in each product were collected from brand websites and grocery stores in each country. The FoPNL system was used to assess the healthiness of the products, which included multiple traffic light labels, a Health Star Rating, and a Nutri-Score.
Results:
Overall, Korean snacks contained significantly more protein, total fat, saturated fat, and cholesterol than US snacks. However, the US chips and carbonated drinks contained more sodium, while the US energy drinks contained more caffeine than Korean products. The serving size of US carbonated drinks was significantly larger than that of Korean drinks, whereas the serving size of US chips was smaller than that of Korean products. The FoPNL system classified the majority of products as ‘less healthy.’
Conclusion
Our results suggest that Korean and US food manufacturers should improve the nutritional quality and/or serving size of commonly consumed food products. Policymakers in both countries should work to improve the presentation of ingredient and nutrient information on nutritional labels to assist consumers in making healthier food choices.
9.Effectiveness of a mobile health intervention on weight loss and dietary behavior changes among employees with overweight and obesity: a 12-week intervention study investigating the role of engagement
Imhuei SON ; Jiyoun HONG ; Young-Hee HAN ; Bo Jeong GONG ; Meng Yuan ZHANG ; Woori NA ; Cheongmin SOHN ; Taisun HYUN
Korean Journal of Community Nutrition 2023;28(2):141-159
Objectives:
This study aimed to determine whether a mobile health (mhealth) intervention is effective in reducing weight and changing dietary behavior among employees with overweight and obesity. The study also investigated whether engagement with the intervention affected its effectiveness.
Methods:
The intervention involved the use of a dietary coaching app, a wearable device for monitoring physical activity and body composition, and a messenger app for communicating with participants and an intervention manager. A total of 235 employees were recruited for a 12-week intervention from eight workplaces in Korea. Questionnaire surveys, anthropometric measurements, and 24-h dietary recalls were conducted at baseline and after the intervention.
Results:
After the intervention, significant decreases in the mean body weight, body mass index, body fat percentage, and waist circumference were observed. Furthermore, the consumption frequencies of multigrain rice and legumes significantly increased, whereas those of pork belly, instant noodles, processed meat, carbonated beverages, and fast food significantly decreased compared with those at baseline. The mean dietary intake of energy and most nutrients also decreased after the intervention. When the participants were categorized into three groups according to their engagement level, significant differences in anthropometric data, dietary behaviors, and energy intake were observed following the intervention, although there were no differences at baseline, indicating that higher engagement level led to greater improvements in weight loss and dietary behavior.
Conclusions
The intervention had positive effects on weight loss and dietary behavior changes, particularly among employees with higher engagement levels. These results indicate the importance of increasing the level of engagement in the intervention to enhance its effectiveness. The mhealth intervention is a promising model for health promotion for busy workers with limited time.
10.Comparison between 24-hour diet recall and 24-hour urine collection for estimating sodium and potassium intakes and their ratio among Korean adults
Taisun HYUN ; Mi-Kyeong CHOI ; Young-Ran HEO ; Heekyong RO ; Young-Hee HAN ; Yeon-Kyung LEE
Nutrition Research and Practice 2023;17(2):284-296
BACKGROUND/OBJECTIVES:
This study aimed to compare 24-h diet recall (DR) and 24-h urine collection (UC) for estimating sodium and potassium intakes and their ratio (Na/K), identifying factors associated with sodium and potassium intakes and Na/K, and identifying those who were likely to underestimate sodium and potassium intakes by DR.
SUBJECTS/METHODS:
A total of 640 healthy adults aged 19–69 yrs completed a questionnaire survey, salty taste assessment, anthropometric measurement, two 24-h DRs, and two 24-h UCs.
RESULTS:
The mean sodium and potassium intakes and Na/K were 3,755 mg/d, 2,737 mg/d, and 1.45 according to DR, and 4,145 mg/d, 2,812 mg/d, and 1.57 according to UC, with percentage differences of −9.4%, −2.7%, and −7.6% in the values between the two methods, respectively.Men, older adults, smokers, obese individuals, those who consumed all the liquid in the soup, and those who were found to be salty in the salty taste assessment consumed significantly more sodium; older adults, the heavy- activity group, and obese individuals consumed more potassium; and men, younger adults, smokers, and obese individuals had a significantly higher Na/K, according to UC. Compared with UC, DR was more likely to underestimate sodium intake in older adults, smokers, obese individuals, those who consumed all the liquid in the soup, and those who consumed eating-out/delivery food at least once a day, and potassium intake in older adults, the heavy-activity group, and obese individuals.
CONCLUSIONS
The mean sodium and potassium intakes and Na/K estimated by DR were comparable to those measured by UC. However, the association of sodium and potassium intakes with sociodemographic and health-related factors showed inconsistent results when estimated by DR and UC. Factors influencing the underestimation of sodium intake by DR compared to UC should be further investigated.

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