2005-2008 Nutrition and Health Survey in Taiwan: the nutrition knowledge, attitude and behavior of 19-64 year old adults.

The purpose of this study is to understand nutrition knowledge, attitude, and behavior in Taiwanese adults. Results indicated that adults' knowledge on 'relationship between diet and disease' and 'comparison of foods in terms of specific nutrients' is acceptable. However, they lack knowledge on 'daily serving requirements' and 'weight and weight loss'. Although they recognize the importance of nutrition, nutrition was not the major concern of food selection. Significant differences were found among gender and age groups. Females of most age groups are better than males in many aspects of nutrition knowledge, attitude and behavior except emotional and external eating behavior. Young (age 19-30) and prime (age 31-44) adults have better knowledge than that of middle adults (age 45-64), while prime adults hold a more positive attitude than young adults. As for nutrition behavior, prime and middle adults are better than young adults. Nutrition knowledge and attitude of adults in urban areas is generally better than those in suburban and remote areas. However, adults in urban areas perform 'emotional and external cued eating' more frequently than those in suburban and remote areas. There are significantly positive correlations among nutrition knowledge, attitude and behavior; and attitude has stronger correlation (r=0.42) with behavior than knowledge does (r=0.27). Therefore, to achieve desirable eating behaviors, the adult nutrition education program should include knowledge of what constitutes a balanced diet and what constitutes being overweight. Proper strategies to enhance the behavioral motivation of healthy food selection must also not be neglected.

Nutrition and Health Survey of Taiwan Elementary School Children 2001-2002: research design, methods and scope.

The "Nutrition and Health Survey of Taiwan's Elementary School Children (2001-2002)" was to investigate the nutritional status, influential dietary and non-dietary factors, health and development, and school performance, as well as the inter-relationships among these factors. The survey adopted a two-staged stratified, clustered probability sampling scheme. Towns and districts in Taiwan with particular ethnic and geographical characteristics were designated into 13 strata including Hakka areas, mountain areas, eastern Taiwan, the Penghu Islands, 3 northern regions, 3 central regions and 3 southern regions. Eight schools were selected from each stratum using the probabilities proportional to sizes method. Twenty-four pupils were randomly selected within each school. The survey included face-to-face interviews and health examinations. Taking seasonal effects into consideration, the face-to-face interviews were evenly allocated into each of the two semesters. A total of 2,419 face-to-face interviews and 2,475 health examinations were completed. Interview data included household information, socio-demographics, 24-hour dietary recall, food frequency, dietary and nutritional knowledge, attitudes and behaviors, physical activity, medical history, oral health, pubertal development, and bone health. Health exam data included anthropometry, blood pressure, physical fitness, bone density, dental health, and blood and urine collection. SUDAAN was used to adjust sampling design effect. There were no significant differences in sibling rank and parental characteristics between respondents and non-respondents, which indicates that our survey is representative and unbiased. The results of this survey will increase our understanding on the nutrition and health status of schoolchildren and can be used to shape public health policy in Taiwan.

Nutrition knowledge, attitude, and behavior of Taiwanese elementary school children.

The purpose of this study is to understand nutrition knowledge, attitude, and behavior in Taiwanese elementary school children, and the relationship of these various components. The results indicated that children's knowledge was fair in nutrition basics, but poor in 'the physiological function of nutrients', 'relationships between diet/nutrients and disease', and 'the daily serving requirement for different food groups'. Children in general valued the importance of nutrition, but they did not concern the health benefit of foods in food selections. Their dietary quality was not satisfactory, and the diet of most children did not meet the recommended serving requirements for milk, vegetable, fruit, and cereals and grains groups. Positive relationships were found among nutrition knowledge, attitude, caring- about-nutrition behavior and dietary quality score. The restraint or disinhibited eating behavior of 4th to 6th graders was not serious, but a large number of children already performed some self-controlling practices to avoid obesity, but not frequently. One fourth of the students skipped meals, especially breakfast, and one quarter of 4th to 6th graders prepared their own breakfast; which may have some impact on children's diet quality. A gap was found between nutrition knowledge, attitude and eating behavior, especially vegetable and fruit consumption, indicating that the attitude toward eating for health was not strong in this age group. Future nutrition education for school children should not only include food serving requirements of food groups, but also apply appropriate theories to improve the motivation for healthy eating.

The relationship between snack intake and its availability of 4th-6th graders in Taiwan.

The purpose of this study was to examine the relationship between the snack intake and snack availability of elementary school children. Data analyzed were from 722 4th to 6th graders' food availability and food intake questionnaires collected in the Nutrition and Health Survey in Taiwan Elementary School Children 2001-2002. The snacks commonly eaten were divided into two groups. Healthy snacks included dairy products, 100% fruit juice and fresh fruits. Unhealthy snacks included high fat/sugar snacks, cookies, candy, carbonated/sugared beverages and fast food. Structural equating modeling was used to test the models that describe the availability and intake of two snack groups. Results indicated that parents' intake and children's preference were major predictors of children intake of both healthy and unhealthy snacks. Other than that, the intake of unhealthy snacks was positively associated with "purchase by children themselves" but not the intake of healthy snacks, which was influenced predominantly by "present in home". The results support the perception that a positive family food environment is important for improving children's diet quality. To build a healthy family food environment, parents have to not only provide healthy snacks but also limit the unhealthy snacks in home. In addition to that, the role modeling of parents as eating healthy snacks instead of unhealthy snacks themselves may help children to develop similar behaviors.

Dietary supplement usage among elementary school children in Taiwan: their school performance and emotional status.

Dietary supplement consumption practices among 2417 children (1295 boys and 1122 girls) aged 6 to 12 years in Taiwan were derived from the Nutrition and Health Survey in Taiwan Elementary School Children (NAHSIT 2001-2002). The proportion (22%) of boys and girls using supplements was equivalent. Some 77% of the child supplement takers took only one type of supplement. The top five supplements consumed were: multivitamins and minerals, calcium, vitamin C, cod-liver oil and bee propolis in that order. Children in the most urbanized southern Taiwan had the highest usage (33%), but prevalence was lowest in the mountainous areas (5%). Higher parental education level and household monthly income were associated with higher intakes. Supplement users were more competent at school; however, the frequency and number of supplement types were not related to competence.

The usage of dietary supplements among the elderly individuals in Taiwan.

This study describes dietary supplement consumption practices among the Taiwanese population over the age of 65. Data for the analyses were derived from the Elderly Nutrition and Health Survey in Taiwan (1999-2000) which was carried out from 1999-2000. Data from a total of 1937 participants (970 men and 967 women) were collected in the study to delineate patterns of supplement usage. The results indicated that the percentage of women taking supplements was 34.9%, which was higher than 30.1% for men. About 50% of male and female supplement takers took only one type of supplement. The numbers of people taking supplements decreased as the total number of supplement types chosen increased. The top five types of supplements consumed from highest to lowest were: multivitamins and minerals, calcium, vitamin E, vitamin C and fish oil. The elderly residing in the first stratum in the northern areas of Taiwan had the highest rate of taking supplements compared to other locations. In contrast, the elderly residing in mountain areas, eastern areas, and the third stratum in the central areas of Taiwan had a significantly lower rate of supplement ingestion. In addition, elderly people with the following characteristics had a significantly higher rate of taking supplements: higher education, higher monthly income, sufficient disposable income, higher scores in nutrition knowledge, daily ingestion of vitamin or mineral supplements, awareness of nutritional knowledge, regular ingestion of health-enhancing medicines, a lacto-ovo vegetarian diet, good understanding of their own health status, and frequent exercisers.