OBJECTIVES:To evaluate the effectiveness of a health belief model (HBM)-based nutrition education program in improving dietary behaviors, nutrition knowledge, and self-management among Koreans with type 2 diabetes mellitus (T2DM), and to examine age-related differences and the effects of intervention delivery strategies. METHODS:A pre-post intervention study was conducted among 21 adults with T2DM (glycated hemoglobin levels ≥ 7.5%) attending outpatient clinics at university hospitals in Korea. The HBM-based program incorporated passive learning strategies (lectures and videos) and active, experiential learning strategies. Nutrition knowledge, dietary attitudes, and dietary behaviors were assessed before and after the intervention. Participants' interest and satisfaction were also evaluated using interest-satisfaction analysis (ISA). RESULTS:Nutrition knowledge and dietary behaviors improved significantly among adults following the intervention. Adults (n = 15) showed significant increases in nutrition knowledge (0.50 to 0.60, P < 0.05) and dietary behavior scores (2.26 to 2.47, P < 0.05), whereas no significant changes were observed among older adults (n = 6). The mean interest and satisfaction scores were 4.44 and 4.43 out of 5, respectively. Experiential learning strategies were associated with higher satisfaction than passive approaches. ISA showed that hands-on activities received the highest interest and satisfaction ratings, whereas passive methods were rated less favorably. CONCLUSION:Participation in an HBM-based nutrition education program was associated with improved dietary behaviors among Koreans with T2DM in a clinical nutrition setting. Experiential learning approaches appeared to be more effective than passive methods, and the age-related differences observed suggest a need for tailored intervention strategies. These findings support the development of scalable, patient-centered nutrition interventions for chronic disease management.
OBJECTIVES:In this study, the association between the frequency of watching mukbang/ cookbang (online eating and cooking broadcasts) and obesity in Korean adolescents was investigated using data from the 21st (2025) Korea Youth Risk Behavior Web-based Survey. METHODS:The subjects were 52,624 middle- and high-school students, who were classified based on watching frequency as follows: non-watchers, monthly watchers, and weekly watchers (≥ 1 time/week). Changes in the dietary behavior of the watchers (n = 34,375) were assessed. Obesity was defined as a sex- and age-specific body mass index ≥ 95th percentile as per the 2017 Korean Children and Adolescents Growth Standard. Complex sample multiple logistic regression was used to calculate the adjusted odds ratios (aORs) and 95% confidence intervals (CIs), controlling for sociodemographic, health-related, and dietary covariates. Sex-stratified analyses and P for trend tests were also conducted. RESULTS:Overall, 65.3% of students watched mukbang/cookbang in the past year. The weekly watchers had significantly higher odds of obesity than the non-watchers (aOR = 1.09, 95% CI: 1.02-1.16; P for trend = 0.011). Sex-stratified analyses showed a positive association in boys (aOR = 1.20, 95% CI: 1.11-1.30), but an inverse association in girls (aOR = 0.86, 95% CI: 0.77-0.97). Among the watchers, the "eating quickly" group had the highest odds for obesity (aOR = 1.54, 95% CI: 1.31-1.82), whereas the "eating night snacks/ snacks" (aOR = 0.85, 95% CI: 0.74-0.98) and "eating spicy or highly flavored foods" (aOR = 0.85, 95% CI: 0.73-0.99) groups were associated with lower odds of obesity. CONCLUSION:Regular mukbang/cookbang viewing was significantly associated with adolescent obesity. A media-induced "fast eating rate" was identified as a potential behavioral pathway linked to higher obesity risk, suggesting that adolescent obesity prevention programs should incorporate media literacy and behavioral interventions that promote slower eating.
