Profiling the socioeconomic characteristics, dietary intake, and health status of Korean older adults for nutrition plan customization: a comparison of principal component, factor, and cluster analyses.

Objectives: This study was conducted to establish profiles of socioeconomic characteristics, dietary intake, and health status among Korean older adults by employing 3 multivariate analysis techniques. Methods: Data were obtained from 1,352 adults aged 65 years and older who participated in the 2019 Korea National Health and Nutrition Examination Survey. Principal component analysis (PCA), factor analysis (FA), and cluster analysis (CA) were utilized for profiling, with data preprocessing undertaken to facilitate these approaches. Results: PCA, FA, and CA yielded similar results, reflecting the high common variance among the variables. PCA identified 4 components, accounting for 71.6% of the accumulated variance. FA revealed 5 factors, displaying a Kaiser-Meyer-Olkin value of 0.51 and explaining 74.3% of the total variance. Finally, CA grouped the participants into 4 clusters (R2=0.465). Both PCA and FA identified dietary intake (energy, protein, carbohydrate, etc.), social support from family (incorporating family structure, number of family numbers, and engagement in social eating), and health status (encompassing oral, physical, and subjective health) as key factors. CA classified Korean older adults into 4 distinct typologies, with significant differences observed in dietary intake, health status, and household income (p<0.01). Conclusion: The study utilized PCA, FA, and CA to analyze profiling domains and derive characteristics of older adults in Korea, followed by a comparison of the results. The variables defining the clusters in CA were consistent with those identified by PCA and FA.

The level of food literacy and its association with food intake and obesity status among Seoul citizens: results from Seoul Food Survey 2021.

BACKGROUND/OBJECTIVES: Food literacy (FL) is a crucial skill for selecting sustainable and healthy food options, necessitating the identification of vulnerable groups in the community using valid measurement tools. Identifying weak domains in FL is essential for enhancing the overall FL. This study examined the FL levels of Seoul citizens based on their sociodemographic characteristics and assessed the relationship between FL, food intake, and weight status. SUBJECTS/METHODS: This study utilized the data from the Seoul Food Survey, a cross-sectional study employing representative samples of Seoul citizens. Data collection occurred from September to October 2021, with 4,039 citizens aged 18 yrs and above participating in face-to-face surveys. Thirty-three FL items were assessed, comprising 14 items in the nutrition and safety (NS) domain, eight items in the cultural and relational (CR) domain, and 11 items in the socio-ecological (SE) domain. In addition, data on food intake sufficiency and obesity status were collected. The descriptive statistics, t-tests, analysis of variance, and logistic regression analysis were used for analysis. RESULTS: Men, students, young adults, older citizens, and people experiencing food insecurity had the lowest scores for all the FL domains. The highest quartile group of NS scores had a higher probability of consuming adequate servings of vegetables and fruits, with significant linear trends observed (P for trend < 0.05). In all three FL domains, the odds ratio for obesity was significantly lower in the groups with high FL scores (P < 0.05). CONCLUSIONS: A close relationship was observed between low FL, obesity, and food intake, even after controlling for other covariates. Vulnerable groups with low FL were also identified. Therefore, it is essential to develop programs to improve FL and the health and well-being of these groups.

Development and Validation of a Perceived Community Food Accessibility Measurement Questionnaire for Korean Older Adults.

As the community food environment is known to be an important factor in healthy food choices, it needs to be measured, to increase awareness and improve healthy eating. The objective of this study was to develop a perceived community food accessibility measurement (P-CFAM) questionnaire applicable to older adults in Korea and evaluate its reliability and validity. The questionnaire was developed based on community food environment factors that were found to affect food choices in previous studies. We evaluated the internal consistency reliability, construct validity, and criterion-related validity. The subjects were 188 older adults for validity. The Cronbach's alpha value for the reliability measure was 0.9. The confirmatory factor analysis to evaluate the construct validity of the questionnaire showed values close to those of the optimal model (GFI = 0.983, AGFI = 0.948, RMR = 0.004, NFI = 0.987, CFI = 0.996). Regarding the criterion-related validity, the P-CFAM questionnaire results were significantly related to objective measurement indicators such as the number of grocery stores, the travel time to a grocery store, and the intake of vegetables and fruit. In conclusion, the developed P-CFAM questionnaire was shown to be reliable and valid, and useful for assessing older adults' perceptions of community food accessibility in Korea.

