This study examined meal patterns and protein-rich food utilization in the foodservice practices of public and private geriatric long-term care hospitals in South Korea. Over a period of 6 months, a total of 612 daily menus (306 from each hospital type, breakfast, lunch, and dinner) were collected from four hospitals (two public, two private). Each menu was categorized by meal composition, included staple food, soup, main dish, side dishes, and kimchi. The most common meal pattern consisted of a staple food, soup, main dish, two side dishes, and kimchi. Compared with private hospitals, public hospitals offered a greater variety in meal composition, staple foods, soups, and main dishes. However, no significant differences were observed in protein foods of main dishes. Overall, meat accounted for about half, whereas fish accounted for one-third. Approximately 30% of protein foods in main dishes were processed. In side dish 1, the proportion of protein-rich foods was lower in public than in private hospitals, whereas the proportion of processed foods exceeded two-thirds in both hospital, but was significantly higher in public hospitals. Soup was the second most important protein source after the main dish, with fish as the most often used; however, processed protein foods were also common. These findings indicate that the main dish and soup are the principal protein sources, and the relatively high inclusion of fish reflects a favorable pattern. However, to ensure intake of high-quality proteins by older adults, the high reliance on processed protein foods highlights the need to reconsider foodservice practices.
Obesity is a multifactorial chronic disease influenced by behavioral, environmental, genetic, and psychological factors. One primary determinant of childhood obesity is the presence of dietary factors commonly acquired through the shared home food environment, which parents can greatly influence. Thus, the present study examined the similarity in diet quality between children or adolescents with obesity and their mothers. We analyzed baseline data collected from the Intervention for Children and Adolescent obesity via Activity and Nutrition study. Seventy mother–offspring dyads were identified, which included children and adolescents with obesity aged 8–16 years and their mothers living in Seoul and Gyeonggi Province, South Korea. Food or nutrient intake and diet quality were evaluated from 3-day food records. Childhood obesity was defined as body mass index ≥ 95th percentile based on the 2007 Korean National Growth Charts. No significant difference was observed in the diet quality score between children with obesity and their mothers. However, correlation coefficients between mothers and their children’s total Diet Quality Index-International (DQI-I) score (r = 0.30) and subcategories, such as variety (r = 0.29), adequacy (r = 0.43), moderation (r = 0.45), and overall balance (r = 0.30), were positively correlated (p < 0.05). Linear regression analysis of the influence of maternal diet quality on offspring diet quality revealed that the maternal DQI-I score influenced the offspring’s DQI-I score, consistent with our prediction. Further studies with larger and more representative samples are needed to confirm the applicability of our findings to all children and adolescent populations.
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Children with autism spectrum disorder (ASD) often present with selective eating behaviors and dietary imbalances, which contribute to nutritional deficiencies that can adversely impact growth and development. Despite increasing awareness of the role of nutrition in ASD management, existing nutritional interventions frequently fail to accommodate the unique dietary needs of this population. This study aimed to develop tailored nutritional counseling materials for ASD children by adapting the food exchange list framework originally designed for individuals with diabetes. A comprehensive food database was constructed using data from the Korean Diabetes Association, the Korea Rural Development Administration, and related resources, specifically addressing the dietary habits and nutritional deficiencies observed in ASD children. Representative foods were selected, standardized for exchange units, and visually documented through photographs to enhance usability. These elements were integrated into a practical, visually engaging educational brochure, which includes detailed food exchange unit tables, photographic representations of portion sizes, and portion standards to guide caregivers in meal planning. The materials focus on enhancing dietary diversity, correcting common nutrient deficiencies, and fostering balanced eating habits. However, limitations exist in adapting a diabetes-centric framework, which may not fully capture the unique dietary preferences and challenges of ASD children. Nevertheless, the developed materials provide a valuable resource for nutritional education and intervention, supporting the health and development of ASD children. Further research is required to refine these materials and evaluate their effectiveness across diverse settings and populations.
This review offers a comprehensive analysis of food for special medical purposes (FSMPs)—specially formulated foods designed to support the dietary management of individuals with specific medical conditions. The regulatory frameworks governing FSMP differ significantly across key regions, including the European Union, North America (with a focus on the United States), and Asia (primarily China and India). FSMP is critical in addressing malnutrition, metabolic disorders (including inborn errors of metabolism), and chronic diseases, such as cancer, diabetes, and neurological conditions. Recent advancements, such as the application of three-dimensional printing technology and the growing emphasis on personalized nutrition, are poised to revolutionize the FSMP industry. The global market for FSMP is experiencing rapid growth, particularly in China, driven by factors like aging populations and the increasing prevalence of chronic diseases. Future trends suggest a shift toward more personalized, technologically advanced FSMP formulations. However, challenges such as high costs, limited accessibility, unclear regulations, and poor palatability must be addressed to maximize the potential of FSMP in enhancing patient care.
