Higher food literacy scores are associated with healthier diet quality in children and adolescents: the development and validation of a two-dimensional food literacy measurement tool for children and adolescents

BACKGROUND/OBJECTIVES@#Most child and adolescent food literacy measurement tools focus on nutrition and food safety. However, the importance of aspects related to the food system such as food distribution and food waste and their effects on environmental sustainability is growing. We therefore developed and validated a two-dimensional tool for children (8–12 years old) and adolescents (13–18 years old) that can comprehensively measure food literacy. The association of food literacy with diet quality and self-reported health was assessed. @*SUBJECTS/METHODS@#First, we developed a food literacy conceptual framework that contains food system and literacy dimensions through a literature review, focus group interviews, and expert review. After a face validity study, we conducted the main survey (n = 200) to validate the questionnaire. Construct validity and reliability were assessed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Cronbach's alpha. @*RESULTS@#As a result of the Delphi study, content validity was confirmed for the remaining 30 items after two items were excluded (content validity ratio = 0.86). Eleven items were excluded from the EFA results, while the CFA results indicated appropriate fit indices for the proposed model (comparative fit index = 0.904, root mean square error of approximation = 0.068). The final food literacy questionnaire consisted of 19 questions and comprised 5 factors: production, distribution, selection, preparation and cooking, and intake. Food literacy was positively associated with diet quality, as assessed by the Nutrition Quotient score, in both children and adolescents and with self-reported health in adolescents. @*CONCLUSIONS@#Based on this integrated conceptual framework, a two-dimensional 19-item food literacy measurement tool was developed and verified for practical use to improve the diet quality and food-related environmental sustainability awareness of children and adolescents.

In vitro development of canine somatic cell nuclear transfer embryos in different culture media

The objective of the present study was to investigate the effects of three different culture media on the development of canine somatic cell nuclear transfer (SCNT) embryos. Canine cloned embryos were cultured in modified synthetic oviductal fluid (mSOF), porcine zygote medium-3 (PZM-3), or G1/G2 sequential media. Our results showed that the G1/G2 media yielded significantly higher morula and blastocyst development in canine SCNT embryos (26.1% and 7.8%, respectively) compared to PZM-3 (8.5% and 0%) or mSOF (2.3% and 0%) media. In conclusion, this study suggests that blastocysts can be produced more efficiently using G1/G2 media to culture canine SCNT embryos.

Factors Associated with Fruit and Vegetable Consumption of Subjects Having a History of Stroke: Using 5th Korea National Health and Nutrition Examination Survey (2010, 2011) / 대한지역사회영양학회지

OBJECTIVES: Intake of fruits and vegetables has protective effects against stroke attack. This study intended to examine the status of consuming fruits and vegetables and to find out which factors may influence the frequency of consumption of fruits and vegetables in individuals with a history of stroke. METHODS: The data of 208 subjects from 5th (2010, 2011) Korea National Health and Nutrition Examination Survey (KNHNES) who reported a stroke diagnosis was used for analysis. To identify major factors influencing the consumption of fruits and vegetables, a classification-tree analysis was carried out. RESULTS: Among those who reported a stroke diagnosis, the frequencies of consumption of fruits and vegetables were influenced by their age, place of residence (urban or rural), economic status, educational level, occupation, number of family members, frequency of eating out, and having meals (breakfast or lunch) with family members. Two factors from fruits and three factors from vegetables were generated by exploratory factor analyses. Urban residents ate fruits and vegetables more frequently in all factors than rural residents. Eating frequencies of 'seasonal fruits (orange, apple, strawberry, melon, pear and watermelon)', 'easily-accessible fruits (persimmon, tangerine, grape, peach, banana)', and 'Western-style vegetables (cabbage, mushroom, carrot, tomato, spinach)' were influenced by the socioeconomic status. Eating frequencies of 'Korean-style vegetables (bean sprout, radish leaves, pumpkin/squash, sea weed)', 'preserved vegetables (Korean cabbage, radish, laver, cucumber)' were influenced by having breakfast with amily members. CONCLUSIONS: The results of this study suggested that by eating more fruits and vegetables, more preventive effects against secondary stroke attack are expected in stroke patients who live in the rural areas and who do not eat breakfast with family members. In addition, more outreach and education programs are needed for them.

