Purpose: This study was conducted to update the Nutrition Quotient for Adolescents (NQ-A), which is used to assess the overall dietary quality and food behavior among Korean adolescents. Methods: The first 30 candidate items of the measurable eating behavior checklist were obtained based on a previous NQ-A checklist, the results of the seventh Korea National Health and Nutrition Examination Survey data, Korea Youth Risk Behavior Survey data, national nutrition policies and dietary guidelines, and literature reviews. A total of 100 middle and high school students residing in Seoul and Gyeonggi Province participated in a pilot study using the 25-item checklist. Factor analysis and frequency analysis were conducted to determine if the checklist items were organized properly and whether the responses to each item were distributed adequately, respectively. As a result, 22 checklist items were selected for the nationwide survey, which was applied to 1,000 adolescent subjects with stratified sampling from 6 metropolitan cities. The construct validity of the updated NQ-A 2021 was assessed using confirmatory factor analysis. Results: Twenty checklist items were determined for the final NQ-A 2021. The items were composed of three factors: balance (8 items), moderation (9 items), and practice (3 items). The standardized path coefficients were used as the weights of items to determine the nutrition quotients. NQ-A 2021 and 3-factor scores were calculated according to the weights of questionnaire items. The weight for each of the 3 factors was determined as follows: balance, 0.15; moderation, 0.30; and practice, 0.55. Conclusion The updated NQ-A 2021 is a useful instrument for easily and quickly evaluating the dietary qualities and eating behaviors of Korean adolescents

Purpose: This study was undertaken to revise and update the Nutrition Quotient (NQ) for Korean adults, a tool used to evaluate dietary quality and behavior. Methods: The first 31 items of the measurable food behavior checklist were adopted based on considerations of the previous NQ checklist, recent literature reviews, national nutrition policies, and recommendations. A pilot survey was conducted on 100 adults aged 19 to 64 residing in Seoul and Gyeonggi Province from March to April 2021 using a provisional 26-item checklist. Pilot survey data were analyzed using factor analysis and frequency analysis to determine whether checklist items were well organized and responses to questions were well distributed, respectively. As a result, the number of items on the food behavior checklist was reduced to 23 for the nationwide survey, which was administered to 1,000 adults (470 men and 530 women) aged 19 to 64 from May to August 2021. The construct validity of the developed NQ (NQ-2021) was assessed using confirmatory factor analysis, linear structural relations. Results: Eighteen items in 3 categories, that is, balance (8 items), moderation (6 items), and practice (4 items), were finally included in NQ-2021 food behavior checklist. ‘Balance’ items addressed the intake frequencies of essential foods, ‘moderation’ items the frequencies of unhealthy food intakes or behaviors, and ‘practice’ items addressed eating behaviors. Items and categories were weighted using standardized path coefficients to calculate NQ-2021 scores. Conclusion The updated NQ-2021 appears to be suitable for easily and quickly assessing the diet qualities and behaviors of Korean adults.

Purpose: This study was undertaken to update the Nutrition Quotient for Elderly (NQ-E), which reflects dietary quality and behavior among Korean older adults. Methods: The first 29 items of the measurable food behavior checklist were obtained from a previous NQ-E checklist, recent literature reviews, and national nutrition policies and recommendations. One-hundred subjects (50 men and 50 women) aged ≥ 65 years living in the Seoul Metropolitan Area, including Gyeonggi Province, completed a pilot survey from March to April 2021. Based on the results of the pilot study, we conducted factor analysis and frequency analysis to determine whether the items of the survey were properly organized and whether the distribution of answers for each evaluation item was properly distributed. As a result, we reduced the number of items on the food behavior checklist and used 23 items for the national survey. Nationwide, 1,000 subjects (472 men and 528 women) aged > 65 years, completed the checklist survey, which was applied using a face-to-face survey method from May to August 2021. The construct validity of the NQ-E 2021 was assessed using confirmatory factor analysis, LISREL. Results: Seventeen food behavior checklist items were selected for the final NQ-E 2021.Checklist items addressed three factors: balance (8 items), moderation (2 items), and practice (7 items). Standardized path coefficients were used as the weights of items to determine nutrition quotients. NQ-E and three-factor scores were calculated according to the weights of questionnaire items. Conclusion The updated NQ-E 2021 produced by structural equation modelling provides a suitable tool for assessing the dietary quality and behavior of Korean older adults.