Objectives: Korea has entered a super-aged society, resulting in a growing socioeconomic burden and rapidly increasing demand for home- and community-based nutrition services. This review aimed to examine the nutritional health status of Korean older adults and the existing nutrition programs, along with suggesting effective nutritional strategies to improve their healthy life expectancy.Methods: This narrative review was conducted by collecting and synthesizing domestic and international literature, including journal articles, books, government documents, national health statistics, and reports on foreign nutrition programs. The literature was collected through scholarly databases and institutional websites searches using relevant keywords.Results: The synthesized results indicate that Korean older adults have insufficient intakes of essential nutrients, such as calcium, vitamin A, and vitamin C, alongside a high prevalence of multimorbidity and associated polypharmacy. Existing community-based nutrition programs provide meal services, home-delivered meals/side dishes, and nutrition education/counseling to vulnerable older populations. Additionally, the Center for Social Welfare Foodservice Management contributes to overseeing nutrition and hygiene management in small-scale elderly foodservice facilities. However, more effective nutritional strategies are required to achieve fully integrated community care. First, homebased nutrition care services for community-dwelling older adults should be introduced to enable tailored nutritional management. Second, expanding and strengthening the role of the Center for Social Welfare Foodservice Management may facilitate efficient management of meals across elderly foodservice facilities. Third, specialized education and training programs are required to enhance the professional competency of dietitians delivering these services. Furthermore, robust legal, institutional, and budgetary foundations, improved working conditions and job security for dietitians, and heightened public awareness of nutrition services are needed.Conclusion: Implementing these strategies may prevent functional decline and disease aggravation, and ultimately reduce the socioeconomic costs associated with medical treatment, nursing, and long-term care of older adults.
Objectives: This study analyzed the current evaluation indicators used for early childhood programs by the Center for Children’s and Social Welfare Foodservice Management (CCFSM) in South Korea and developed a logic model-based performance evaluation framework to improve the system through outcome-oriented assessment.Methods: The study comprised four stages. First, existing on-site evaluation indicators were mapped onto a logic model framework to assess their suitability for evaluating program effectiveness. Second, focus group interviews were conducted with stakeholders and experts to examine their understanding of, and perceived limitations in, the current evaluation system. Third, new outcome indicators were developed using checklist items for hygiene, safety, and nutrition management implemented across centers, and program effectiveness was evaluated using these indicators. Fourth, additional indicators were developed to assess the effectiveness of child-targeted nutrition and dietary education programs, and their practical applicability was examined.Results: The current evaluation indicators focused primarily on structural (input) and process measures, with limited emphasis on outcomes reflecting the ultimate program goals. Few indicators directly assessed improvements in children’s health and dietary behaviors, and existing outcome measures relied largely on subjective satisfaction surveys completed by facility directors and parents. Based on the logic model, the proposed outcome indicators included, in the mid-term, improvements in hygiene, safety, and healthy eating practices scores, and, in the long-term, reductions in foodborne illness and food allergy incidents, increased fruit and vegetable intake, and decreased sodium and sugar intake.Conclusion: The findings highlight the need to transition the CCFSM evaluation system toward a performance-oriented framework. A logic model-based evaluation system would improve accountability and better align evaluation practices with policy objectives, whereas phased implementation would help minimize operational burden on practitioners.
Objectives: This study aims to examine how perceived risks associated with upcycled foods shape consumer decision-making through the lens of Protection Motivation Theory (PMT). Although upcycled foods have gained increasing attention as a promising approach to reducing food waste and supporting sustainable diets, consumer acceptance remains uncertain due to concerns about safety, quality, unfamiliarity, and perceived contamination. Specifically, this study investigates the cognitive mechanisms by which threat and coping appraisals influence protection motivation and purchase intention.Methods: Using a cross-sectional survey design, data were collected from 211 consumers in South Korea through an online questionnaire. The survey measured perceived risk, perceived severity, perceived vulnerability, response efficacy, self-efficacy, protection motivation, and purchase intention toward upcycled foods. Confirmatory factor analysis and structural equation modeling were employed to assess the validity and reliability of the measurement model and to test the proposed PMT-based framework and hypothesized relationships among perceived risk, cognitive appraisals, motivation, and intention.Results: Perceived risks significantly increase perceived severity and vulnerability while reducing response efficacy. These findings indicate that consumers who perceive greater risks associated with upcycled foods are more likely to recognize potential negative consequences and their personal susceptibility, and to question whether purchasing such products can effectively address sustainability-related concerns. Both threat appraisal and coping appraisal significantly affect protection motivation, which in turn positively influences purchase intention. The relationship between perceived risk and self-efficacy was not supported, suggesting that risk perception alone may not directly undermine consumers’ confidence in their ability to choose or consume upcycled foods.Conclusion: The findings demonstrate that perceived risks do not uniformly inhibit consumption of upcycled food but operate through nuanced cognitive pathways. By highlighting the central role of coping appraisal, this study suggests that strengthening consumers’ efficacy beliefs is critical to promoting informed, sustainable adoption of upcycled foods. The results have practical implications for marketers, policymakers, and food industry stakeholders by emphasizing the need for transparent information, credible communication, and consumer education to reduce uncertainty and reinforce the perceived effectiveness and accessibility of upcycled food choices.
