Still life with less: North Korean young adult defectors in South Korea show continued poor nutrition and physique

Choi, Seul-Ki,Park, Sang-Min,Joung, Hyo-Jee The Korean Nutrition Society 2010 Nutrition Research and Practice Vol.5 No.6

North Korean defectors who settle in South Korea have experienced severe food shortage and transition of food environment which could affect their health status. However, little is known about their anthropometric measurements and dietary intake after settlement in South Korea. The purpose of this study is to compare anthropometric measurements and dietary intake between North Korean young adults who defected to South Korea and those of South Koreans. We hypothesized that North Korean young adults' physiques and dietary intake would be poorer than that of South Koreans. We compared anthropometric measurements and dietary intake from 3-day food records in a cross-sectional study of 103 North Korean young adult defectors, aged 12 to 24 and 309 South Korean subjects. North Korean subjects were significantly shorter (4.9 to 10.8 cm) and lighter (6.0 to 12.5 kg) than the control group. Body mass index were significantly different between North and South Korean groups only in men. North Korean young adult defectors had lower mean daily intakes of energy and most nutrients and food groups compared to the control group, while North Korean subjects had higher nutrient density diet than that of South Koreans. The proportion of subjects who had dietary intakes of nutrients of less than the Estimated Average Requirement was higher in North Korean subjects than in controls except for in the cases of vitamin A and vitamin C. In conclusion, we recommend providing nutrition support programs for North Korean young adult defectors to secure adequate nutrient intake.

Public Health Nutrition Policies and the Role of the Government: International Examples and the Need for Action in the Republic of Korea

Engellhardt, Katrin,Joung, Hyojee The Korean Nutrition Society 2005 Nutritional Sciences Vol.8 No.1

Many of the non-communicable diseases, which are now the major causes of death and disability worldwide, can be linked to our lifestyles, and thus to what eat The life-style related risk factors are - to a great extent - preventable. Public health nutrition (PHN) policies are means through which govemments can have an enornous impact on the reduction of nutrition-related non-communicable diseases, such as diabetes, hypertension, obesity, cancer and cardiovascular disease, by creating and supporting environments which enable healthier food choices and which are conducive to healthy nutrition behavior. More and more countries are developing nutrition policies. Nutrition policies are tools through which governments can intervene and control nutrition-related concerns throughout all levels of society. The need for more concerted action in the Republic of Korea is demonstrated, by showing the lack of priority for nutrition issues. Four recommendations for action are made; the first recommendation places emphasis on the need to implement a structure at the political level, through which nutrition concerns can be addressed, such as a nutrition unit within the Ministry of Health and Welfare. The second recommendation stresses the need for a strong nutrition advocacy strategy, to raise the awareness of the gains that can be achieved by promoting healthy nutrition. The third recommendation calls for more vigorous regulations and stricter enforcement of food and nutrition advertisement, and the fourth recommendation emphasizes the need for a settings-bsed approach to nutrition interventions. Acknowledging the developments that have already occurred in Korea, public health nutrition has yet to become a priority on the agenda of policy makers in Korea.

Historical background and development of applied nutrition and community nutrition in Korea

Mo, Su-Mi The Korean Nutrition Society 2007 Nutrition Research and Practice Vol.1 No.1

This paper overviews the historical background and development of applied nutrition and community nutrition in Korea. The nutrition studies in the early years focused on animal experiments, human metabolism, and food analysis and therefore were limited to classrooms and research laboratories in universities without spreading into the lives of people. Korean specialists trained through the UN International Course of Applied Nutrition initiated the Applied Nutrition Program (ANP) in Korea in the 1960s. The ANP in Korea was effectively implemented until 1986 with support from UNICEF, FAO, and WHO as a national project to improve the nutrition and health of rural residents. With economic development and urbanization in Korea, the rural-focusing ANP was re-born to a more extended version with the name of "Community Nutrition", targeting the nutrition and health of the entire Korean population. Scholarly associations including the Korean Society of Community Nutrition established in 1995 have significantly contributed to the development of Community Nutrition in Korea and are expected to continue to work for a better connection between nutrition and health promotion.