Middle School Students' Perception of Environment-friendly Agricultural Products (EAPs) and the Degree of Confidence about the Certification Mark in Daegu / 대한지역사회영양학회지

The purpose of this study was to investigate middle school students' perception of environment-friendly agricultural products (EAPs) and the degree of confidence about the certification mark. Questionnaires were distributed to 444 students of 6 middle schools located in Daegu, and a total of 416 responses were used for analysis. 28.6% of the respondents were using EAPs at home, and 62.0% of respondents didn't know whether to use EAPs at home. The 6 items representing the perception of EAPs were analyzed, resulting in 2 distinct dimensions-'benefits of EAPs' and 'attitude toward EAPs'. Regarding Benefits of EAPs, the score of 'EAPs better for health' was the highest, followed by 'EAPs have higher quality', 'EAPs were better for environmental protection', respectively. The proportion of students responded that 'the amount of pesticides should be reduced gradually' was 65.5% and only 3.4% for 'current level of pesticide use is not a problem'. There were significant differences between male and female students with regard to an interest in EAPs (p < 0.05) and opinion on the use of pesticides (p < 0.05), while no significant difference was found between groups with different education level of mothers. The respondents who use EAPs at home showed significantly higher scores with attitude toward EAPs (p < 0.001), and higher response rate for 'pesticides should not be used even if the price increases' (p < 0.05). Degree of confidence about the EAPs certification mark also affected students' perception of EAPs (p < 0.001). Our results indicate the importance of education for students on EAPs to enhance students' attitude towards EAPs and improve school meal satisfaction.

Actual Status of School Dietitians' Recognition and Use of Superior Agricultural Products in Daegu / 대한지역사회영양학회지

The purpose of this study was to investigate the perception of the school dietitian on superior agricultural products (SAP) and the status of using superior agricultural products in school meals. Questionnaires were distributed to 185 school dietitians after face to face interview, and a total of 181 responses were used for analysis. 82.3% of the respondents were using SAPs in school meals and there was a significant difference between elementary school (95.1%), middle school (76.8%) and high school (66.7%) dietitians (p < 0.001). 85.2% of the dietitians, who were using SAP, were purchasing SAPs through electronic bidding, and the main reason of not using SAPs was the higher price of SAPs than that of general agricultural products. The good agricultural practices (GAP) product was considered the most appropriate agricultural products for school meals by the majority of respondents (66.9%), and organic products was the next (13.3%). In addition, the most important selection criterion for a SAP perceived by school dietitians was safety (58.0%), and the main reason of using SAPs in school meals, when two choices were allowed, was 'to provide healthful food to children' (98.9%). The major barriers to using SAPs in school meals (two choices were allowed) were 'too expensive' (73.5%) and 'unstable supply' (32.6). In conclusion, it was suggested that there should be an improvement in SAP supply and management systems to increase the use of SAPs in school meals.

Attitudes of Adolescents toward Suicide: Q-Methodological Approach

PURPOSE: The purpose of this study was to identify attitudes of adolescents toward suicide. METHODS: Q-methodology which provides a method of analyzing the subjectivity of each item was used. Thirty middle and high school students classified 37 selected statements into a normal distribution using a 9 point scale. Collected data were analyzed using the Quanl PC Program. RESULTS: Three types of attitudes toward suicide were identified. The first type (opposing suicide-moral minded) showed an attitude of opposing suicide and thinking that suicide is a sin. The second type (understanding-empathizing suicidal person) showed an attitude of understanding the situation of the adolescents who has suicidal ideation and empathizing with them. The third type (ambivalent attitude) showed an attitude of understanding the suicidal person but, at the same time, opposing suicide. CONCLUSION: Results of the study indicate that different approaches to suicide prevention programs should be developed based on the three types of suicide attitudes among adolescents.