Purpose: The purpose of this study was to investigate the effects of nutrient intake and dietary diversity score (DDS) on osteoporosis after controlling for sex, age, socioeconomic level, drinking, smoking, physical activity, and body mass index (BMI) as mediators using the 2015–2017 Korean National Health and Nutrition Examination Survey (KNHANES) data. Methods: This study was focused on the age group of 50s and older by using the 2015–2017 KNHANES data. Subjects diagnosed with osteoporosis were classified as the osteoporosis group, and the other subjects were classified as the normal group. Logistic regression was used to assess the association between nutrient intake and DDS after controlling for mediators. Results: The risk of osteoporosis was 2.38 times lower in the 50–65 age group than in the 75 years and older group. The mediators affecting the incidence of osteoporosis by age group were sex, age, household income level, and education level in the 50–64 age group; sex, education level, drinking, and BMI in the 65–74 age group; and sex, age, current smoking, drinking, BMI, and energy intake in the 75 years and older group. The effect of nutrient intake on osteoporosis, with the exception of vitamin B1, was fully mediated by these mediators. The effect of vitamin B1 was partially mediated by mediators in the age group of 65–74 years, and vitamin B1 was effective for preventing the risk of osteoporosis by 25% when consumed over EAR. The effect of DDS was partially mediated in the age group of 75 years and older, and DDS of 2 or less increased the risk of osteoporosis by 2.59 times. Conclusion As a result of this study, it is necessary to recommend the balanced intake of various foods including grains, meat·fish·legumes, vegetables, fruits, and dairy products as dietary guidelines for the prevention of osteoporosis and promotion of bone health in the elderly.

Purpose: This study was undertaken to develop a nutrition quotient for elementary school children (NQ-C) for evaluating the overall dietary quality and eating behaviors. Methods: The NQ-C was developed by implementing 3 stages: item generation, item reduction, and validation. Candidate food behavior checklist (FBC) items of the NQ-C were derived from systematic literature reviews, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. For the pilot survey, 260 elementary school students (128 second graders and 132 fifth graders) completed self-administered questionnaires as well as 24-hour dietary intakes, with the help of their parents and survey team staff, if required. Based on the pilot survey results, expert reviews, and priorities of national nutrition policy and recommendations, checklist items were reduced from 41 to 24. A total of 20 items for NQ-C were finally selected from results generated from 1,144 nationwide samples surveyed. Construct validity of the NQ-C was assessed using the confirmatory factor analysis, LInear Structural RELations. Results: Analyses of the exploratory factors of NQ-C identified that 5 dimensions of diet (balance, diversity, moderation, practice and environment) accounted for 46.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-C and 5-factor scores of the subjects were calculated using the obtained weights of the FBC items. Conclusion Our data indicates that NQ-C is a useful and suitable instrument for assessing nutrition adequacy, dietary quality, and eating behaviors of Korean elementary school children.

PURPOSE: The purpose of this study was to develop a valid instrument for measuring the dietary quality and behaviors of Korean elderly. METHODS: The development of the Nutrition Quotient for Elderly (NQ-E) was conducted in three steps: item generation, item reduction, and validation. The 41 items of the NQ-E checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Pearson's correlation was used to determine the level of agreement between the questionnaires and nutrient intake level, and 24 items were selected for a nationwide survey. A total of 1,000 nationwide elderly subjects completed the checklist questionnaire. The construct validity of the NQ-E was assessed using confirmatory factor analysis, LISREL. RESULTS: The nineteen checklist items were used as final items for NQ-E. Checklist items were composed of four-factors: food behavior (6 items), balance (4 items), diversity (6 items), and moderation (3 items). The standardized path coefficients were used as the weights of the items. The NQ-E and four-factor scores were calculated according to the obtained weights of the questionnaire items. CONCLUSION: NQ-E would be a useful tool for assessing the food behavior and dietary quality of the elderly.
Aged ; Checklist ; Humans ; Nutrition Policy ; Nutrition Surveys ; Weights and Measures

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

PURPOSE: This study was conducted to develop a nutrition quotient (NQ) to assess overall dietary quality and food behaviors of Korean adults. METHODS: The NQ was developed in three steps: item generation, item reduction, and validation. Candidate items of the NQ checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the Korea National Health and Nutrition Examination Survey (2010 ~ 2013) data, and national nutrition policies and recommendations. A total of 368 adults (19 ~ 64 years) participated in a one-day dietary record survey and responded to 43 items in the food behavior checklist. Pearson's correlation coefficients between responses to the checklist items and nutritional intake status of the adults were calculated. Item reduction was performed, and 24 items were selected for a nationwide survey. A total of 1,053 nationwide adult subjects completed the checklist questionnaires. Exploratory and confirmatory factor analyses were performed to develop a final NQ model. RESULTS: The 21 checklist items were used as final items for NQ. Checklist items were composed of four factors: nutrition balance (seven items), food diversity (three items), moderation for the amount of food intake (six items), and dietary behavior (five items). The four-factor structure accounted for 41.8% of the total variance. Indicator tests of the NQ model suggested an adequate model fit (GRI = 0.9693, adjusted GFI = 0.9617, RMR = 0.0054, SRMR = 0.0897, p < 0.05), and item loadings were significant for all subscales. Standardized path coefficients were used as weights of the items. The NQ and four-factor scores were calculated according to the obtained weights of the questionnaire items. CONCLUSION: NQ for adults would be a useful tool for assessing adult dietary quality and food behavior. Further investigations of adult NQ are needed to reflect changes in their food behavior, environment, and prevalence of chronic diseases.
Adult* ; Checklist ; Chronic Disease ; Diet Records ; Eating ; Humans ; Korea ; Nutrition Policy ; Nutrition Surveys ; Prevalence ; Weights and Measures

