kjcn Korean Journal of Community Nutrition Korean J Community Nutr 1226-0983 2287-1624 Journal of the Korean Society of Community Nutrition 10.14253/KJCN.2012.17.1.109 kjcn-17-109 Original Article Change of Children's Meal Structure in Terms of Temporal and Spatial Dimensions : Analysis of the Data from the Korea National Health and Nutrition Examination Surveys of 1998 and 2009 LeeYoungmi 1 ShimJae Eun 1 2 YoonJihyun 1 2 Department of Food and Nutrition, Seoul National University, Seoul, Korea Research Institute of Human Ecology, Seoul National University, Seoul, Korea Corresponding author: Jihyun Yoon, Department of Food and Nutrition, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea Tel: (02) 880-8750, Fax: (02) 884-0305 E-mail: hoonyoon@snu.ac.kr 122012 18122012 171 109118 Copyright © 2012 Journal of the Korean Society of Community Nutrition 2012 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

This study was conducted to characterize changes in the meal structure of Korean children in terms of temporal and spatial dimensions. The data of 1,891 and 1,627 school-aged children and adolescents extracted respectively from the 1998 and 2009 Korea National Health and Nutrition Examination Surveys were analyzed by gender, age group, and residential area. From 1998 to 2009, the total eating events increased from 4.3 to 4.6 (p=0.001); the average number of meal intake decreased from 2.8 to 2.7 (p<0.001) while that of snack intake increased from 1.5 to 1.9 (p<0.001). The prevalence of “3 meals a day” pattern tended to decrease while that of “2 meals a day” pattern increased over the years. Especially, the “2 meals a day” pattern with “lunch+dinner” increased from 13% in 1998 to 20% in 2009. The percentage of eating breakfast or dinner at home decreased over the years. These results indicate that over the last decade, “destructuration” occurred in Korean children's meal structure in terms of temporal and spatial dimensions. Especially, such alteration was more distinctive in male than female and in the high school-aged group than the elementary or middle school-aged groups. Overall, the difference of meal structure between genders and residential areas became smaller while the difference among age groups became larger over the years. (Korean J Community Nutr 17(1): 109~118, 2012)

 KEY WORDS children adolescent meal structure meal pattern destructuration REFERENCES Anderson AS Macintyre S West P 1993 Adolescent meal patterns: grazing habits in the west of Scotland Health Bull 513 15865 Chiva M 1997 Cultural aspects of meals and meal frequency Br J Nutr 77(Suppl.1): S21-S28 Cho A Dietrich M Brown CJP Clark CA Block G 2003 The effect of breakfast type on total daily energy intake and body mass index: results from the third national health and nutrition examination study(NHANES III) J Am Coll Nutr 22 296302 Darmon N Drewnowski A 2008 Dose social class perdict deit quality? Am J Clin Nutr 87 11071117 Doi T 1990 Gaishoku Nikkei, Tokyo, p.9 Drewnowski A Popkin BM 1997 The nutrition transition: new trends in the global diet Nutr Rev 552 3143 Drummond S Crombie N Kirk T 1996 A critique of the effects of snacking on body weight status Eur J Clin Nutr 50 779783 Fishcler C 1979 Gastro-nomie et gastro-anomie. Sagesse du corps et crise bioculturelle de l'alimentation moderne Communications 31 189210 Fjellström C 2004 Mealtime and meal patterns from a cultural perpective Scand J Nutr 484 161164 Gross SM Bronner Y Welch C Dewberry-Moore N Paige DM 2004 Breakfast and lunch meal skipping patterns among fourth-grade children from selected public schools in urban, suburban, and rural Maryland J Am Diet Assoc 104 420423 Herpin N 1988 Le repas comme institution. Compte rendu d'une enquête exploratoire R Franç Sociol 29 503521 Jahns L Siega-Riz AM Popkin BM 2001 The increasing prevalence of snacking among US children from 1977 to 1996 J Pediatr 138 493498 Kang MH Choi MK Kim MH 2011 Evaluation of energy and nutrient intake as well as dietary behaviors in elementary school and middle school students residing in Chungnam according ot breakfast eating status J Korean Diet Assoc 171 1831 Kerr MA Rennie KL McCaffrey TA Wallace JM Hannon-Fletcher MP Livingstone MBE 2009 Snacking patterns among adolescents: a comparison of type, frequency and portion size between Britain in 1997 and Northern Ireland in 2005 Br J Nutr 101 122131 Kim BH Lee JW Lee Y Lee HS Jang YA Kim CI 2005 Food and nutrient consumption patterns of the Korean adult population by income level-2001 national health and nutrition survey Korean J Community Nutr 106 952962 Kim K Park E 2005 Nutrtient density of fast-food consumed by the middle school students in Cheongju city Korean J Community Nutr 103 271280 Kim SH 1999 Children's growth and school performance in relation to breakfast J Korean Diet Assoc 52 215224 Korean National Statistical Office 2011 The statistics of single parent family Available from http://www.kostat.go.kr [cited 2011 December 15] Lazarou C Kalavana T 2009 Urbanization influences dietary habits of Cypriot children: the CYKIDS study Int J Public Health 54 6777 Lee MY Kim YA 2006 The perception and utilization of Korean traditional food and fast food of elementary school children in Ansan area J Korean Home Econ Assoc 4410 109120 Marshall D Bell R 2003 Meal construction: exploring the relationship between eating occasion and location Food Qual Prefer 14 5364 Meiselman HL 2000 Dimensions of the meal: The science, culture, business and art of eating Aspen, Gaithersburg, pp. 79 Meiselman HL (2008): Dimensions of the meal. J Foodserv 19: 13-21 Mestdag I 2005 Disappearance of the traditional meal: Temporal, social and spatial destruction Appetite 45 6274 Mintz S 1993 Feeding, eating, and grazing: some speculations on modern food habits J Gastronomy 71 4657 Nicklas TA Morales M Yang SJ Baranowski T Moor CD Berenson G 2004 Children's meal patterns have changed over a 21-year period: The Bogalusa heart study J Am Diet Assoc 104 753761 Oh SY 1993 Dietary behavior of Koreans in biological and cultural aspects over the last 50 years Korean J Dietary Culture 84 373380 Oltersdorf U 1996 Impact of changing food choices and eating habits on nutritional status in European countries (Workshop under the auspices of IUNS, AGEV and BFE; Freising-Munich, 21-22 October 1995) Appetite 27 9194 Oltersdorf U Schlettwein-Gsell D Winkler G 1999 Assessing eating patterns-an emerging research topics in nutritional sciences: Introduction to the symposium Appetite 32 17 Ovaskainen ML Reinivuo H Tapanainen H Hannila ML Korhonen T Pakkala H 2006 Snacks as an element of energy intake and food consumption Eur J Clin Nutr 60 494501 Piernas C Popkin BM 2010 Trends in snacking among US children Health Aff 293 398404 Popkin BM 1994 The nutrition transition in low-income countries: An emerging crisis Nutr Rev 529 285298 Popkin BM 1999 Urbanization, lifestyle changes and the nutrition transition World Dev 2711 19051916 Poulain JP 1999 L'espace social alimentaire Cahiers de Nutr et de Diététique 34 271280 Poulain JP 2002 The contemporary diet in France: "de-structuration" or from commensalism to "vagabond feeding" Appetite 39 4345 Appetite 39: 43-45 Rampersaud GC Pereira MA Girard BL Adams J Metzl JD 2005 Breakfast habits, nutritional status, body weight, and academic performance in children and adolescents J Am Diet Assoc 105 743760 Rotenberg R 1981 The impact of industrialization on meal patterns in Vienna Austria. Ecol Food Nutr 11 2535 Savige G MacFarlane A Ball K Worsley A Crawford D 2007 Snacking behaviours of adolescents and their association with skipping meals Int J Behav Nutr Phys Act 41 3644 Shim JE Paik HY Moon HK Kim YO 2004 Comparative analysis and evaluation of dietary intakes of Koreans by age groups: (5) meal patterns J Korean Home Econ Assoc 428 169185 Siega-Riz AM Carson T Popkin B 1998 Three squares or mostly snacks-what do teens really eat? A sociodemographic study of meal patterns J Adolesc Health 19 2936 Yeoh YJ Yoon J Shim JE 2009 Relation of breakfast intake to diet quality in Korean school-aged children: analysis of the data from the 2001 National Health and Nutrition Survey Korean J Community Nutr 141 111 Yeoh YJ Yoon J Shim JE Chung SJ 2008 Factors associated with skipping breakfast in Korean children: Analysis of data from the 2001 National Health and Nutrition Survey, Korean J Community Nutr 131 6268 Zizza C Siega-Riz AM Popkin BM 2001 Significant increase in young adults' snacking between 1977-1978 and 1994-1996 represents a cause for concern! Prev Med 32 303310 Figures and Tables

