Nutrition Policies in the Republic of Korea : Expert Opinions and Recommendations

Engelhardt Katrin,Joung Hyojee Korean Society of Community Nutrition 2005 Journal of community nutrition Vol.7 No.4

Considering the increasing global burden of disease attributable to nutrition, the demand for national nutrition policies is growing stronger and stronger. The Republic of Korea is beginning to respond to this growing demand and there have been numerous recent achievements in the area of nutrition. The purpose of this paper is two fold. In the first part of the paper, an overview is provided about existing nutrition action in Korea. In the second part, information is elicited from Korean experts in the field of public health and nutrition. A structured questionnaire was sent directly to renowned Korean experts and was disseminated through the list serve of the Korean Nutrition Society. It asked about existing nutrition related policies, obstacles to nutrition policies in Korea, which professions are 'responsible' for the prevention of nutrition-related diseases and for example about existing nutrition programs within settings. Twenty-two questionnaires were returned. Based on the results, the following actions were considered crucial to develop and implement a nutrition policy in Korea: having a clear advocacy strategy for nutrition to raise awareness about the importance of nutrition, increase transparency of nutrition-related action and make the information easily accessible for all stakeholders, ensure the enforcement of regulations regarding misleading and incorrect food advertisements, strengthening the (public health) nutrition workforce, strengthen the settings-based approach and build and maintain partnerships, and last not least: educate and empower the citizens and ensure that healthy choices are 'easy choices'! Acknowledging the past and ongoing efforts in Korea, it is pivotal that the nutrition workforce grows stronger and the voice of nutritionists even louder, in order to promote and ensure the health and quality of life of the country's citizens. (J Community Nutrition 7(4) : $175\∼183$, 2005)

Developing a University-Community Partnership Model Integrating Research and Intervention to Improve Food Decisions in Families and Communities

Gillespie, Ardyth H. Korean Society of Community Nutrition 1998 대한지역사회영양학회지 Vol.3 No.1

A major goal of the Community Plant Food Project is to develop partnerships between the Cornell Community Nutrition Program and Community-based organizations, including Cooperative Extension. A core principle behind this work is integrating research and intervention. Based on our work in Rochester, New York, we have developed a process and principles for effective partnerships. This new paradigm what we call the University-Community Partnership Model is a team effort that builds on the experiential literature in the fields of communication, leadership, community and team development, sociology, and participatory research and action. We have applied this model both to increase our understanding of Family Food Decision-making and to develop programs for families. In this project, we have used a variety of qualitative methods to understand food decisions from the perspectives of families and community stakeholders, including a group method for analyzing our qualitative interview data. For our survey of families, we developed the Enhanced Response Method, an approach for improving the validity and reliability of community surveys with families and, at the same time, building relationships with families and other stakeholders in the community for integrated and sustainable interventions. Because the knowledge we develop through the partnership and the interventions we seek to implement are products of the process, we are constantly seeking to refine this knowledge and to adapt emerging interventions through an ongoing evaluation process we call the Continuous Improvement Method.

A Comparison of Obesity Prevalence between Korean-American Children and Korean Children

Sim Young-Ja,Kim Eun-Kyung,Park Kye-Wol,Kim Hee-Sun The Korean Society of Community Nutrition 2006 Journal of community nutrition Vol.8 No.1

This study is to compare the prevalence of obesity between Korean-American children and Korean children, and to investigate the role of environmental factors in obesity development. Prevalence of child obesity is compared by their residence, parents' anthropometric data, education and occupation, and the length of immigration, and birth place of the children. A total of 593 children between the ages of 9 and 12 were examined. 262 Korean-American children (KcUS group) from New Jersey, USA and 331 Korean children (KcK group) from Seoul, Korea were compared. KcUS group showed a higher obesity rate (male: 12.6% and female: 8.2%), compared to KcK group (male: 8.0% and female: 5.1 %). KcK male children showed lower weight and prevalence of obesity than Korean-American male children who lived in the United States for more than three years. Korean-American female children had higher weight and obesity rate than Korean female children. Waist circumference and hip circumference were also higher in obese children in both KcK and KcUS groups. The children who live in America had an odds ratio of 1.69 to be obese compared to KcK, while those born in America and those who have lived in America for more than 3 years had odds ratios of 1.53 and 1.25 to be obese, respectively. This study found that environmental factors, immigration to America for instance, could playa bigger role in child obese development than the genetic factor.

