The effect of a healthy school tuck shop program on the access of students to healthy foods

Kirang Kim,Seo Ah Hong,Sung Ha Yun,Hyun Joo Ryou,Sang Sun Lee,Mi Kyung Kim 한국영양학회 2012 Nutrition Research and Practice Vol.6 No.2

The objective of this study was to evaluate the effect of a healthy school tuck shop program, developed as a way of creating a healthy and nutritional school environment, on students’ access to healthy foods. Five middle schools and four high schools (775 students) participated in the healthy school tuck shop program, and nine schools (1,282 students) were selected as the control group. The intervention program included restriction of unhealthy foods sold in tuck shops, provision of various fruits, and indirect nutritional education with promotion of healthy food products. The program evaluation involved the examination of students’ purchase and intake patterns of healthy foods, satisfaction with the available foodstuffs, and utilization of and satisfaction with nutritional educational resources. Our results indicated that among of the students who utilized the tuck shop, about 40% purchased fruit products, showing that availability of healthy foods in the tuck shop increased the accessibility of healthy foods for students. Overall food purchase and intake patterns did not significantly change during the intervention period. However, students from the intervention schools reported higher satisfaction with the healthy food products sold in the tuck shop than did those from the control schools (all P < 0.001), and they were highly satisfied with the educational resources provided to them. In conclusion, the healthy school tuck shop program had a positive effect on the accessibility of healthy food. The findings suggest that a healthy school tuck shop may be an effective environmental strategy for promoting students’ access to healthy foods.

Nutritional status in toddlers and preschoolers according to household income level

Kirang Kim,Jae eun Shim 한국식품영양과학회 2015 한국식품영양과학회 학술대회발표집 Vol.2015 No.8

Nutritional status of toddlers and preschoolers according to household income level

Kirang Kim,Sam Cheol Shin,Jae Eun Shim 한국영양학회 2015 Nutrition Research and Practice Vol.9 No.5

BACKGROUNDS/OBJECTIVES: The effects of malnutrition on growth of toddlers and preschoolers by socioeconomic status are not well known. This study aimed to examine the effects of dietary intake on growth outcomes in toddlers and preschoolers by household income level. SUBJECTS/METHODS: The study population was a total of 1,687 children aged 1 to 5 years that participated in the KNHANES from 2009 to 2011. Growth of children was assessed by height for age (HFA) and weight for height (WFH). Children were classified into three groups according to children’s HFA and WFH compared to the 10th and 90th percentiles of the 2007 Korean Children and Adolescent Growth Standard. Average monthly household income was divided into quartile groups. Dietary intake data were obtained by using the one day 24-hr recall method. Risks of inadequate intake of nutrients and unfavorable growth were estimated by using a multiple logistic regression model adjusted for sex, age, region, and energy intake. RESULTS: The low HFA group (< 10th percentile) had significantly lower intakes of energy, carbohydrate, and thiamin as compared with the high group (≥ 90th percentile). For WFH status, vitamin C intake was lower in the low group than in the high group. Household income level was related to WFH status but not HFA. Children from lower income households were more likely to have high WFH than those from higher income households (P for trend = 0.038). Household income status was also significantly related with risk of inadequate intake of micronutrients such as thiamin (P for trend = 0.032) and vitamin C (P for trend = 0.002), showing higher odds of inadequate intakes in children from lower income households. CONCLUSIONS: Children from lower income households were prone to be overweight and to have inadequate intakes of micronutrients such as thiamin and vitamin C. To reduce nutritional and health disparities, collective action in the public sector is required from early life.

아동·청소년 비만 예방을 위한 인구기반 예방 전략 개발

김기랑(Kirang Kim),이은영(Eun Young Lee),김혜련(Hye-Ryun Kim) 한국보건교육건강증진학회 2011 보건교육건강증진학회지 Vol.28 No.3

국가 나트륨 저감화 정책에 따른 생산 및 조리 주체별 나트륨 섭취 감소 기여 요인 분석

김기랑(Kirang Kim),박소현(Sohyun Park),김지영(Jee Young Kim) 한국영양학회 2020 Journal of Nutrition and Health Vol.53 No.6