Food literacy and its relationship with food intake: a comparison between adults and older adults using 2021 Seoul Food Survey data.

OBJECTIVES: This study was conducted to examine the differences in food literacy between adults and older adults and the association of food literacy with food group intake. METHODS: In total, 4,039 participants from the 2021 Survey for Food Consumption in Seoul were included in this study. The intake of whole grains, high-protein foods, total vegetables, vegetables excluding kimchi and pickles, fresh fruits, and milk and dairy products was assessed using a simple food frequency questionnaire. Food literacy was measured using a food literacy measurement questionnaire. RESULTS: With the exception of milk and dairy, adults had a significantly higher proportion of insufficient food intake than older adults (p<0.001). Both adults and older adults with sufficient food group consumption had higher food literacy scores. Notably, the difference in food literacy scores by level of food intake was highest for fresh fruits (p<0.001). After adjusting for confounding factors affecting food literacy scores, a higher score was associated with a lower probability of having insufficient food intake in all food groups for both adults and older adults. Specifically, those in the highest food literacy score quartile were less likely to have insufficient intake of vegetables (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.28 to 0.43) and fresh fruits (OR, 0.32; 95% CI, 0.24 to 0.43), compared to the lowest quartile. CONCLUSIONS: Improving food literacy is an important factor for promoting healthy food intake in older adults as well as adults. Therefore, it is necessary to develop intervention programs to work toward this goal.

Macronutrients intake and physical frailty in Korean older adults: A cohort-based cross-sectional study.

AIM: To investigate the relationship of energy and macronutrients with physical frailty in Korean older individuals who had a high proportion of energy intake from carbohydrates. METHODS: This study included 954 adults aged 70 to 84 years and used baseline data from the Korean Frailty and Aging Cohort Study (KFACS) collected in 2016. The relationship between energy or macronutrients and frailty was evaluated using multivariable logistic regression models and multivariable nutrient density models. RESULTS: A high carbohydrate intake was related to a higher prevalence of frailty (odds ratio [OR] = 2.01, 95% confidence interval [CI] = 1.03-3.93). In the participants who had low energy intake, replacement of 10% energy from fats with isocaloric carbohydrates was related to a higher prevalence of frailty (10%, OR = 1.59, 95% CI = 1.03-2.43). Regarding proteins, we found no evidence for a relationship between the replacement of the energy of carbohydrates or fats with isocaloric protein and the prevalence of frailty in older adults. CONCLUSIONS: This study showed that the optimal proportion of energy intake from macronutrients may be an important nutritional intervention factor for reducing the risk of frailty among people who are likely to have low energy intake. Geriatr Gerontol Int 2023; 23: 478-485.

The effect of combining nutrient intake and physical activity levels on central obesity, sarcopenia, and sarcopenic obesity: a population-based cross-sectional study in South Korea.