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Nutrition fact labels (NFLs) are a simple way to help people improve their nutritional intake by making healthier food choices. This study aimed to evaluate NFL use and eating habit changes among quarantined and hospitalized coronavirus disease 2019 (COVID-19) patients during the pandemic. This cross-sectional study used data from the 2019 and 2020 Korean Community Health Surveys (KCHSs). Data were collected from 229,099 subjects in 2019 and 229,269 subjects in 2020. In the 2020 KCHS, data from 1,073 COVID-19 patients were included. NFL use was divided into 4 categories based on a questionnaire: affect, read, aware, and never heard. Among COVID-19 patients, 32.15% reported that they had not heard of NFLs (never heard group) compared to 44.36% of the healthy population (p < 0.001). A total of 35.1% of COVID-19 patients who reported daily life change scores of 20 or less were in the affect group compared to 23.8% of healthy subjects. In the affect group, the proportion of respondents who reported increased consumption of delivered food was 38.7% in the COVID-19 group, which was 17.1% higher than that in the never heard group (Cramér’s V = 0.257; p < 0.001). Respondents with increased consumption of fast food/soda showed a higher ratio of having never heard of NFLs among healthy subjects (28.5%) than among COVID-19 patients (22.5%; p = 0.043). Confirmed COVID-19 infections and more unfavorable daily life changes due to COVID-19 led to increased nutritional information seeking and NFL use.
Following up with recovered coronavirus disease 2019 (COVID-19) patients is necessary. Given the importance of psychological function accompanied by significant effects of food quality, we want to examine the association between food quality score (FQS) and mental disorders among recovered COVID-19 patients. This case-control study was performed on 246 eligible adults. A validated food frequency questionnaire (FFQ) was used to evaluate dietary intake. We using Depression Anxiety Stress Scales, Insomnia Severity Index, Pittsburgh Sleep Quality Index, and 36-Item Short Form Health Survey questionnaires to evaluate the psychological function. Logistic regression analysis was conducted to estimate the odds ratio (OR) and 95% confidence intervals (CIs) for score categories of the FQS index and psychological function in multivariate-adjusted models. Only in case subjects, we found significant associations between adherence to the FQS diet and depression, anxiety, and stress in the crude model (OR, 0.796, 95% CI, 0.661–0.958, p = 0.016; OR, 0.824, 95% CI, 0.707–0.960, p = 0.013; OR, 0.824, 95% CI, 0.709–0.956, p = 0.011, respectively). These associations remained significant in all two adjusted models. However, no significant associations were found between FQS and psychological functions in the control group. Our data suggests that overall food quality intake is associated with depression, anxiety, and stress symptoms during the post-infection period. Also, adequate daily intakes of fruits, legumes, nuts, and whole grains are associated with reduced risks of psychological impairment and sleep disorders which are common among recovered patients.
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A food exchange list is a tool developed to help diabetic patients control their energy intake and plan balanced meals. Korean food exchange lists were first developed in 1988, revised in 1995, and updated again in 2010. With rapidly changing dietary habits and increasing demand for diverse food cultures, the Korean Diabetes Association in cooperation with 4 related organizations established a Task Force Team (TFT) to revise food exchange lists in March 2022. Starting with a workshop, TFT held 11 official revision meetings, culminating in a public hearing in May 2023. The final revised version of Korean food exchange lists was published in December 2023. Key outcomes of the revision are summarized as follows: 1. Based on the National Standard Food Composition Table 10.0 database, the existing classification system and nutrient standards for each food group remain unchanged this time. 2. Based on a survey conducted among diabetes educators, the number of items on the food exchange lists has increased from 339 in 2010 to 435 this time. 3. Considering patients’ usual eating habits, meal planning examples were developed distributing food group exchange units by energy level based on 3 types of proportions of carbohydrate energy (40%–45%, 50%–55%, 60%–65%). 4. Due to limitations in real-time updates for rapidly changing information, detailed guidance on how to access and interpret the data is provided. These revisions will help people with diabetes manage their blood sugar levels and facilitate the implementation of healthy meal planning in various other conditions, including obesity.