국내 나트륨 평균 섭취량은 2017년 3,477 ㎎으로 2010년 4,876 ㎎ 대비 71.3% 수준으로 감소하였다. 나트륨 섭취량 감소 추이에서 생산 및 조리 주체별 구분에 따른 기여도에서는 산업체에서 생산된 식품과 가정에서 조리한 식품으로부터의 나트륨 섭취량 감소 비율이 단체급식과 외식업체에서 조리하여 제공하는 식품으로부터의 나트륨 섭취량 감소 비율보다 컸다. 식품군과 음식군으로부터 나트륨에 가장 많이 기여하는 요인은 생산 및 조리 주체별로 다르게 나타났는데, 산업체 생산에서는 김치류에서, 가정과 단체급식에서는 조리한 국/탕/찌개/전골류에서, 외식업체에서는 조리한 면/만두류였고, 나트륨 기여도가 가장 높았던 이들 식품 및 음식들은 연도에 따른 나트륨 섭취량 감소 폭도 가장 큰 것으로 나타났다. 특히 가정에서 조리한 국/탕/찌개/전골류와 면/만두류의 나트륨 함량 감소 폭은 외식업체 및 단체급식에서 조리한 음식보다 더 큰 것으로 나타났다. 나트륨 섭취량에 주로 기여하는 주요 식품군과 음식군의 종류는 연도가 증가함에 따라 나트륨 급원 식품이 특정 식품 위주에서 다양한 식품으로 확대되는 경향을 보여, 향후 나트륨 저감 대상 품목에 대한 다양한 접근이 요구됨을 시시하였다. 국내 나트륨 섭취에 기여하는 식품은 가공식품을 완제품 형태로 섭취하는 것 외에도 조리 단계에서 식재료로 다양하게 사용하는 비율이 높으므로 본 연구에서 제안한 생산 및 조리 주체별로 식품군 또는 음식군을 분류하여 나트륨 섭취 주요 급원 및 감소 요인을 파악한 결과는 저염 식품의 개발 및 생산, 저염 섭취와 관련된 식생활 교육 등과 같은 분야의 기초 자료로 활용될 것으로 기대된다. 향후 식문화를 고려한 다양한 식품 분류체계 방법을 마련하여 나트륨 섭취량 분석 및 저감 전략 수립에 활용하는 것이 필요할 것으로 생각된다. Purpose: Sodium intake is persistently decreasing because of the government’s sodium reduction policy. This study aimed to identify foods and dishes that contributed to the reduction of sodium intake and evaluate the effects of the sodium reduction policy. Methods: The subjects were 57,809 participants in the Korea National Health and Nutrition Survey from 2010 to 2017. To identify food and dish sources of sodium intake, the food and dish groups were classified into 23 and 21 groups, respectively. Foods and dishes that contributed to sodium intake were categorized according to the production and cooking venues: production by manufacturers, home cooking, cooking at catering service, and restaurant cooking. Results: Sodium intake was 4,876 mg in 2010 to 3,477 ㎎ in 2017, showing a 29.7% decrease in intake in 2010. Sodium intake was decreased mainly in foods produced by manufacturers and home-cooked foods. The main contributory factors to sodium from the food and dish groups differed according to the food manufacturer and cooking venue. The kimchi produced by manufacturers, cooked soup/tang/jjigae/hotpot at home and catering services, and cooked noodles/dumplings in restaurants were the main contributors to the sodium intake. Conclusion: The type of foods and dishes that contribute to sodium intake tended to expand over the years from specific foods and dishes to various groups of foods and dishes. These results provide evidence for the development and production of low-salt foods and dietary education related to low-salt intake.

Cross-sectional relationship between dietary carbohydrate, glycaemic index, glycaemic load and risk of the metabolic syndrome in a Korean population.