BACKGROUND: This study was conducted to investigate the effects of combining nutritional and physical activity (PA) factors on four different categories, according to the presence or absence of sarcopenia and central obesity. METHODS: From the 2008-2011 Korea National Health and Nutrition Examination Survey, 2971 older adults aged ≥ 65 years were included and divided into four groups based on their sarcopenia and central obesity status: healthy control (39.3%), central obesity (28.9%), sarcopenia (27.4%), and sarcopenic obesity (4.4%). Central obesity was defined as a waist circumference of ≥ 90 cm in men and ≥ 85 cm in women. Sarcopenia was defined as an appendicular skeletal mass index of < 7.0 kg/m2 in men and < 5.4 kg/m2 in women, and sarcopenic obesity was defined as the coexistence of sarcopenia and central obesity. RESULTS: Participants who consumed more energy and protein than the average requirement had a lower likelihood of having sarcopenia (odds ratio (OR): 0.601, 95% confidence interval (CI): 0.444-0.814) than those who did not consume enough nutrients. The likelihood of central obesity and sarcopenic obesity decreased in groups with recommended PA levels, regardless of whether energy intake met or did not meet the average requirement. Whether PA met or did not meet the recommended level, the likelihood of sarcopenia decreased in groups with energy intake that met the average requirement. However, when PA and energy requirements were met, there was a greater reduction in the likelihood of sarcopenia (OR: 0.436, 95% CI: 0.290-0.655). CONCLUSION: These findings suggest that adequate energy intake that meets requirements is more likely to be effective as a major prevention and treatment goal for sarcopenia, whereas PA guidelines should be prioritized in the case of sarcopenic obesity.

Who has experienced better or worse health conditions since the outbreak of COVID-19?: results from a representative cross-sectional survey in Seoul.

BACKGROUND/OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has affected the entire world population in many ways. This study aimed to analyze the patterns of changes in eating, food purchasing and preparation, physical activity, and subjective health after COVID-19 outbreak by various sociodemographic factors and to understand the factors associated with changes in subjective health. SUBJECTS/METHODS: A cross-sectional survey using a representative sample from Seoul was used for the analysis. The data collection was conducted from September to October 2020. A total of 3,833 citizens aged more than 18 years old participated in the Seoul Food Survey. Descriptive statistics and generalized ordinal logistic regression models were used to understand the changes in health behaviors, health indicators, and subjective general health by various socioeconomic status. RESULTS: It was shown that the changes in household income, food expenditure, food consumption and physical activities differed significantly by age, education, occupation, income, weight, and food security status. Low-income and food-insecure households were affected more severely by the pandemic. Older age, household food insecurity, income reduction, increased home cooking and frequency of having instant foods, decreased physical activity and weight gain were significant factors explaining worse perceived health during the COVID-19 pandemic. CONCLUSIONS: The results suggest that focusing on older populations and low-income families with food insecurity should be prioritized during infectious disease outbreaks. In addition, the role of physical activities and instant food consumption in explaining perceived health should be investigated further in this prolonged battle with the pandemic situation.

Regional Difference in the Effect of Food Accessibility and Affordability on Vegetable and Fruit Acquisition and Healthy Eating Behaviors for Older Adults.

The food environment has been determined to affect a range of healthy eating and health indicators, but the study on the regional difference of food environment effects on these outcomes is limited. This study aimed to examine whether food environment factors influence vegetable and fruit acquisition and healthy eating behaviors in urban and rural areas using a nationwide dataset. The study participants were community-dwelling older adults aged 65 years and older (n = 830) who participated in the 2019 Consumer Behavior Survey for Food provided by the Korea Rural Economic Institute. Food environment factors were assessed using questionnaires measuring perceived food accessibility and affordability. The negative perceptions of food environment were related to lower vegetable and fruit acquisitions and poor healthy eating behaviors. The higher risks of low vegetable and fruit acquisitions in older rural adults were related to a negative perception of food accessibility only (odds ratio [OR]: 2.34, 95% confidence interval [CI]: 1.27-4.32 for vegetable; OR: 1.96, 95% CI: 1.02-3.75 for fruit). For older urban adults, negative perceptions of both food accessibility and food affordability were related to the increased risk of low vegetable acquisition (OR: 2.03, 95% CI: 1.07-3.83 for food accessibility; OR: 2.52, 95% CI: 1.26-5.04 for food affordability). In terms of healthy eating behaviors, for those who perceived that either food accessibility or affordability was poor, older urban adults were less likely to have various and healthy food eating behaviors when they had a negative perception of affordability (OR: 0.47, 95% CI: 0.25-0.90 for variety; OR: 0.23, 95% CI: 0.11-0.46 for eating healthy foods); however, older rural adults were less likely to have the behaviors when they had a negative perception of accessibility (OR: 0.49, 95% CI: 0.21-0.97 for variety; OR: 0.28, 95% CI: 0.13-0.63 for eating healthy foods). In conclusion, the negative perceptions of food accessibility and affordability were related to low vegetable acquisition and poor healthy eating behaviors. The effects of food accessibility and affordability on vegetable and fruit acquisitions and healthy eating behaviors were different between urban and rural areas.