OBJECTIVES:Although delivery-based contract-managed operations have recently increased in small-scale foodservice facilities serving older adults, studies investigating the nutrient adequacy of meals and chronic disease risk reduction intake remain limited. This study aimed to evaluate nutrient intake levels, nutrient intake adequacy, and their chronic disease risk, and to compare differences between self-operation and contract-managed foodservice. METHODS:Nutrient intakes of 777 participants were assessed for lunch and snack in 18 small-scale foodservice settings serving older adults in Korea. Data collection included 12 visits to six self-operated foodservice settings (November 2024-June 2025) and 24 visits to 12 contract-managed foodservice settings (December 2025-March 2026). Using the individual leftover measurement method, consumption adjustment factors were calculated. By applying it to standardized recipes from lunch and afternoon snacks, nutrient intake was analyzed using CAN-Pro 6.0 (Professional Edition; The Korean Nutrition Society). Based on the 2025 Korean Dietary Reference Intakes, nutrient adequacy ratio (NAR), the proportion of participants with intakes below nutrient reference values, and the proportion over chronic disease risk reduction intake (CDRR) were calculated. RESULTS:Except for significantly higher soup consumption in self-operated foodservice, no significant differences in consumption and consumption adjustment factors were observed among food types between the two foodservice operation types. NARs were low for vitamin B6 (0.29), vitamin D (0.37), vitamin A (0.52), vitamin C (0.55), and calcium (0.61), indicating inadequate micronutrient intake. The highest proportions were for vitamin B6 (94.9%), followed by vitamin A and folate (76.4%), vitamin C (70.4%), and calcium (69.0%). The proportion over CDRR of the participants was highest for sodium (91.2%), followed by saturated fatty acids (46.6%) and total sugars (3.7%), showing significant differences between the two foodservice operation types. CONCLUSION:Nutrition management in small-scale public foodservice facilities for older people should reflect actual consumption and operation type-specific nutrient deficiencies or excesses.
OBJECTIVES:This study aimed to clarify parental perceptions of dietary and nutritional education provided to young children, identify parental support needs, and suggest directions for improvement. METHODS:A mixed-method sequential explanatory design was followed. Quantitative data were collected through an online survey conducted nationwide that included 200 parents of children aged three to six years in South Korea. Qualitative data were subsequently obtained through focus group interviews with fifteen parents to explore their contextual insights and experiences. RESULTS:Needs ratings prioritized expanding activity-based/experiential education (3.65 ± 0.88), followed by strengthening home-school communication and connectivity (3.59 ± 0.84), diversifying topics and content (3.55 ± 0.88), and increasing instructional time (3.39 ± 0.94). Integrated with the focus group interview findings, multilevel barriers were revealed-individual level: strong preferences of children for sweet/processed foods; interpersonal level: strong parental modeling and peer effects counterbalancing limited teacher expertise/time; organizational level: insufficient effective event-based experiential activities, and resource gaps across institutions; community/policy level: infrequent external support, uneven access to local resources, lack of standardized guidance, and limited opportunities for parental participation. Parents favored short, interactive digital content and expressed concerns about overexposure. These convergent findings indicate needs to 1) formalize and extend experiential programs within the regular curriculum, 2) provide standardized guidelines and home resource kits, and 3) institutionalize parental involvement. CONCLUSION:These findings reveal that dietary and nutritional education for young children should move beyond fragmented, event-based programs toward an integrated three-tiered model incorporating (1) a structured, experiential curriculum, (2) home-linked educational packages, and (3) safe and interactive digital content. Establishing standardized guidelines, enhancing educational infrastructure, and institutionalizing parental participation are essential for sustainable improvement of early childhood dietary education.