Effects of grape pomace on the antioxidant defense system in diet-induced hypercholesterolemic rabbits

The effects of grape seeds extract and grape peels extract prepared from grape pomace on the activity of antioxidant enzymes, degree of lipid peroxidation in serum and liver tissue were investigated in rabbits fed on high cholesterol diet. New Zealand white rabbits were divided as follows ; 1) NOR (normal group); 2) CHOL (cholesterol group); 3) GSH (cholesterol + grape seed extract group); 4) GPE (cholesterol + grape peel extract); 5) GSP (cholesterol + grape seed powder); 6) GPP (cholesterol + grape peel powder); 7) GE (cholesterol + grape seed and peel extract); 8) GP (cholesterol + grape seed and peel powder). Eight groups of rabbits were studied for 8 weeks. At the end of the experimental period, rabbits were sacrificed and the liver tissue were removed. Then, GSH, GPx, GST, CAT and MDA in the liver were measured. In liver tissues, total glutathione contents (GSH), glutathione peroxidase (GPx) and catalase (CAT) activity, which was significantly higher by grape seed extract supplementation. The level of malondialdehyde (MDA) was lower in the serum of rabbits fed grape seed extract or grape peel powder plus cholesterol than in the serum of rabbits fed cholesterol alone. It is therefore likely that grape seed extract prepared from grape pomace functioned as antioxidants in vivo, negating the effects of the oxidative stress induced by 1% cholesterol diet. The grape seed extract was found effective in converting the oxidized glutathione into reduced glutathione, and in removing H2O2 that is created by oxidative stress. The grape peel powder was found to have small influence on reduced glutathione content, CAT and GPX activity, but it increased GST activity in liver tissues, resulting in promoting the combination of lipid peroxide and glutathione (GSH), and further, lowering the formation of lipid peroxide in the serum. Therefore, grape pomace (grape seed extract and grape peel powder) supplementation is considered to activate the antioxidant enzyme system and prevent damage with hypercholesterolemia.

An Assessment of Customer Satisfaction towards University Residence Hall Foodservice and Subjective QOL (Quality of Life): Focused on the University Students in Daegu, Gyeongbuk Area / 대한지역사회영양학회지

The purpose of this study was to identify the factors of university residence hall foodservice quality which has correlations with subjective QOL (quality of life) of target customers. A total of 176 questionnaires from students of 4 universities in Daegu, Gyeongbuk area were used for the analysis. The male students using residence hall foodservices were highly satisfied with 'clean appearances of employees' (4.86 +/- 1.25) and 'clean facilities' (4.79 +/- 1.26), while the degree of satisfaction with 'convenient facilities' (4.50 +/- 1.20) showed the highest score with female students. Ranking analysis using Spearman's rho revealed that there were significant correlations between students' satisfactions with the dimensions of 'foods and kindness of employees', 'hygiene', 'nutrition', and 'convenience' and their QOL, even though physical QOL of female students showed no significant correlation with satisfaction towards residence hall foodservices. As a conclusion, there should be efforts to improve the QOL of target customers through foodservice quality management.

The Impacts of Personal Characteristics and Company-Related Characteristics on the Job Satisfaction of Dietitians Engaged in Contract Food Service Management Company / 대한지역사회영양학회지

The purposes of this study were to measure job satisfaction levels of dietitians engaged a in contract food service management company, and to examine the impacts of personal characteristics and organizational characteristics on the job satisfaction of dietitians. The questionnaires developed for this study were distributed to 230 dietitians of contract food service management companies in the Seoul and Gyeonggi areas, and a total of 187 (81.3%) questionnaires were used for analysis. Statistical analyses were completed using SPSS (Win 11.5) for descriptive analysis, correlation analysis, t-test and ANOVA. The average job satisfaction score of the dietitians was 2.83, which is lower than "not satisfied" and "not dissatisfied" (3). "Marital status" (p < 0.001), "payroll per year" (p < 0.001), "age" (p < 0.05) and "work experience as a dietitians" (p < 0.05) had significant effects on job satisfaction of work and environmental factors. "Operating group" (p < 0.05), "type of menu" and "type of service" also affected the job satisfaction. Overall, it is important that managers of contract food service management companies establish specified human resource management strategies with understandings of the characteristics of their dietitians and companies to enhance the job satisfaction of dietitians, and to achieve their managerial goals.