Kim, Kirang,Yun, Sung Ha,Choi, Bo Youl,Kim, Mi Kyung Cambridge University Press ; Agent for U.S.A., The 2008 The British journal of nutrition Vol.100 No.3

<P>Little is known about the effect of dietary carbohydrate, glycaemic index (GI) and glycaemic load (GL) on the risk of the metabolic syndrome, especially in populations with white rice as the staple food. The study examined the cross-sectional relationship between carbohydrate, GI, GL and risk of the metabolic syndrome. There were a total of 910 middle-aged Korean adults. Dietary carbohydrate, GI and GL were determined by an interview-administered FFQ. The metabolic syndrome was defined using the modified criteria published in the Third Report of the National Cholesterol Education Program Adult Treatment Panel III. The risk of developing the metabolic syndrome was positively related to dietary carbohydrate (P for trend = 0.03), GI (P for trend = 0.03) and GL intakes (P for trend = 0.02) in women after adjusting for potential confounding variables. Among the components of developing the metabolic syndrome, the risk of high TAG and low HDL-cholesterol were positively related to high GI and GL intakes in women. The risk of developing the metabolic syndrome was considerably higher in the highest quintiles of carbohydrate (OR 6.44; 95 % CI 2.16, 19.2), GI (OR 10.4; 95 % CI 3.24, 33.3) and GL intakes (OR 6.68; 95 % CI 2.30, 19.4) than in the lowest quintiles among women with a BMI >/= 25 kg/m2. However, there was no difference in risk across quintiles of carbohydrate, GI and GL among women with a BMI < 25 kg/m2. In conclusion, both the quantity and quality of carbohydrate intake has a positive relationship with the risk of the metabolic syndrome in women but this relationship was dependent on the BMI level.</P>

한국 식품 미보장 현황 및 특성

김기랑 ( Kirang Kim ),김미경 ( Mi Kyung Kim ),신영전 ( Young-jeon Shin ) 한국보건사회연구원 2009 保健社會硏究 Vol.29 No.2

이 연구는 2007년도 한국복지패널자료의 식품 보장 측정 지표를 활용하여 국내 식품 미보장 수준을 조사하고 식품 미보장 가구의 특성을 파악하고자 수행하였다. 국내 식품 미보장은 5.4%로 다른 서구산업국가와 비교했을 때, 상대적으로 낮은 수준을 보였다. 식품 미보장은 가구와 가구주의 특성에 따른 차이를 보였는데, 국민기초생활보장 수급가구, 소년소녀가장가구, 한 부모 가구, 독거노인 가구, 저소득 가구 등과 같은 취약 계층의 특성들을 갖고 있는 가구에서는 적게는 13% 많게는 27%의 높은 비율을 보였다. 가구주가 여자 또는 노인이고, 교육 수준이 낮고, 만성질환이 있고, 장애인이거나 직업이 없는 경우, 식품 미보장을 경험할 확률이 높은 것으로 나타났다. 식품 미보장을 경험하고 있는 가구 중 식품 지원 서비스를 받고 있는 가구는 전체 가구가 7.6%, 노인 가구가 16.4%, 아동 가구가 56.9%였고, 식품 지원 서비스를 받은 경험이 있는 가구에서 식품 미보장을 경험하고 있는 가구는 전체 가구가 29.3%, 노인 가구는 45.7%, 아동 가구는 13.1%였다. 결론적으로 국내 식품 미보장은 사회 경제적으로 취약한 가구 및 노인 가구에서 뚜렷하게 나타났으며 이들에 대한 식품 지원 서비스의 접근성은 낮았고, 이러한 서비스에 대한 효과도 미약한 것으로 나타났다. Recently, food insecurity has arisen as an issue in Korean society because of the limited access to food particularly for the socioeconomically disadvantaged population. Thus, this study aims to investigate the prevalence of food insecurity and its characteristics, using the third waves of Korean Welfare Panel Data. The prevalence of food insecurity was 5.4%, relatively lower than in advanced Western countries. The prevalence of food insecurity varied significantly across household types and householder`s characteristics. The socioeconomically disadvantaged households had a 13% to 27% higher prevalence of food insecurity. The households headed by women, elderly, unemployed person, or people with low education level, chronic disease or disability, were more likely to be food insecure. The food insecure households had low participation in food assistance programs (7.6% total households, 16.4% for elderly households, 56.9% for households with children) and among the households participating in food assistance programs, the prevalence of food insecurity was 29.3% for total households, 45.7% for elderly households, 13.1% for households with children. In conclusion, the problem of food insecurity was apparent in socioeconomically disadvantaged households and elderly households, In addition, the access to food assistance programs for these households was low and the programs` effect was modest. Further, the trend of food insecurity needs to investigate to provide evidence for developing a food policy related to food insecurity, using persistent monitoring and longitudinal analysis through the Korean Welfare Panel Study.