Dietary Molar Ratios of Phytate : Zn and Phytate $\times$ Ca : Zn for Zn Nutrition Assessment in Koreans

Kwun, In-Sook,Kwon, Chong-Suk The Korean Nutrition Society 1999 Nutritional Sciences Vol.2 No.2

Zinc nutriture in South Koreans was evaluated by estimating Zn, Ca, and phytate intake, and the molar ratios of phytate : Zn and the millimolar ratios of phytate $\times$ Ca Zn. food consumption data from the 95 National Nutrition Survey was used. For the present study, data from the nationwide, large city and urban area level were used. No standard deviation measures were provided in the 95 National Nutrition Survey : only mean values were reported. Nationwide daily intake of Zn and Ca were 10.1 mg/day and 426.5 mg/day, respectively. The estimated daily phytate intake was 1676.6 mg/day nationwide. The molar ratio of phvtate : Zn, the millimolar ratio of phytate $\times$ Ca : Zn and the phytate $\times$ Ca Zn mmol per 4.2 MJ (1000 kcal) were 15.9, 168.9 and 91.8 in nationwide, respectively. The major food groups for zinc intake were meat, poultry products (43%), and cereals and grain products (18%). Sixty two percent of Zinc was from animal food sources. Cereal and grain products supplied most of the phytate intake (46%), followed by seasonings, fruits, and legume products. The major food source of phytate was rice (39%) . The results of the present study suggest that Zn status of Koreans maybe influenced by high dietary intake of phytate and high molar ratios of phytate : Zn and phytate $\times$ Ca : Zn. These results raise concerns about Zn status of Koreans, who consume a diet higher in phytate than Western diets. further research is necessary to confirm whether such poorly available dietary Zn has any impact on the health of Koreans.

Creating a school nutrition environment index and pilot testing it in elementary and middle schools in urban South Korea

Park, Sohyun,Kwon, Kwang-il,Kweon, Soon Ju,Wang, Youfa,Gittelsohn, Joel The Korean Nutrition Society 2017 Nutrition research and practice Vol.11 No.5

BACKGROUND/OBJECTIVES: The role of a school's nutrition environment in explaining students' eating behaviors and weight status has not been examined in an Asian setting. The purpose of this study was to create a school nutrition environment index and to pilot test the index in elementary and middle schools in urban South Korea. SUBJECTS/METHODS: This study used a mixed-methods approach. Environment assessment tools were developed based on formative research, which comprised literature reviews, in-depth interviews, and focus group discussions. Key elements from the formative research were included in the assessment tool, which consisted of a structured survey questionnaire for school dietitians. Fifteen school dietitians from 7 elementary and 8 middle schools in Seoul completed the questionnaire. RESULTS: The formative research revealed four main sections that guided a summary index to assess a school's nutrition environment: resource availability, education and programs, dietitians' perceptions and characteristics, and school lunch menu. Based on the literature reviews and interviews, an index scoring system was developed. The total possible score from the combined four index sections was 40 points. From the 15 schools participating in the pilot survey, the mean school nutrition-environment index was 22.5 (standard deviation ${\pm}3.2$; range 17-28). The majority of the schools did not offer classroom-based nutrition education or nutrition counseling for students and parents. The popular modes of nutrition education were school websites, posters, and newsletters. CONCLUSIONS: This paper illustrates the process used to develop an instrument to assess a school's nutrition environment. Moreover, it presents the steps used to develop a scoring system for creation of a school nutrition environment index. As pilot testing indicated the total index score has some variation across schools, we suggest applying this instrument in future studies involving a larger number of schools. Future studies with larger samples will allow investigation of the validity and reliability of this newly developed tool.