Perspectives on the systematic review for the 2020 Dietary Reference Intakes for Koreans for calcium.

An accurate assessment of the recommended calcium (Ca) intake may contribute to reducing the risk of fractures and chronic diseases, ultimately improving quality of life. This review was performed to summarize key findings of Ca studies, investigate the effect of Ca intake on health outcomes, and determine the adequacy of evidence to revise the 2015 Dietary Reference Intakes for Koreans (KDRIs) for Ca in 2020. Databases were searched for intervention studies that assessed health outcomes by providing Ca in diets or as supplements. The framework of the systematic review comprised conducting literature searches, data extraction, quality assessment of the literature, and summarizing key findings relevant to set the Estimated Average Requirement (EAR) and Tolerable Upper Intake Level (UL) for Ca for the 2020 KDRI. The final search was performed in June 2019. A total of 13,309 studies were identified through databases and manual search. Sixtyfive studies were included in the final quality assessment and were summarized according to health indicators. As bone health was used as an indicator of the EAR for Ca, literature reports on bone health were further categorized by the life-cycle stage of the participants. This systematic review did not find new evidence that could be applied to the general Korean adult population, including postmenopausal women, for defining a new EAR for Ca in the 2020 KDRIs. Evidence in most of the reviewed literature was considered weak; however, some evidence was found that could improve the criteria on how the EAR for Ca was determined in children and adolescents. A review of the literature for the 2020 KDRIs for Ca did not find strong evidence in order to change the recommended values of the 2015 KDRIs. More clinical interventions are required among Koreans to strengthen the body of evidence to warrant the revision of the KDRIs.

Development of the Korean Healthy Eating Index for adults, based on the Korea National Health and Nutrition Examination Survey.

BACKGROUND/OBJECTIVES: The objective of this study was to describe the development process of the Korean Healthy Eating Index (KHEI) based on the Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: The components of KHEI were selected based on Dietary Guidelines for Koreans, domestic and overseas dietary quality indices, and results of the analysis of association with chronic diseases. The standards for scoring of KHEI were selected based on the 2015 Dietary Reference Intakes for Koreans (KDRI). The KHEI scores of Korean adults were calculated using a 1-day 24-h recall data in the 2013-2015 KNHANES. RESULTS: The KHEI included eight adequacy components evaluating the proper intake of recommended foods such as fruit, vegetable, and milk and three moderation components evaluating the consumption of food that limit intake such as sodium and saturated fatty acid. In addition, three balance components assessing the balance of energy intake were included. The KHEI score was defined to range from the minimum of 0 point to the maximum of 100 points. Among Korean adults, the total KHEI score was 63.2 out of 100. Gender and age differences were found in the average of total KHEI scores. Women showed higher score than men (61.7 in men and 64.7 in women, respectively). By age group, 20s and 30s showed the lowest scores with 57.4 and 61.1 respectively, and the scores increased with age by peaking at 67.8 in ages 60-69 and slowed down again in ages 70 or over. CONCLUSIONS: The KHEI can be useful for establishing and assessing national nutritional policies and in epidemiological studies to assess the relationship between overall dietary quality and chronic diseases. KHEI will need to be continuously updated to reflect changes in dietary guidelines and the KDRI.

Development of Guidelines on the Primary Prevention of Frailty in Community-Dwelling Older Adults.