OBJECTIVES:Sarcopenia is a condition characterized by the loss of muscle mass and function and is often accompanied by aging and chronic diseases such as diabetes and obesity. It increases the risk of falls, frailty, disability, hospitalization, and mortality in older adults. Its global prevalence is estimated as approximately 10%-27% in adults aged > 60 years. This review analyzes evidence from research findings and recommendations to provide a comprehensive overview of dietary factors and nutritional strategies for preventing and managing sarcopenia in older adults. METHODS:Literatures were searched to integrate findings from observational studies, clinical trials, systematic reviews, and meta-analysis on dietary factors and nutritional guidelines for the prevention and management of sarcopenia. Particularly, points were emphasized on protein intake, micronutrient adequacy, dietary patterns, and combined lifestyle interventions relevant to older populations. RESULTS:Sarcopenia develops through multifactorial mechanisms such as dysfunction in muscle protein synthesis, chronic inflammation, mitochondrial dysfunction, and aging-related hormonal decline. Nutritional factors, particularly protein intake, play a central role in its development and management. Adequate protein intake is typically 1.0-1.2 g/kg/day for healthy older adults and more than 1.2 g/kg/day for individuals with sarcopenia or frailty. High-quality protein intake, sufficient leucine intake, and amino acids or β-hydroxy-β-methylbutyrate supplementation may help to counteract dysfunction in muscle protein synthesis. The adequacy of vitamin D supports musculoskeletal health. Dietary patterns, such as the Mediterranean and Dietary Approaches to Stop Hypertension diets have been consistently associated with better muscle mass, strength, and function. Strong evidence has demonstrated synergistic benefits when optimized nutrition is combined with resistance exercise. CONCLUSION:The comprehensive management of sarcopenia in older adults requires an integrated strategy that prioritizes adequate protein and energy intake, vitamin D adequacy, healthy dietary patterns, and regular resistance exercise.
OBJECTIVES:This study aimed to develop play-based nutrition education (PBNE) materials for young children and to evaluate their applicability and effectiveness. METHODS:An online survey of 1,253 primary caregivers of preschool children was conducted, and the findings were used to develop age-specific utilization guides, slides, activity sheets, activity cards, posters, educational videos, and parent newsletters. Selected materials were implemented in child-care centers through the Children's Foodservice Management Centers between October and November 2023. The effectiveness of the PBNE program was assessed by examining changes in mushroom consumption as well as food awareness and preferences, before and after the intervention. RESULTS:A total of eight media formats and 320 educational contents were developed, and mushrooms were as the pilot theme among the 12 possible food items. Following the intervention, children's positive awareness of mushrooms increased, and > 96% of participants attempted to consume them. Teachers in child-care centers rated the appropriateness and applicability of the content, its contribution to behavioral improvement, and their overall satisfaction at > 4.9 out of 5 points. CONCLUSION:This study developed experiential, PBNE materials aligned with the national standard child- and play-centered curriculum. The materials were effective in enhancing food awareness and promoting attempts at consumption. Future efforts should focus on developing additional experiential teaching tools that incorporate teacher feedback and on strengthening home-linked programs to support healthy seasonal food intake and positive dietary experiences in young children.