Nutritional Assessment of the Older Population: Practical Application and Limitation

Yoon, Jin-Sook Korean Society of Community Nutrition 2000 Journal of community nutrition Vol.2 No.1

Evaluation of nutritional status is an essential element in providing appropriate intervention strategies to achieve the highest level of health, Nutritional assessment of the older population is complicated by many factors which do not significantly affect the nutritional status in young adults, therefore, it should be considered in two ways; community-dwelling elders group and hospitalized or institutionalized elderly group. To sort out the individuals with nutritional problems in a community efficiently, nutrition screening tools must be simple, relatively inexpensive, and applicable to a large number of subjects. Combination of tools and indicators such as 24-hour food recall, body weight and height, and questionnaires on eating practices, and the presence of chronic diseases is practically applicable as basic tools of nutritional screening of older age group. However, the lack of validated screening techniques remains a barrier in improving nutrition. Validation is only limited to energy, BMI, protein intake of the older populations living in western countries. Further refinement of nutritional assessment tools is demanded to figure out whether those are practically applicable to community-living older adults in Asian Society. A careful and systematic evaluation of nutritional assessment tools should be carried out prior to implementation of stepwise nutrition service to the heterogeneous older population. For an in-depth nutritional assessment at the individual level, we need to extend research efforts to clarify the requirements of nutrients due to aging and diseases. More cost-effective method that will allow rapid analysis of survey results are needed so that information can be readily available to policymakers.

Living Arrangements Affect Nutritional Status of the Elderly

Kim, Cho-Il,Lee, Haeng-Shin Korean Society of Community Nutrition 2001 Journal of community nutrition Vol.3 No.2

With a continuous and steep increase in life expectancies, Korean society is expected to enter the aged society by year 2020. And as the number of elderly increases, the burden of medical and health care expenses for them becomes greater in every developed society. Hence, the preventive approach for chronic degenerative diseases remains to be the best solution for the above-mentioned problem and warranting optimal nutrition would be one of the most important approaches. We performed a nutrition survey on 585 older adults of 50 years of age and older, residing in 3 metropolitan areas including Daejun, Daeku and Kwangju. Anthropometry, including body composition analysis based on the bioelectrical impedance analysis using InBody 3.0 and dietary intake survey by semi-quantitative flood frequency questionnaires, were used in collecting data. As one of the most important factors affecting the health and nutritional status of the elderly, we focused on living arrangements. Analyses were performed on the data from 550 subjects only, after excluding statistical outliers. Three hundred and sixty-eight of them(66.9%) were female and the number of elderly(65 years of age and older) was 485. According to the statistical analyses, the female elderly were more vulnerable to malnutrition than the male elderly. And the older they befame, the less adequate they were in nutrient intake. In addition to this, the elderly living alone showed the poorest patterns of nutrient intake and anthropometry. Although the exact effect of living alone could differ among different sex-age groups, the fact that the elderly living alone is vulnerable to malnutrition would remain concrete. This raises the utmost necessity of nutrition intervention to be devised and directed to the targeted population, namely the living-alone elderly from the government level. The intervention may include nutrition education, nutrition counseling and support In forms of meal service by networking the efforts of central as well as local governments to ensure the good health of the Korean elderly.

A Comparison of Food Frequency, Food Attitude, and Eating Habits between Korean -American and Korean Children

Kim, Eun-Kyung,Sim, Young-Ja,Park, Kye-Wol,Kim, Hee-Sun The Korean Society of Community Nutrition 2006 Journal of community nutrition Vol.8 No.4

Food frequency, food attitude, eating habits and physical activities of Korean-American children and Korean children were compared. Two hundred and sixty two Korean-American children living in New Jersey and New York in the United States of America(KcUS group) and three hundred and thirty one Korean children living in Seoul, Korea (KcK group) between the ages of 9 and 12 were included. There were significant differences in food frequency between these groups. The KcUS group ate more western food, more food at meal time and more snack than the KcK group. In addition, KcUS group slept longer hours and exercised less than KcK group. In this study, we learned that higher rate of obesity in Korean-American children could be partially explained by the difference in food intake, food attitude, eating habit, and physical activities between the two groups. It is suggested that a different approach will be useful in developing nutrition education programs against childhood obesity for the Korean-American children and Korean children.

Generating Grounded Theory with Community Partners

Gillespie Ardyth H.,Gillespie Jr Gilbert W. The Korean Society of Community Nutrition 2006 Journal of community nutrition Vol.8 No.1

This paper describes a methodology for conducting Community Nutrition research with rather than on people in a community to generate grounded theory. This collaborative grounded theory methodology incorporates local knowledge and wisdom and builds community leadership capacity through engaging community-based professionals and para-professionals in the research process. In addition to building capacity for participation and leadership in research, education and action, this approach can increase the validity and value of the research and facilitate its application in community led programs. The methodology has five components: background, study design, data gathering, data analysis and interpretation, and application of findings in community programming. Three stages of the data analysis component focus sequentially on each interview independently, comparing across interviews, and systematically testing theory developed in the first two.