BACKGROUND: Despite the increasing number of older adults as the population ages, there is a lack of frailty prevention guidelines for community-dwelling older adults. The Korean Frailty and Aging Cohort Study conducted systematic review on contributors to frailty and developed guidelines on the primary prevention of frailty in community-dwelling older adults. METHODS: This study updated a previous systematic review of contributors to frailty by adding the most recent articles. Based on this updated systematic review, experts in geriatrics and gerontology developed guidelines for preventing frailty using the Delphi method. RESULTS: These guidelines categorized the recommendations into physical activity, resilience, oral health, management of non-communicable diseases, involvement in society, smoking cessation, and eating various kinds of food. CONCLUSION: Unlike previous frailty-related guidelines, this study developed evidence-based frailty prevention guidelines based on a systematic review. The guidelines are expected to contribute to the healthy aging of community-dwelling older adults by the primary prevention of frailty.

Effects of Perceived Food Store Environment on Malnutrition and Frailty among the Food-Insecure Elderly in a Metropolitan City.

This study aimed to identify food environment factors in the local community that could affect the levels of nutritional status and frailty in 372 older adults (at least 65 years old) experiencing food insecurity and enrolled in the integrated Community Health Promotion Program (CHPP) in two districts of Seoul. The local food environment was assessed using perceived food store accessibility questionnaires. In order to quantify nutrient intake, the 24-h recall method was applied. Malnutrition was measured using the Mini Nutritional Assessment tool, while frailty was assessed using the Frailty Measurement Questionnaire developed for the CHPP. Malnourished or frail elderly adults commonly had a lower intake of cereals and potatoes, meats, and vegetables than those who were not, and their resulting intake levels of energy, protein, iron, and vitamin groups were also significantly lower (all p-values < 0.05). Among the local community food store environment factors, the sufficiency of food stores (odds ratio (OR) = 1.988, 95% confidence interval (CI] = 1.211-3.262), freshness of foods (OR = 1.767, 95% CI = 1.075-2.886), and variety in foods (OR = 1.961, 95% CI = 1.197-3.212) were significant factors affecting the risk of malnutrition. For frailty, the freshness of foods (OR = 1.997, 95% CI = 1.053-3.788), variety in foods (OR = 2.440, 95% CI = 1.277-4.661), and small purchase of foods (OR = 2.645, 95% CI = 1.362-5.139) were significant environmental factors. In conclusion, we found that the perceived food store environment in the local community can influence the occurrence of malnutrition and frailty in vulnerable, urban older adults.

Is the Perceived Fruit Accessibility Related to Fruit Intakes and Prevalence of Overweight in Disadvantaged Youth: A Cross-Sectional Study.

BACKGROUND: Few investigations have studied the relationship between home and school food environments, fruit intakes, and prevalence of overweight in children and adolescents from disadvantaged backgrounds. This study aimed to determine whether food environments for fruit intake at household and school levels affect fruit intakes and risk of overweight among children and adolescents with low household income. METHODS: Students (n = 3148) in Seoul, Korea completed questionnaires pertaining to select aspects of their food environments, frequency of fruit intakes, and weight status. Chi-square tests and logistic regressions evaluated associations between the aforementioned variables. RESULTS: Participants consumed fruit an average of 0.77 times per day, though its frequency increased when fruit accessibility was perceived positively. The percentage of overweight participants was 23.5% for boys and 22.8% for girls. Generally, fruit intake frequency was linked to a lower prevalence of overweight. Regular provision of fruit in school lunches was associated with a reduced risk of overweight among elementary school girls (odds ratio (OR): 0.52, 95% confidence interval (CI): 0.30-0.92), and having someone at home to prepare fruit was associated with a reduced risk of overweight in elementary school boys (OR: 0.64, 95% CI: 0.43-0.94) and girls (OR: 0.63, 95% CI: 0.43-0.93). CONCLUSIONS: The frequency of fruit intake was low among disadvantaged youth. Increasing access to fruit in their food environments appears to enhance consumption and lower the risk of overweight, especially for elementary school girls.

Do Where The Elderly Live Matter? Factors Associated with Diet Quality among Korean Elderly Population Living in Urban Versus Rural Areas.