Objectives Korea and China have the highest sodium intakes globally. The sodium index is a quantitative measure of the estimated sodium intake, calculated using a regression equation with proven validity and reliability in individuals aged 19–69 years. This study aimed to compare the sodium index of Korean and Chinese university students and analyze the association between the sodium index and the risk of obesity. Methods A total of 218 university students—110 Korean (63 males, 47 females) and 108 Chinese (60 males, 48 females)—participated in this study in 2019. Sodium-related awareness, nutritional knowledge, and sodium index were compared between Korean and Chinese students. Obesity indicators were compared according to three criteria for the sodium index of Korean and Chinese students: “moderate,” “careful,” and “severe”. The association between sodium index levels and risk of obesity was analyzed using multiple logistic regression analysis adjusted for age and sex. Results Overall, 84% of students recognized that they consumed large amounts of sodium. Korean students demonstrated higher nutritional knowledge scores than Chinese students. The average estimated sodium intake was 3,751 mg, and no significant difference was observed between Korean (3,857 mg) and Chinese (3,643 mg) students. The overall average sodium index was 187, which falls under the “careful” level. As the sodium index levels increased, the students’ body mass index, waist-hip ratio (WHR), and fat-related indicators significantly increased. At the “severe” level of the sodium index, Korean and Chinese students had 2.402-fold and 1.636-fold increases in the risk of obesity based on body fat percentage, and 3.682-fold and 1.622-fold increases based on WHR, respectively. Conclusion This study demonstrated an association between sodium index and obesity risk, showing that excessive sodium intake affects body fat-related indicators in university students.
OBJECTIVES:To examine the prevalence of coronary artery disease (CAD) according to lifestyle characteristics, nutrient intake level, and comorbidities among Koreans aged ≥ 40 years. METHODS:Data were derived from 11,025 participants aged ≥ 40 years in the 7th Korea National Health and Nutrition Examination Survey. Participants were assigned to a CAD group (n = 470) or a non-CAD group (n = 10,555). Socio-demographic characteristics (age, sex, residence, income, marital status, education level, and employment status), lifestyle characteristics (smoking, drinking, walking, strength training, sleep duration, stress level, and subjective health perception), energy and nutrient intakes, and comorbidities, including obesity, hypertension, dyslipidemia, diabetes mellitus, stroke, cancer, depression, renal failure, cataract, asthma, chronic obstructive pulmonary disease, osteoarthritis, and osteoporosis were analyzed. RESULTS:The prevalence of CAD was higher in older participants and in male. Participants with CAD had higher rates of smoking, engaged in less strength training, experienced higher stress, and had poorer perceived health. They had lower intakes of energy, fiber, folate and iron. The prevalence of obesity, hypertension, dyslipidemia, diabetes mellitus, stroke, depression, renal failure, cataract, asthma, allergic rhinitis, osteoarthritis, or osteoporosis was significantly higher in the CAD group. The likelihood of having CAD was significantly higher among participants with renal failure (odds ratio [OR], 4.25; 95% confidence interval [CI], 2.24-8.08), depression (OR, 2.14; 95% CI, 1.55-2.95), asthma (OR, 2.07; 95% CI 1.48-2.91), and dyslipidemia (OR, 2.03; 95% CI, 1.69-2.44). CONCLUSION:In Koreans aged ≥ 40 years, CAD was associated with unhealthy lifestyle habits, low nutrient intake, and increased comorbidities such as renal failure, depression, asthma, and dyslipidemia. These findings suggest the need for lifestyle management and intensive chronic disease management to reduce the risk of CAD.