국민건강영양조사 식품안정성 측정 도구 개발

김기랑(Kim Kirang),홍서아(Hong Seo Ah),권성옥(Kwon Sung Ok),오세영(Oh Se-Young) 韓國營養學會 2011 Journal of Nutrition and Health Vol.44 No.6

Given that household food security issues have become the concern of the Korean society, this study aimed to develop food security measures for the Korean population. Based on the literature reviews on previously developed food security measures, the 18-item US household food security survey module (US HFSSM) was adapted. The developed food security measures was assessed by qualitative validity method. It was evaluated and modified by face validity by expert focus groups belong to university, public health center, and government agencies and by cognitive interview by 40 subjects with low household income who live in an urban community and are participants in welfare programs of local districts. Then, it was reviewed and revised by the National Institute of the Korean Language and the advisory committee for nutrition survey of Korean National Health and Nutrition Examination Survey (KNHANES). The results showed that the developed questionnaire items were well adapted by expert focus groups and general subjects, showing the feasibility of measuring food security with the developed measures although there were discrepancies in some expressions of questionnaire items between experts focus groups and general subjects. The study to assess reliability and quantitative validity of the developed food security measures should be further needed to examine its application for KNHANES. (Korean J Nutr 2011; 44(6): 551 ~ 561)

한국인의 생애 주기별 교육 수준에 따른 영양 상태와 식품 불충분성-2005년도 국민건강영양조사 자료를 이용하여

김기랑(Kim Kirang),홍서아(Hong Seo Ah),김미경(Kim Mi Kyung) 韓國營養學會 2008 Journal of Nutrition and Health Vol.41 No.7

This study aimed to identify a nutritionally vulnerable group and to examine their nutritional problems based on a relationship between socioeconomic position and nutritional status through life-course. A cross-sectional nationwide survey of 2005 Korean National Health and Nutrition Examination Survey (KNHANES) was used. A total of 8,930 participants aged ≥ 1 year were included. The socioeconomic position indicator was education level. Nutritional status was assessed by the percentage attainment of a dietary reference intake (DRI) and dietary quality based on nutrient intakes estimated by a 24 hour-recall data. Food insufficiency was examined by one-item food insufficiency questionnaire. The difference in nutritional status and food insufficiency according to educational level was tested by General Linear Model and Chi-square test, respectively. The nutritional status and food insufficiency was the worst during adolescence and older age than other period. Both quantity and quality of nutrient intakes was poorer in low education group than high education group. The prevalence of food insufficiency also was higher in low education group. The results were consistent across the life-course and sex. Based on these findings, we suggest that the development of various policy and strategies targeted to nutritionally vulnerable group is necessary to reduce nutritional inequality by socioeconomic position.

Factors contributing to participation in food assistance programs in the elderly population

Seo Ah Hong,Kirang Kim 한국영양학회 2014 Nutrition Research and Practice Vol.8 No.4

BACKGROUND/OBJECTIVES: The study objectives were to examine the participation rate in food assistance programs and explore the factors that contribute to such participation among the Korean elderly population. SUBJECTS/METHODS: The study sample comprised 3,932 respondents aged 65 years or older who were selected from a secondary data set, the fourth Korean Welfare Panel Study (KoWePS). The factors, related to participation in programs were examined based on the predisposing, enabling and need factors of the help-seeking behavior model. Multiple logistic regression analysis was used to select the best contributors among the factors related to program participation. RESULTS: The predisposing rate in food assistance programs was 8.5% (7.1% for men and 10.4% for women). When all variables were included in the model, living without spouse, no formal education, low income, having social security benefits and food insecurity in elderly men, and age, low income, having social security benefits and feeling poor in elderly women were significantly related to a higher tendency to program participation. CONCLUSIONS: The predisposing and need factors, such as living without spouse, low education level, food insecurity and feeling poor were important for program participation, as well as enabling factors, such as household income and social security benefits. A comprehensive approach considering these factors to identify the target population for food assistance programs is needed to increase the effectiveness and target population penetration of these programs.