This study aimed to examine whether there is an area difference on diet quality among the Korean elderly population. The effect of personal factors on diet quality is also estimated and compared between rural and urban areas. A cross-sectional data from the 2013-2015 Korea National Health and Nutrition Examination Survey (KNHANES) was used for this study. The participants were older adults aged ≥ 65 years (n = 3207) who participated in the KNHANES. Urban and rural areas classified the region and the Korean Healthy Eating Index (KHEI) assessed the diet quality. Personal factors that were related to diet quality included socio-demographic factors, health behaviors, and health conditions. This study found that the diet quality was different between urban and rural areas in the Korean elderly population, showing a higher mean of KHEI scores in urban areas than rural areas (67.3 for urban seniors, 63.6 for rural seniors, p < 0.001), and the regional difference was still significant, even after adjusting for the personal factors (p < 0.001). Different sets of personal factors were found to be significant that explain the diet quality of participants between areas, such as economic resources, walking exercise, and perceived oral health status in urban areas, and age and food insecurity in rural areas. In conclusions, this study found that there was a regional disparity in diet quality and some personal factors affecting diet quality were dependent on areas, which implied that regional environment with diverse contexts could influence diet quality. These findings emphasize the need to provide targeted intervention programs that take into account both the characteristics of individuals and local food environments in order to improve the overall diet quality in older adults.

Combined effects of disease management and food insecurity on physical and mental health in Korean adults.

OBJECTIVE: The present study aimed to examine the combined effects of disease management and food insecurity on physical and mental health in a representative Korean population. DESIGN: A cross-sectional study. SETTING: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2012-2015. PARTICIPANTS: Adults aged ≥30 years (n 17 934) who participated in the KNHANES. RESULTS: Among health-care factors, unmet health-care needs and mental health counselling were different by food insecurity status, with a higher prevalence in adults with food insecurity. The prevalence of underweight was higher in men with food insecurity (5·9 %), whereas the prevalence of obesity was higher in women with food insecurity (37·4 %), than that in men and women with food security. Food insecurity was associated with a high risk of all mental health outcomes. For the combined effects of disease management and food insecurity, unmet health-care needs was related to increased risk of obesity for food-insecure men (Pinteraction = 0·029) and lack of participation in nutrition education or counselling was related to increased risk of obesity for food-insecure women (Pinteraction = 0·010). In addition, higher unmet health-care needs in adults with food insecurity was related to higher risk of mental health outcomes. CONCLUSIONS: Unmet health-care needs may exacerbate obesity for food-insecure men and mental health problems for both food-insecure men and women. In addition, lack of participation in nutrition education or counselling may exacerbate the obesity for food-insecure women.

Objective and perceived food environment and household economic resources related to food insecurity in older adults living alone in rural areas.

BACKGROUND: Limited attention has been paid to an association between food environment and household economic resources related to food expenditure in food-insecure seniors. The aim of the study was to investigate the relationship between factors of economic resource, food environment, and food insecurity in single seniors residing in rural areas of South Korea. METHODS: A cross-sectional study was conducted in 170 single senior households aged 65 years or over residing in rural areas. Face-to-face interviews were performed to collect data on demographic characteristics, household economic resources/expenditure, food environmental factors, and food insecurity. RESULTS: Among economic resources, generally limited food expenditures due to housing fees and heating costs during the winter were positively related to food insecurity. Among food environmental factors, food accessibility at community level such as food stores located far from home and inconvenient bus routes was related to food insecurity. The most explainable economic and food environment factors related to food insecurity by stepwise logistic regression analysis were the percentage of total expenditure on housing fee (OR = 1.021, 95% CI: 1.008-1.034), foods purchasing at super supermarket (OR = 0.398, 95% CI: 0.166-0.951), having difficulties in food purchasing due to food stores being located far from home (OR = 14.487, 95% CI: 5.139-40.842) and inconvenient bus routes (OR = 0.083, 95% CI: 0.015-0.460). CONCLUSION: Inadequate community food environment as well as limited household food resources were an important risk factor for food insecurity in Korean single rural seniors. Findings of this study could help us better understand how characteristics of household food resources and community food environment can serve as barriers or facilitators of food security among single older adults residing in rural areas.