OBJECTIVES:The aim of this qualitative study was to explore and understand the behaviors and challenges of self-nutrition management from the perspective of elderly. METHODS:In May 2025, ten elderly aged 65-83 years with prior experience using digital devices were recruited through purposeful sampling. Data were collected via focus group interviews using a semi-structured questionnaire until saturation was reached, and all interviews were recorded, transcribed, and analyzed using traditional content analysis methods. The collected interview data were extracted focusing on phrases or sentences relevant to the research purpose, and various concepts derived through memo writing and the constant comparison were categorized based on common meanings. Subsequently, the categorized statements were deeply interpreted and reclassified into subcategories for final analysis. RESULTS:Under the overarching theme of development directions for a digital self-nutrition management education program for elderly, three main categories and 13 subcategories were derived. The three main categories include: (1) processes of acceptance and utilization of digital technologies; (2) potential for applying digital self-nutrition management; and (3) strategies for implementing digital-based nutrition education. CONCLUSION:Our findings indicate that elderly face barriers to utilizing digital tools for self-nutrition management not only due to physical or technical limitations, but also because of the confusion arising from limited nutrition knowledge and information overload. To overcome the barriers that may arise during the digital-based education process for elderly, strategies (educational topics, delivery strategies, and operational strategies) were derived to vitalize a digital self-nutrition management education program. These results highlight the necessity of developing tailored digital nutrition education programs that reflect the characteristics of elderly, which may enhance their practical applicability and provide foundational evidence for establishing a digital-nutrition integrated care model within the senior customized care service.
Objectives This study aimed to investigate the intake of ultra-processed foods (UPF) and dietary behaviors in Korean adolescents. Methods This study used 24-hour dietary recall data from the Korea National Health and Nutrition Examination Survey (2019–2023). In total, 1,720 adolescents aged 12–18 years were included in this study and categorized into quartiles based on the percentage of energy intake from the UPF. Nutritional status, contributing subgroups of UPF intake, and healthy dietary practices were examined using Health Plan 2030 indicators across quartiles of UPF intake. Results The nutrient intake of protein, vitamins (A, B1, B2, niacin), and minerals (iron, potassium) was the lowest in the fourth quartile of UPF intake compared with the first quartile (P for trend < 0.001), whereas calcium intake increased across quartiles, from 47.68% in the first quartile to 58.51% in the fourth quartile (P for trend < 0.001). The main contributing subgroups to UPF intake differed across quartiles of UPF intake, and the highest contributing subgroups were ‘instant noodles and dumplings,’ ‘desserts, cakes, and ice cream,’ and ‘sauces and seasonings.’ Healthy dietary practices were the lowest in the fourth quartile (22.18%, P < 0.001), and the proportions of appropriate fat and fruit/vegetable intake were significantly lower in the higher quartiles of UPF intake (P < 0.001). Conclusion This study suggests that a lower UPF intake was associated with better nutritional status and healthy dietary practices in Korean adolescents. These findings provide fundamental evidence for promoting healthier food choices and balanced dietary practices.
OBJECTIVES:Korea is experiencing rapid population aging, with older adults forming a large proportion of rural communities. Aging leads to physiological and functional declines, resulting in lower physical activity, poor diet quality, and higher risk of chronic diseases. Although the Nutrition Quotient for the Elderly (NQ-E) is a validated tool to assess dietary quality, few studies have applied it to rural populations. This study aimed to compare nutrient intake and NQ-E scores by age and sex and examine their associations with lifestyle factors. METHODS:This study investigated the relationship between nutrient intake and NQ-E scores among older adults in rural Korean community, considering age, sex, and lifestyle factors. A cross-sectional study was conducted with 79 community-dwelling older adults (24 male and 55 female; mean age: 76.3 years) residing in Geochang-gun, Gyeongsangnam-do, Korea. Participants were recruited from community centers and health posts between June 2024 and December 2024. Data collection included general characteristics, 24-hour dietary recalls, and NQ-E questionnaires. RESULTS:Female aged > 75 years had significantly lower intakes of energy, protein, fat, vitamin E, riboflavin, folate, and zinc than their male counterparts (P < 0.05). The mean NQ-E score was 55.01, which was lower than the national average reported for urban older adults (57.6). Participants with higher NQ-E grades had significantly higher intakes of dietary fiber, vitamin A, thiamine, riboflavin, niacin, potassium, and magnesium, and regular physical activity and dietary supplement use were positively associated with higher NQ-E grades (P < 0.01). CONCLUSION:These findings suggest that older female in rural communities are particularly vulnerable to inadequate nutrient intake and lower dietary quality, and that the NQ-E is a useful screening tool for identifying nutritional risk in this population. Community-based nutrition interventions promoting physical activity, supplement use, and dietary diversity are warranted to improve dietary quality and support healthy aging.