Development of Internal Branding Performance Measure and Analysis on the Difference of Internal Branding Performances between Local and International Hotels / 대한지역사회영양학회지

The purposes of this study were to develop a tool for assessing internal branding performance and to identify the difference of internal branding performance between local and international hotels. The internal branding performance measure was developed through literature studies and face-to-face in-depth interviews with managers in various departments of 5 deluxe hotels. The questionnaires were distributed to 460 employees in food and beverage departments of 11 deluxe hotels in Seoul, and a total of 398 questionnaires were used for analysis (86.5%). The statistical analyses were completed using SPSS Win (12.0) for descriptive analysis, reliability analysis and t-test, and AMOS (5.0) for confirmatory factor analysis. The results of this study showed that the measure developed in this study was reliable and valid for assessing internal branding performances of hotels. In addition, the internal branding performances of hotels were high at understanding of brand dimensions and relatively low at work and organizational culture and human resource management dimensions, and local hotels showed lower levels of performance than international hotels at the dimensions of work and organizational culture (t = -3.801, p < 0.001) and human resource management(t = -5.397, p < 0.001). In conclusion, it is considered that a strong internal branding strategy should be established for successful brand management, and the practical measure for internal branding performance would be a key factor.

Using Activity-Based Cost in Menu Engineering for Restaurant Menu Analysis / 대한지역사회영양학회지

The purposes of this study were to investigate methods of applying activity-based cost to menu engineering and to examine the feasibility. A total of 6 menu items of XYZ restaurant in Seoul were selected and the ledger of September 2005 was used for menu analysis. The menu mix percent of beef sirloin steak (61.95%) and beef tenderloin steak (17.13%) were labeled as high, whereas BBQ pork ribs (4.94%), salmon fillet (2.66%), seafood platter (5.77%), and teriyaki chicken (7.56%) showed low menu mix percent. In addition, the contribution margin for BBQ pork ribs (29,000 won), salmon fillet (25,810 won), seafood platter (22,400 won), and teriyaki chicken (22,000 won) were higher than the average contribution margin (21,957 won), and those for beef sirloin steak (21,200 won) and beef tenderloin steak (21,900 won) were lower than average. When popularity and contribution margin were applied in menu engineering, BBQ pork ribs, salmon fillet, seafood platter and teriyaki chicken were classified as puzzles and beef tenderloin steak and beef sirloin steak as plowhorses. Menu engineering using popularity and operating profit, which was calculated from activity-based cost, also gave the same results, whereas the additional label for activity cost placed BBQ pork ribs and salmon fillet in the brain teaser category. Ranking analysis on variables estimating menu profitability using Spearman's rho revealed that there were no significant correlation between variables, which means the estimation of menu item profitability could differ by methods of analysis. With these results, it was concluded that activity-based cost would help to establish more detailed marketing strategy for a restaurant.

The Impacts of Customer Characteristics and Service Quality on Attitudes and Behaviors of Bakery Cafe Customers / 대한지역사회영양학회지

The purposes of this study were to examine the impacts of characteristics of bakery cafe customers and service quality on customer perceived value, customer satisfaction, intention to revisit, and intention to recommend, and to provide comprehensive understanding on attitudes and behaviors of bakery cafe customers. The questionnaire was developed through literature review and focus group interviews and was modified after pilot test. The questionnaires for the main survey were distributed to 320 males and females aged 20 and over in Seoul. A total of 275 questionnaires were used for analyses (85.9%) and the statistical analyses were completed using SPSS Win (12.0) for descriptive analyses, regression analyses, and correlation analysis. The main results were as follows. There were significant differences of intention to revisit between groups of different gender, age, and personal expenses. The service quality of product dimension affected all tested variables, and the service quality of services and price dimension had effects on customer perceived value and intention to recommend. Customer satisfaction was a unique variable that is affected by service quality of the interior environments dimension. Overall, researchers and managers of bakery cafes should understand customer attitudes and behaviors, and the results of this study would help to establish marketing strategies that meet target customers' needs.