PURPOSE: The purpose of this study was to explore the relationship between milk intake and prevalence rates of chronic diseases using KNHANES data, and the significance of the relationship was tested based on meditators, socioeconomic status (income, education), dietary behaviors (smoking, alcohol drinking, breakfast, and eating out), and physical activity (walking, medium, and high). METHODS: Using the 5(th) and 6(th) survey data of KNHANES, milk intake rates and presence of seven chronic diseases were summarized and analyzed by ANOVA for two groups of adult men and women as follows: hypertension, hypertriglyceridemia, low HDL-cholesterol, diabetes, abdominal obesity, obesity, and metabolic syndrome. The dependent variables for the presence of seven chronic diseases regressed with socioeconomic, dietary behavior, and physical activity variables according to Logistic models. The dependent variables for milk intake using predictor variables of socioeconomic, dietary behaviors and physical activity were analyzed according to Logistic models. Finally, the significant socioeconomic, dietary behavior, and physical activity variables in the above model along with milk intake as a control variable or mediator variable regressed with significant chronic diseases according to Logistic models. RESULTS: Milk intake, socioeconomic status, dietary behaviors, and physical activity were significantly different among the two groups of adult men and women, which were also critical factors to the prevalence of chronic diseases. The dependent variable for prevalence of chronic diseases regressed with significant factors of socioeconomic status, dietary behavior, and physical activity variables according to chronic diseases using the control or mediator variable of milk intake and summarized as follows: For adult men, milk intake controlled the education effect on diabetes partly, alcohol on hypertension and hypertriglyceridemia, low HDL-cholesterol, metabolic syndrome, breakfast on metabolic syndrome, eating out on obesity, and medium physical activity on hypertriglyceridemia. For adult women, household income on hypertriglyceridemia, diabetes, abdominal obesity, education level on hypertension, alcohol drinking, eating out, and walking activity on abdominal obesity, alcohol, breakfast, eating out, walking activity on low HDL-cholesterol, and medium physical activity on hypertriglyceridemia and low HDL-cholesterol were partly controlled by milk intake. Other significant socioeconomic status, dietary behavior, and physical activity variables related to prevalence of chronic diseases were fully controlled or mediated by milk intake. CONCLUSION: This study shows that milk intake (daily more than 200 g) prevents chronic diseases such as hypertension, hypertriglyceridemia, low HDL-cholesterol, diabetes, obesity, abdominal obesity, and metabolic syndrome.
Adult* ; Alcohol Drinking ; Breakfast ; Chronic Disease* ; Eating ; Education ; Family Characteristics ; Female ; Humans ; Hypertension ; Hypertriglyceridemia ; Korea* ; Logistic Models ; Male ; Milk* ; Motor Activity ; Nutrition Surveys* ; Obesity ; Obesity, Abdominal ; Prevalence* ; Social Class ; Walking

PURPOSE: The purpose of this study was to develop a nutrition quotient for adolescents (NQ-A) to assess overall dietary quality and food behavior of Korean adolescents. METHODS: Development of the NQ-A was undertaken in three steps: item generation, item reduction, and validation. Candidate items of the NQ-A checklist were selected based on literature reviews, results of the fifth Korea National Health and Nutrition Examination Survey data, dietary guidelines for Korean adolescents, expert in-depth interviews, and national nutrition policies and recommendations. A total of 213 middle and high school students participated in a one-day dietary record survey and responded to 41 items in the food behavior checklist. Pearson's correlation coefficients between the responses to the checklist items along with nutritional status of the adolescents were calculated. Item reduction was performed, and 24 items were selected for the nation-wide survey. A total of 1,547 adolescents from 17 cities completed the checklist questionnaire. Exploratory factor and confirmatory factor analyses were performed to develop a final NQ-A model. RESULTS: Nineteen items were finalized as the checklist items for the NQ-A. Checklist items were composed of five factors (balance, diversity, moderation, environment, and practice). The five-factor structure accounted for 47.2% of the total variance. Standardized path coefficients were used as weights of the items. The NQ-A and five-factor scores were calculated based on the obtained weights of the questionnaire items. CONCLUSION: Nutrition Quotient for adolescents (NQ-A) would be a useful instrument for evaluating dietary quality and food behavior of Korean adolescents. Further research on NQ-A is needed to reflect changes in adolescent's food behavior and environment.
Adolescent* ; Checklist ; Diet Records ; Humans ; Korea ; Nutrition Policy ; Nutrition Surveys ; Nutritional Status ; Weights and Measures