Dietary intake and major source foods of vitamin E among Koreans: findings of the Korea National Health and Nutrition Examination Survey 2016-2019

Shim, Jee-Seon,Kim, Ki Nam,Lee, Jung-sug,Yoon, Mi Ock,Lee, Hyun Sook The Korean Nutrition Society 2022 Nutrition Research and Practice Vol.16 No.5

BACKGROUND/OBJECTIVES: Vitamin E is essential for health, and although vitamin E deficiency seems rare in humans, studies on estimates of dietary intake are lacking. This study aimed to estimate dietary vitamin E intake, evaluate dietary adequacy of vitamin E, and detail major food sources of vitamin E in the Korean population. SUBJECTS/METHODS: This study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016-2019. Individuals aged ≥ 1 year that participated in a nutrition survey (n = 28,418) were included. Dietary intake was assessed by 24-h recall and individual dietary vitamin E intake was estimated using a newly established vitamin E database. Dietary adequacy was evaluated by comparing dietary intake with adequate intake (AI) as defined by Korean Dietary Reference Intakes 2020. RESULTS: For all study subjects, mean daily total vitamin E intake was 7.00 mg α-tocopherol equivalents, which was 61.6% of AI. The proportion of individuals that consumed vitamin E at above the AI was 12.9%. Inadequate intake was observed more in females, older individuals, rural residents, and those with a low income. Mean daily intakes of tocopherol (α-, β-, γ-, and δ-forms) and tocotrienol were 6.02, 0.30, 6.19, 1.63, and 1.61 mg, respectively. The major food groups that contributed to total dietary vitamin E intake were grains (22.3%), seasonings (17.0%), vegetables (15.3%), and fish, and shellfish (7.4%). The top 5 individual food items that contributed to total vitamin E intake were baechu kimchi, red pepper powder, eggs, soybean oil, and rice. CONCLUSIONS: This study shows that mean dietary vitamin E intake by Koreans did not meet the reference adequate intake value. To better understand the status of vitamin E intake, further research is needed that considers intake from dietary supplements.

Comparisons of food security, dietary behaviors and nutrient intakes between adult North Korean Refugees in South Korea and South Koreans

Kim, Ji Yoon,Lee, Soo-Kyung,Kim, Sin Gon The Korean Nutrition Society 2020 Nutrition research and practice Vol.14 No.2

BACKGROUND/OBJECTIVES: North Korean refugees (NKRs) in South Korea are a unique population as they must adapt in a new country with similar cultural traits but different social, political, and economic systems, but little research has been conducted on diet and nutrition in this population. This study examined food security, dietary behaviors, and nutrient intakes among adult NKRs living in South Korea and compared them to those of South Koreans. SUBJECTS/METHODS: The subjects were 139 adult NKRs (25 men, 114 women) living in the Seoul metropolitan area, and 417 age- and sex- matched South Korean controls (SKCs; 75 men, 342 women) selected from the Korea National Health and Nutrition Examination Survey (KNHANES). Food security and dietary behaviors (meal skipping, eating-out, meals with family, nutrition education and counseling, and nutrition label knowledge and utilization) were obtained using self-administered questionnaires. Nutrient intakes were assessed by 24-hr recall. The statistical analysis was performed using IBM SPSS ver. 23.0. RESULTS: In South Korea, food security had improved over the previous 12 months, but remained significantly poorer for NKR women than SKC women. Meal skipping was three times more frequent than for SKCs and eating-out was rare. Average energy intake was 1,509 kcal for NKR men and 1,344 kcal for NKR women, which was lower than those of SKCs (2,412 kcal and 1,789 kcal, respectively). Significantly more NKRs (men 24.0%, women 21.9%) showed simultaneously deficient intake in energy, calcium, iron, vitamin A, and riboflavin than SKCs (men 2.7% (P = 0.003), women 7.0% (P < 0.001)). NKR women had a significantly higher index of nutrient quality (INQ) for some nutrients than SK women. CONCLUSIONS: This study reports significant differences in food security, dietary behaviors, and nutrient intakes between NKRs and SKCs. Generally, NKRs reported lower intakes despite improved food security, but relatively good INQs across nutrients. Further research is needed to understand processes of food choice and consumption among NKRs to provide appropriate support aimed at improving diets.

A comparison of food and nutrient intake between instant noodle consumers and non-instant noodle consumers in Korean adults

Park, Ju-Yeon,Lee, Jung-Sug,Jang, Young-Ai,Chung, Hae-Rang,Kim, Jeong-Seon The Korean Nutrition Society 2011 Nutrition Research and Practice Vol. No.