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The purpose of this study was to evaluate the nutritional adequacy of senior-friendly foods sold in Korea, focusing on protein and sodium. This study examined the nutritional content of 170 products with nutritional labels that were sold in online stores in Korea and categorized the products into 93 staple foods (cooked rice, porridge, and mousse) and 77 side-dish and snack foods (braized·steam·roast products, broth, sauces, and snacks). Then, the adequacy of the nutritional content of these foods, focusing on protein and sodium, was evaluated according to product type. The 93 staple products and 77 side-dish products had average serving sizes of 163.27 g and 127.92 g, prices of $3.25 and $2.72, and energy contents of 295.25 kcal and 141.95 kcal, respectively. For staple foods, the energy content was significantly greater in cooked rice, but the protein content and index of nutrition quality (INQ) were significantly greater in mousse. There were no significant differences in sodium content or contribution to adequate intake (AI) by product type, but the sodium INQ was significantly greater in the mousse and porridge. For side-dish foods and snack products, the protein content, contribution to the recommended intake, and INQ were all significantly greater for the braized·steam·roast products. Sauces and braized·steam·roast products were significantly higher in sodium content and contribution to the AI, while broth was significantly higher in sodium INQ. These findings can be used to guide proper product selection and nutritional management that considers the health characteristics of health-vulnerable and elderly people.
Numerous studies have indicated that low levels of serum adiponectin are linked with the development of various chronic diseases. While some recent research has suggested that soy has a positive impact on serum adiponectin levels, the results are inconsistent. Therefore, we aim to conduct a thorough systematic review and meta-analysis of randomized controlled trials (RCTs) that investigate the effects of soy on serum adiponectin levels in adults. The search was conducted until March 2024 on PubMed, Scopus, Web of Science, and Cochrane Library databases to identify RCTs that studied the effects of soy supplementation on serum adiponectin levels. A random-effects model was used to pool the weighted mean differences (WMDs). Ten and nine RCTs were selected for the systematic review and meta-analysis, respectively. After analyzing data from 9 eligible RCTs, it was found that soy supplementation did not significantly impact the concentrations of adiponectin (WMD = −0.24 μg/mL; 95% confidence interval, −1.56 to 1.09; p = 0.72). However, there was significant heterogeneity between the studies (I2 = 89.8%, p < 0.001). Sensitivity analysis showed that overall estimates were not affected by the elimination of any study. We did not observe any evidence regarding publication bias. In conclusion, soy supplementation did not have a significant effect on adiponectin levels in adults. However, further RCTs are needed with longer intervention duration, higher doses, and studies conducted in different countries.
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The study aimed to investigate the basic data to derive plans for snack provision to improve the nutritional status of older adults living in long-term care facilities (LFs) or long-term care hospitals (LHs). The 252 respondents (118 from LHs and 134 from LFs) were included in the study. The questionnaire of nationwide cross-sectional survey was developed by the authors and registered dietitians. The written questionnaire was sent to the food service managers across 800 LFs or LHs. The online survey was introduced using the online platform and network site for dietitians. More than 70% of live-in and non-live-in LFs provided snacks, which were mainly provided one to two times a day. Most institutions provided fruits one to three times a week. The main considerations when providing fruit were in the order of residents’ preference, cost, and ease of consumption. The reasons for not serving fruit included cost and differences in the residents’ eating and mastication abilities. Most institutions also provided dairy products at a frequency of one to three times a week. The reasons for not serving dairy products included cost and the lack of awareness of the need to provide them. To improve the quality of life and the offer benefits of fruits and dairy products to older people, efforts are needed to propose a plan to expand the provision of snacks in appropriate quantities and varieties.