Spatial Disparity in Food Environment and Household Economic Resources Related to Food Insecurity in Rural Korean Households with Older Adults.

Different contextual factors of a household and a community, such as access to resources and transportation, may influence the level of food insecurity. The objective of this study was to identify how food environmental factors and economic resources were related to food insecurity in Korean older adults residing in different contexts of rural areas. Face-to-face interviews with 248 older adults residing in land (n = 149) and mountain (n = 99) rural areas were performed. In both areas, risk of food insecurity was increased for households with limited community food accessibility measured by having difficulties in food purchasing due to food stores far from home. There were discrepancies in factors related to increased risks of food insecurity between households in land and mountain areas. The experience of reducing food expenditure resulting from burden of heating costs during the winter in households in a mountain area whereas the percent proportion of housing fee and household cook's physical disability in households residing in the land area were found to be factors associated with increased risks of food insecurity. For households residing in mountain areas, the risk of food insecurity was decreased when economic resources measured by average monthly income for the last one year was increased and there was farming or home gardening activity. Such spatial disparity might affect household food insecurity in rural areas. In addition, food environmental factors and economic resources may affect household food insecurity differently according to the diverse contexts of rural areas. Better understanding of spatial challenges in food insecurity faced by seniors in a large rural area would help prepare programs or policy change to strengthen and improve their food environments.

Food Acquisition through Private and Public Social Networks and Its Relationship with Household Food Security among Various Socioeconomic Statuses in South Korea.

This study was conducted to understand food acquisition practices from social networks and its relationship with household food security. In-depth interviews and a survey on food security were conducted with twenty-nine mothers and one father in metropolitan areas of South Korea. Many families acquired food from their extended families, mainly participants' mothers. Between low-income and non-low-income households, there was a pattern of more active sharing of food through private networks among non-low-income households. Most of the low-income households received food support from public social networks, such as government and charity institutions. Despite the assistance, most of them perceived food insecurity. We hypothesized that the lack of private social support may exacerbate the food security status of low-income households, despite formal food assistance from government and social welfare institutions. Interviews revealed that certain food items were perceived as lacking, such as animal-based protein sources and fresh produce, which are relatively expensive in this setting. Future programs should consider what would alleviate food insecurity among low-income households and determine the right instruments and mode of resolving the unmet needs. Future research could evaluate the quantitative relationship between private resources and food insecurity in households with various income statuses.

Protein Intake Recommendation for Korean Older Adults to Prevent Sarcopenia: Expert Consensus by the Korean Geriatric Society and the Korean Nutrition Society.

Sarcopenia, a common clinical syndrome in older adults, is defined as decreased muscle mass, strength, and physical performance. Since sarcopenia is associated with the incidence of functional decline, falls, and even mortality in older adults, researchers and health care providers have been keen to accumulate clinical evidence to advocate the screening and prevention of sarcopenia progression in older adults. The factors that may accelerate the loss of muscle mass and function include chronic diseases, inactivity, and deficiency in appropriate nutritional support. Among these, nutritional support is considered an initial step to delay the progression of muscle wasting and improve physical performance in community-dwelling older adults. However, a nationwide study suggested that most Korean older adults do not consume sufficient dietary protein to maintain their muscle mass. Furthermore, considering age-associated anabolic resistance to dietary protein, higher protein intake should be emphasized in older adults than in younger people. To develop a dietary protein recommendation for older adults in Korea, we reviewed the relevant literature, including interventional studies from Korea. From these, we recommend that older adults consume at least 1.2 g of protein per kg of body weight per day (g/kg/day) to delay the progression of muscle wasting. The amount we recommend (1.2 g/kg/day) is 31.4% higher than the previously suggested recommended daily allowance (i.e., 0.91 g/kg/day) for the general population of Korea. Also, evidence to date suggests that the combination of exercise and nutritional support may enhance the beneficial effects of protein intake in older adults in Korea. We found that the current studies are insufficient to build population-based guidelines for older adults, and we call for further researches in Korea.