Instant noodles are widely consumed in Asian countries. The Korean population consumed the largest quantity of instant noodles in the world in 2008, However, few studies have investigated the relationship between instant noodles and nutritional status in Koreans. The objective of this study was to examine the association between instant noodle consumption and food and nutrient intake in Korean adults. We used dietary data of 6,440 subjects aged 20 years and older who participated in the Korean National Health and Nutrition Examination Survey III. The average age of the instant noodle consumers (INC) was 36.2 and that of the non-instant noodle consumers (non-INC) was 44.9; men consumed more instant noodles than women (P<0.001), With the exception of cereals and grain products, legumes, seaweeds, eggs, and milk and dairy products, INC consumed significantly fewer potatoes and starches, sugars, seeds and nuts, vegetables, mushrooms, fruits, seasonings, beverages, meals, fishes, and oils and fats compared with those in the non-INC group. The INC group showed significantly higher nutrient intake of energy, fat, sodium, thiamine, and riboflavin; however, the INC group showed a significantly lower intake of protein, calcium, phosphorus, iron, potassium, vitamin A, niacin, and vitamin C compared with those in the non-INC group. This study revealed that consuming instant noodles may lead to excessive intake of energy, fats, and sodium but may also cause increased intake of thiamine and riboflavin. Therefore, nutritional education helping adults to choose a balanced meal while consuming instant noodles should be implemented, Additionally, instant noodle manufacturers should consider nutritional aspects when developing new products.

A big picture view of precision nutrition: from reductionism to holism

Kwon, Oran The Korean Nutrition Society 2019 Journal of Nutrition and Health Vol.52 No.1

Purpose: This review describes the historical changes in nutrition philosophy from a reductionist to a holistic approach during the $20^{th}$ century. Also, the role and efficient use of a holistic approach to precision nutrition are discussed. Results: Over the past century, significant progress has been made in human nutrition research, unraveling fundamental mechanisms of single nutrients on single targets or pathways. This kind of a reductionist approach has helped to save populations from nutrient deficiency diseases and improve associated health outcomes in large parts of the world. However, a new set of nutrition problems, like obesity and diet-related chronic diseases, are growing each year worldwide, increasing the financial burden on the health care system. A linear cause-effect association between single nutrients and a single physiologic effect, is insufficient to solve the complex nutrition-health relationships. Research that involves a more holistic rather than reductionist approach is needed to tackle a new set of nutrition problems. Recent advances in technology, informatics, and statistical methods are enabling an understanding of the diversity of individuals and the complex interactions between foods and human bodies, leading to the concept of "precision nutrition." Conclusion: The emerging goal of precision nutrition is to provide tailored dietary advice for maintaining health and preventing obesity and diet-related chronic diseases. The parts are already being installed. To grab the complexity, reductionism and holism must be used interdependently.

The association between dietary sodium intake and the risk of cataract: data from Korean National Health and Nutrition Examination Survey 2012

Choi, Jeong-Hwa,Heo, Young-Ran The Korean Nutrition Society 2019 Journal of Nutrition and Health Vol.52 No.3

Purpose: Sodium intake is known to be a critical dietary factor in several diseases including cataract. Earlier studies have reported that excess intake of sodium may elevate the risk of cataract. However, little is known about this in Koreans. Thus, the purpose of this study was to examine whether dietary intake of sodium and potassium might modify the risk of cataract. Methods: A total of 1,319 males (219 cases) and 1,966 females (369 cases) from Korean National Health and Nutrition Examination Survey 2012 were analyzed. Energy adjusted dietary intakes of sodium and potassium and their ratios were evaluated to ascertain their associations with the risk of cataract. Dietary intake levels were stratified into quartiles and their risk modifying effects were estimated with logistic regression models with or without subjects' socio-economic characteristics and life styles for each sex. Results: Findings suggested that various descriptive factors were associated with the risk of cataract either in males or females. Males' intake levels of sodium and potassium and their ratios did not differ between phenotypes. Higher intakes or higher ratio was not associated with the risk of cataract. In contrast, female controls had higher intakes of sodium and potassium. Higher intake of potassium reduced the risk of cataract in females. However, such association was not retained when subjects' socioeconomic status and life styles were factored into the analysis. Conclusion: Dietary sodium and potassium intakes minimally affected the risk of cataract in Korean males and females. More studies are needed to ascertain the true pathological effect of sodium intake on cataract aetiology.