Objectives The dietary habits of school-aged children play a critical role in their growth and development, and are strongly influenced by the home environment. Household income is closely associated with caregivers’ food literacy, social support, and food environment. This directly affects the nutritional status of children. This study aimed to provide evidence to inform policies and educational programs for improving dietary habits in children, and to establish a foundation for tailored support strategies for low-income families. Methods This cross-sectional study included 846 primary caregivers of school-aged children from 17 regions across Korea, recruited through an online survey. Household income, caregivers’ food literacy, social support, and food environment were assessed. Nutritional status in children was measured using the Nutrition Quotient for Children (NQ-C). Statistical analyses included descriptive statistics, chi-square tests, one-way analysis of variance, analysis of covariance, correlation analyses, and multiple linear regression. Results Caregivers from higher income households demonstrated significantly greater food literacy and social support (P < 0.001). Children from these households showed high balance scores and a large proportion of these children were in the “high” NQ-C grade. The NQ-C score in children was positively correlated with food literacy (r = 0.425), social support (r = 0.471), and the food environment (r = 0.235) (P < 0.001). Multiple regression analysis showed that food literacy (β = 0.256) and social support (β = 0.348) were significant predictors of nutritional status in children. Conclusion This study confirmed that the nutritional status in children is not only determined solely by household income but is also mediated by caregivers’ food literacy, social support, and food environment. These findings highlighted the limitations of providing only economic support. The findings underscore the need for multifaceted interventions such as strengthening parental nutrition education, expanding social support networks, and improving access to healthy foods.
Objectives Dietary quality is a modifiable determinant of type 2 diabetes mellitus (T2DM). However, evidence on the Korean Healthy Eating Index (KHEI) and sex-specific differences in its association with T2DM risk remains limited. This study is to examine the longitudinal association between KHEI and incident T2DM in Korean adults, with a focus on potential sex differences. Methods We analyzed 56,000 adults (37,684 women and 18,316 men) from the Health Examinee cohort of the Korean Genome and Epidemiology Study. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire, and KHEI scores were constructed based on national guidelines. Incident T2DM was defined using physician diagnosis, treatment history, or biochemical criteria. Cox proportional hazards models and restricted cubic spline analyses were applied to evaluate associations, with adjustments for demographic, lifestyle, and clinical covariates. Results Over a median follow-up of 4.2 years, 2,252 women and 1,776 men developed T2DM. Women in the highest quartile of KHEI had a 18% lower risk of T2DM compared with those in the lowest quartile (hazard ratio [HR]: 0.82, 95% confidence interval [CI]: 0.71–0.93; P for trend = 0.007). In men, no significant association was observed (HR: 1.11, 95% CI: 0.95–1.29). The interaction by sex was statistically significant (P for interaction < 0.05). Spline analyses indicated a linear inverse association between KHEI and T2DM risk in women, whereas no trend was evident in men. Conclusion Higher diet quality, as measured by the KHEI, was associated with a reduced risk of T2DM in women but not in men, suggesting sex-specific effects of dietary patterns on diabetes prevention. These findings highlight the need for tailored nutritional strategies that consider biological and behavioral differences between women and men in Korea.