A Case Study for Pricing Strategy Planning of a Family Restaurant Using Price-Sensitivity Measurement / 대한지역사회영양학회지

The purpose of this study was to suggest menu pricing strategy based on understanding about customer perceived value of products and services. The technique known as PSM (Price Sensitivity Measurement) was used for analysis of price sensitivity for 3 menu items of a family restaurant in Seoul. A questionnaire was developed through literature review and modified after pilot test. Questionnaires for the main survey were distributed to 250 customers on their visit to the restaurant, and a total of 138 questionnaires were used for analysis (55.2%). The statistical analysis of price sensitivity was conducted using PSM, and descriptive analyses were conducted using SPSS Win (12.0). The main results of this study were as follows: the price sensitivity of beef tenderloin steak was higher than two other menus and the stress range of teriyaki chicken was almost 0, that is, the price sensitivity of teriyaki chicken was very low. Present menu prices of 3 menu items were within the range of acceptable prices, but had some distances from the optimal pricing point. From the result of this study, it was concluded that price adjustment or price promotion strategy would be effective for increase in sales of beef tenderloin steak, and marketing strategies to enhance consumers' perceptions of value should be conducted for all menu items by situations. Overall, PSM technique could be a helpful tool for researchers and managers of foodservice organizations to understand how consumers' perceptions of value are affected by the interaction of price and quality.

Development of a Scale to Measure Self-Care for Korean Patients with Chronic Obstructive Pulmonary Disease / 간호학회지

PURPOSE: The objective of this study was the development and validation of a scale to measure the self-care of patients with chronic obstructive pulmonary disease(COPD) in Korea. METHOD: Self-care scale was developed based on the self-care activities patients had to carry out in order to manage their COPD. The original scale contained 34 items rated along a five-point Likert scale and was reviewed by 18 professional nurses and 10 Korean patients with COPD for content validity. Subsequently, patients with COPD were asked to complete this 23-item scale and further tests were done with the 125 useable responses. RESULT: Factor analysis identified eight factors- "maintaining a clean air way", "taking medication", "support from family", "preventing infection", "managing symptoms", "breathing exercising", and "taking in nutrition". The internal consistency of the total scale was Cronbach's alpha=0.7226. These eight factors explained 60.8% of total variance. There was correlation among Korean Self-Care Scale score, administration level, and knowledge level but there was no correlation to patients' satisfaction with medical services. CONCLUSION: The 23 item questionnaire positively identified 8 areas defined important for COPD patients. Further studies are required to see how these can be integrated into patient education.

The Evaluation of a Nutrition Education Camp Program for Overweight and Underweight Adolescents / 대한지역사회영양학회지

This study was performed to evaluate the effectiveness of a nutrition education program developed for nutritionally imbalanced adolescents. A summer nutrition camp was held for 23 overweight and 16 underweight subjects. Its effectiveness with regard to was evaluated at the end of the camp and 6 months later. Nutrition knowledge, nutritional attitude, food behavior, nutrient intake, exercise habit and ideal body figures desired by the subjects. The results showed significantly higher nutrition knowledge scores at the end of the camp as compared to those obtained prior to the camp program, and these scores were maintained for at least six months. Nutrition attitude scores also improved after the education program, and these improved scores also lasted for 6 months. However, the food behavior scores measured 6 months after the education program were not significantly different from those obtained prior to the camp. Also, the exorcist habit, the ideal body figures and the body figures desired by the subjects remained unchanged. When nutrient intakes of subjects were assessed before the program and 6 months later, the mean daily vitamin C intake was significantly increased after the education program. Also, the intake of iron from plant food sources increased in the overweight subjects, while less iron from animal source were consumed by the underweight subjects. Both groups tended to consume more vegetables and fruits 6 months after the education program which may have contribute to the higher vitamin C and plant-based iron intakes. These results indicate that a 4-day nutrition education camp program sustained changes in nutrition knowledge and nutrition attitude for 6 months. The increased intake of vegetables and fruits was also achieved through this education program. However, changes in dietary behavior in adolescents may require repeated education.