Obesity and overweight pose a significant public health problem, as they are associated with an elevated risk of metabolic syndrome (MetS). Several studies have shown that diet quality is associated with the development of MetS risk factors. Analyzing dietary patterns may be more helpful in determining the relationship between eating habits and chronic diseases compared to focusing on single foods or nutrients. In this study, our
objective
was to evaluate the association of food quality score (FQS) with risk factors for MetS in individuals with obesity and overweight. The participants in this cross-sectional study were 340 adults with overweight and obesity. Participants’ food intake was measured using a Food Frequency Questionnaire, then the FQS was calculated. A fasting blood sample assessed serum glucose, triglycerides, total cholesterol (TC), high-density lipoprotein cholesterol, and serum insulin levels. Fat-free mass, height, basal metabolic rate, socio-economic score, and waist-to-hip ratio significantly differed among FQS tertiles. TC, systolic and diastolic blood pressure, and fasting blood glucose were significantly lower in the highest tertile of FQS. After multivariable adjustment, our results showed that individuals in the third tertile of FQS had reduced risk of higher levels of TC (odds ratio [OR], 0.982; 95% confidence interval [CI], 0.970–0.984) and higher levels of low-density lipoprotein cholesterol (OR, 0.974; 95% CI, 0.974–0.999). Our findings demonstrate an inverse relationship between diet quality, as measured by FQS, and MetS risk factors. However, further experimental and longitudinal investigations are warranted to elucidate the causal nature of this association.
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This study analyzed the 2019 Community Health Survey data to compare and analyze the health levels and life satisfaction of single-person elderly households based on food security. The final study subjects were 15,606 single-person elderly individuals aged 65 and above. These subjects were classified based on their response to food security into three groups: food sufficient-diverse, food sufficient-not diverse, and food insufficient. The study results showed that the proportion of the food insufficient group among single-person elderly households was 7.4% for men and 10.6% for women, with a slightly higher rate for female elderly. Both male and female elderly over 80 years of age, with low education levels, and basic living support recipients showed significantly higher proportions in the sufficient-not diverse and food insufficient groups. For male elderly, significant differences were observed in subjective health status and oral health level in the food insufficient group, and for female elderly, stress levels also showed significant differences. Life satisfaction scores were generally lower for female elderly compared to male, and significant differences were found in both male and female elderly based on food security. Common factors that significantly influence life satisfaction among single-person elderly households, both male and female, include food security, subjective health status, and living environment satisfaction, with food security being the most impactful factor. The study suggests that it is necessary to include these significant factors in the development of various social activity programs, such as dietary programs, to enhance life satisfaction and food security of single-person elderly households.
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Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disorder with widespread synovitis. Isoflavones, the main active component of soy, have been reported to have potent anti-inflammatory effects; the previous RA animal models showed the promising effect of soy supplementation. We aimed to evaluate the effect of soy bread on inflammatory markers and lipid profiles in RA patients. The present study was designed as a randomized controlled trial. RA patients were randomly allocated to obtain soy bread (n = 22) or placebo bread (n = 22) for 8 weeks. Fasting serum levels of lipid profile, total antioxidant capacity (TAC), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and DAS28 were checked. Findings showed that there were no significant differences between the two groups in physical activity and dietary intake at the beginning of the study and the end of the study. There were no significant differences between the two groups in measured lipid profile markers, including high-density lipoprotein, low-density lipoprotein, total cholesterol, triglyceride, and very low-density lipoprotein, at the end of the trial. In addition, TAC and CRP also were not significant at the end of the trial between the 2 groups (0.66 and 0.12, respectively). However, the serum levels of TNF-α reduced significantly in the soy bread group at the end of the intervention (p < 0.000) and compared with the control group (p < 0.019). Soy bread consumption only decreased circulating TNF-α serum concentration. Other outcome measures were not changed following supplementation. Future long-term, well-designed studies are needed to confirm these findings.
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This study aimed to investigate the current state of foodservice management and demands for improvement in long-term care hospitals. The survey was performed in experienced dietitians working at 25 hospitals. General characteristics, status of sanitary management (document management, self-assessment of importance and performance), necessity and ranking of sanitary management items were investigated. Approximately 2.5 dietitians worked in each hospital, but only 7 (28.0%) hospitals employed clinical dietitians. From the questionnaire, the scores of the importance in sanitary management and performance were 4.5 ± 0.7 and 4.3 ± 0.9, respectively, and were significantly different (p = 0.000). Participants also reported “special therapeutic diets management” and “compliance with standards of refrigerating time, food, method management” had the lowest importance and performance, respectively. The result of Importance-Performance Analysis revealed a significant positive correlation between importance and performance (R2 = 0.427). However, items such as “performing hand hygiene” and “compliance with standards of refrigerating time, food, method” and etc. had low importance recognition with low performance. All participants reported “preparing sanitary management standards was necessary” is necessary and “development of sanitary management manual” is the most important. These findings suggest that sanitary management is important in food service management of long-term care hospitals, and improving awareness is required. Developing a hospital foodservice hygiene manual would ensure better safety and quality for patient care and public health.
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