Objectives Individuals with disabilities require targeted interventions to ameliorate disability-related conditions and improve overall health status. Nutritional challenges and counseling needs vary according to the type of disability, necessitating comprehensive assessments of dietary habits, physical activity, and food intake. Compared to traditional education, nutrition counseling offers a more sustainable and environmentally adaptable approach that effectively addresses individualized nutritional issues. Therefore, this study aimed to develop and evaluate a practical nutrition counseling manual and meal guidelines for people with disabilities in Korea, addressing their diverse dietary needs and improving nutritional care in social welfare facilities. Methods A four-stage integrated research design was employed. Stage 1 involved qualitative research through in-depth interviews with 11 facility staff. In Stage 2, a nationwide survey (n = 249) was conducted based on the results of the interviews. Stage 3 integrated both qualitative and quantitative findings. Stage 4 focused on developing and evaluating a nutrition counseling manual and five types of meal guidelines through feedback from 26 nutritionists at 24 Korean Centers for Social Welfare Foodservice Management. Results Six major nutrition counseling topics were identified: healthy eating, managing salt and sugar intake, dysphagia diet, appropriate intake, and hygiene. The manual and guidelines demonstrated high field usability, with average satisfaction scores of 3.98 ± 0.80, respectively. Conclusion The integrated study resulted in the development of a specialized nutrition counseling manual and handbook for individuals with disabilities in Korean social welfare facilities. The materials were revised and improved based on practical evaluations by dietitians, enhancing their field applicability. These tools are expected to contribute to better dietary management and health promotion among facility residents. The developed materials reflect the real-world needs of people with disabilities and offer practical tools for effective nutrition counseling and dietary management in institutional settings.
Objectives:This review aimed to elucidate the characteristics of dysphagia and age-related swallowing changes (presbyphagia) in older adults and to comprehensively examine assessment tools and standardized meal management strategies applicable in community settings to propose effective meal management strategies for healthy longevity. Methods:Domestic and international literatures were analyzed regarding the definition and causes of dysphagia, physiological and structural characteristics and clinical impacts of presbyphagia, assessment and diagnostic tools Korea version of EAT-10 (K-EAT-10) and Korea version of Dysphagia Risk Assessment for the Community-dwelling Elderly (K-DRACE), and the International Dysphagia Diet Standardization Initiative (IDDSI). Results:Dysphagia compromises safe swallowing and nutritional intake in older adults, leading to serious complications, such as aspiration pneumonia, dehydration, malnutrition, sarcopenia, and reduced quality of life. The K-EAT-10 and K-DRACE proved effective for rapid screening of dysphagia risk in community-dwelling older adults. Moreover, texture-modified meals and viscosity adjustments based on the IDDSI standards are useful for reducing the risk of aspiration and improving nutrient intake. Meals can be classified as liquidized, minced, chopped, or regular, allowing for individualized management. Conclusion:Presbyphagia is a multidimensional problem, and the integrated use of assessment tools and standardized meals is crucial. Community-based dysphagia management programs and collaboration among dietitians and healthcare professionals are needed to improve the nutritional status and quality of life of older adults.
Objectives Persons with disabilities face heightened nutritional risks due to barriers in dietary management, yet research remains limited. This study examined the nutritional health status and associated risk factors among disabled adults in Korea. Methods Data were drawn from the 2020 Disability and Life Dynamics Panel, a nationally representative survey of registered disabled Koreans aged ≥ 20 years. Nutritional health was assessed using the Nutrition Screening Initiative checklist and categorized as low, moderate, or high risk. Multivariate multinomial logistic regression was applied to identify predictors of nutritional risk. Results Among adults with disabilities aged 20–64 years, the prevalence of low, moderate, and high nutritional risk was 62.6%, 19.8%, and 17.5%, respectively. In the ≥ 65 years group, the distribution was 56.8% (low), 22.0% (moderate), and 21.2% (high). Moderate to high nutritional risk was most prevalent among individuals with facial deformity or internal organ disability (51.2%) in the 20–64 years group, and those with mental disabilities (61.7%) in the ≥ 65 years group. Significant predictors of high nutritional risk included living alone, lowest income quartile, chronic disease, depressive symptoms, and perceived underweight for both age groups. Compared with visual or speech impairments, facial deformity or internal organ disability (in the 20–64 years group) and physical disability (in the ≥ 65 years group) were significantly associated with moderate or high nutritional risk. Conclusion Nearly 40% of disabled Koreans are at nutritional risk. Tailored dietary interventions that address disability type, socioeconomic status, and health conditions are required to reduce disparities in nutritional health.