Health and Nutrition Messages in the Baby Food Advertisements of Women's Magazines

Kim, Ki-Nam The Korean Society of Community Nutrition 2003 Journal of community nutrition Vol.5 No.3

Content analysis of food advertisements was undertaken to investigate the nature of the messages related to health, nutrition or consumer-promotion in 2001 women's magazines. Advertisements on baby foods were collected from three women's magazines and the final samples obtained were 42 different copies of advertisements. All the messages in each sample were counted and calculated for their frequency (%). Messages were categorized into four areas (health, nutrition, non-nutrition, consumer promotion), and each area was classified into more detailed categories. Results showed that all the messages in 42 samples and average messages per advertisement were 1288 and 30.7, respectively. The most common type of promotional messages was health related (e.g., appeal to enhanced immune function and disease prevention and brain development), followed by consumer related, nutrition and non-nutrition messages in order. Messages about high quality and all natural ingredients were more emphasized in the consumer related category. Messages on fats (DHA, lecithin and arachidonic acid), proteins (neucleotides, taurine) and mineral (calcium, iron) were most frequently found in nutrition category. Amongst the three kinds of baby foods, formula ads had the most numerous messages related to health and nutrition. There were more consumer related messages in the ads of weaning foods, and more promotional messages about no addition of antiseptic, artificial additives, and food colors in the ads for older infant foods. Messages violating regulation (e.g., exaggerated or inaccurate or non-scientific messages) were frequently found in the advertisements of three kinds of baby foods. In conclusion, tighter supervision of food advertisements and nutrition education is required to protect the consumers from misleading advertisements.

Characteristics and Nutritional Status of Elders Who Under-report Intake on 24 Hour Recalls in USA

Kye, Seung-Hee Korean Society of Community Nutrition 2000 Journal of community nutrition Vol.2 No.2

The objectives of this study were to determine whether older Americans would provide valid energy intake information using a 24-hr recall method and to determine which characteristics were predictive of under-report of energy intake. We conducted 24-hour recalls on 83 male and 105 female community-dwelling older adults(66-87y) in the USA to assess energy(EI) and nutrient intakes. Basal metabolic rate(BMR) was calculated from age-and gender-specific equations of Schofield. Under-reporting was defined a priori as EI : BMR<0.9. Subjects volunteered demographic information, underwent depression and cognition exams, and completed a Level II Nutrition Risk Screen. Differences between under- and adequate-reporters were assessed using t-tests for characteristics and macro-nutrient profile. Stepwise regression analyses were used to predict under-reporting status. Under-reporting of EI occurred in 34% of the sample. Neither geriatric depression scale(GDS) score, nor self-reported weight loss were related to under-reporting. On average, under-reporters had higher body mass indices. The most significant variables for the main effect to predict the ratio of energy intake to estimated basal metabolic rate(EI : BMRest) were BMI and age. Using a standard cut-off of 76% of the recommended dietary allowances for Americans, under-reporters were consistently more likely to be classified as having inadequate nutrient, as well as energy, intakes. (J Community 2(2) 135∼140, 2000)

Evaluation of Dietary Risk Factors for Abnormal Serum Cholesterol in Korean Sedentary Male Adults

Jjn, Bok-Hee,Kim, Young-Ok Korean Society of Community Nutrition 1997 대한지역사회영양학회지 Vol.2 No.5

This study investigated whether dietary factors are more influential factor than other health behavior such as drinking, smoking and exercise on abnormal serum cholesterol level inspite of Korean dietary pattern differences compared to Europeans and Americans. A double case control study model has been used for the study design. One model consisted of high blood cholesterol cases and control. the other model consisted of low blood cholesterol cased and controls. 5.398 sedentary male workers who had taken medical examinations at a university hospital were used as the study subjects. Out of the study subjects, 36individuals with high blood cholesterol cases and 30 individuals with low blood cholesterol cases were selected. For the 66 individual control selection, the individual control selection, the individuals matching method was adopted. The food frequency method was used to collect the data for assessment of the dietary factors. A standardized questionnaire was used to investigate other health behavior. logistic regression analysis was employed to measure the relative importance between the factors considered. There were no statistically significant differences observed in nutrients consumption or other health behavior among the low, normal and high blood cholesterol groups, An overmatching effect had been suspected as the cause of those findings. However, the results of logistic regression analysis to identify the factors influencing high serum cholesterol showed that odd ratios of dietary factors such as tocopherol(3.0) and saturated fatty acid(1.6) were higher than I. I of smoking and 1.2 of drinking. Similar results were also observed incases of low serum cholesterol. The above findings imply that although the dietary pattern is quite different from that of Europeans and America, the dietary factor is still a significant factor for abnormal blood cholesterol in Koreans. Therefore, the dietary risk factor identified in high fat consumption populations are still relevant for the relatively healthy Korean as guideline for preventive health practices. (Korean J Community Nutrition 2(5) : 721∼727, 1997)