An Ecological Study of Food and Nutrition in Elementary School Children in Korea / 대한지역사회영양학회지

The current socioeconomic climate has meant more children spend more time alone at home even for dining. This study was performed to characterize modem Korean childrens' food ecology based on mealtime atmosphere. A total of 705 elementary school students, 347 girls and 358 boys took part in the study. They were chosen evenly from the Seoul metropolitan areas, provincial cities, or rural areas, and were asked to fill out a questionnaire. The questionnaire was categorized to determine various factors related to food ecology, life styles, and health related symptoms. The average age of the study subjects was 11.5 years. The average height, weight, body mass index, and Rohrer index were 143.2 cm, 37.6 kg, 18.2 and 127.2 respectively. A significant number of children(39.2%) answered their bed time was between 11 and 12 pm. Only 28.3% answered that the whole family has breakfast together, and 47.7% have dinner together. A considerable number of children, 17.8% for breakfast and 6.9% for dinner, answered they eat alone. Most of the children answered they like to have dinner with the whole family. Half of the children answered they do not feel hungry before having breakfast. Proportions of children for their favorite meal time were 66.8%, and 25.4% and 7.8% for dinner, school lunch, and breakfast respectively. The largest proportions of children, 53.3% and 68.7%, have breakfast and dinner at home. Most of the children(75.2%) never purchase their dinner. Forty two% of the children answered they like school lunch, however, 60% of children answered they leave portions of lunch uneaten occasionally or always. Only 38.0% and 46.2% of the children have nutritionally adequate diet for breakfast and dinner. Children having more meals with the whole family possessed a more positive attitude towards breakfast compared to the children who eat with the whole family less frequently. In conclusion, Korea children are exposed to different health threatening food ecology problems related to changing environments, and consistent concern and support from community nutritionists are required.

The effect of continuous subcutaneous insulin infusion therapy on oxidative stress in Korean type 2 diabetic patients / 대한내과학회지

BACKGROUND: It is known that hyperglycemia increase oxidative stress. Korean type 2 diabetic patients usually appear to be insulin deficient and insulin resistant. The blood glucose control can be normalized by the intensive insulin therapy. It has been reported that hyperinsulinemia have harmful effects on oxidative stress. The purpose of this study was to determine whether continuous subcutaneous insulin infusion (CSII) therapy by insulin pump affects the defense mechanism of oxidative stress in Korean type 2 diabetic patients. METHODS: Fasting blood from eighty three subjects was collected prior to starting CSII therapy using portable insulin pump and after hospitalization for 2 weeks. Serum and red blood cell lipid peroxide concentrations were analyzed by Yagi's methods. Serum tocopherol and vitamin C concentrations were measured by HPLC. Red blood cell glutathione peroxidase, superoxide dismutase and catalase activities were also measured. RESULTS: The mean age of subjects were 50.0+/-10.9 years, and they had diabetes for 8.4+/-5.8 years. Their average body mass index was 23.4+2.7 kg/m2. Their blood glucose levels were not controlled by oral hypoglycemic agents, diet and exercise treatment. Patients were divided into two categories according to blood glucose levels prior to CSII treatment. One category consists of patients with less than 11.1 mmol/L of average daily blood glucose levels prior to CSII treatment (the controlled group). The other category consists of patients with more than 11.1 mmol/L of average daily blood glucose levels (the uncontrolled group). Patients in the uncontrolled group had higher serum lipid peroxide levels than those in the controlled group before CSII therapy. After 2 weeks of CSII therapy, oxidative stress was not changed in controlled and uncontrolled groups. Serum insulin levels of all patients were increased after CSII treatment, but the levels before and after treatments were in the normal range, not hyperinsulinemic. Also, serum insulin levels did not correlate with serum lipid peroxide levels regardless of CSII treatment. Average serum vitamin C levels were remarkably increased after the therapy in all patients, but average serum total tocopherol levels was not altered. Also, activities of antioxidant enzymes such as glutathione peroxidase, superoxide dismutase, and catalase were not significantly changed. CONCLUSION: The blood glucose levels were normalized with the normal ranges of serum insulin levels after two weeks of CSII treatment. However, serum lipid peroxide levels were not changed even though serum vitamin C levels were increased. It is concluded that the oxidative stress of Korean type 2 diabetic patients are not changed after two weeks of CSII treatment, but there may be possibility the longer duation of CSII therapy may gradually improve oxidative stress.