General characteristics of the subjects1)

Characteristics 1998 (n = 1,891) 2009 (n = 1,627) Total (n = 3,518) p-value2
      %    
Gender Male 52.0 53.1 52.5 0.551
Female 48.0 46.9 47.5
Age group Elementary school-aged 46.1 44.9 45.5 0.004
Middle school-aged 23.9 29.7 26.8
High school-aged 30.0 25.5 27.7
Residential area Rural area 20.7 15.1 17.8 0.140
Urban area 79.3 84.9 82.2
      Mean ± SE    
Family size   4.27 ± 0.03 554.23 ± 50.035 554.25 ± 50.02 0.460
House hold income (10,000 won/month)   158.98 ± 5.32 372.97 ± 36.17 267.08 ± 19.21 < 0.001

1) Weights for nutrition surveys were applied for all estimates.

2) by chi-square test or t-test

Average numbers of eating events in 1998 and in 20091)

Gender Age group Residential area
Classification Male Female Elementary school-aged Middle school-aged High school-aged Rural Urban Total
1998 2009 1998 2009 1998 2009 1998 2009 1998 2009 1998 2009 1998 2009 1998 2009
(n=984) (n=839) (n=907) (n=788) (n=911) (n=889) (n=448) (n=425) (n=532) (n=313) (n=610) (n=261) (n=1,281) (n=1,366) (n=1,891) (n=1,627)
Mean±SE
Total 4.36 ± 0.06 4.61 ± 0.06 4.27 ± 0.06 4.50 ± 0.07 4.51 ± 0.07 7 4.83 ± 0.06 4.24 ± 0.07 4.37 ± 0.09 4.07 ± 0.07 4 4.29 ± 0.09 4.13 ± 0.09 4.58 ± 0.12 4.36 ± 0.06 4.56 ± 0.06 4.31 ± 0.05 4.56 ± 0.05
p-value2) < 0.004 < 0.012 < 0.001 < 0.225 < 0.060 < 0.004 < 0.025 < 0.001
Meal 2.81 ± 0.02 2.67 ± 0.02 2.74 ± 0.02 2.65 ± 0.02 2.86 ± 0.02 2 2.80 ± 0.02 2.76 ± 0.02 2.60 ± 0.03 2.65 ± 0.03 2 2.47 ± 0.04 2.72 ± 0.03 2.64 ± 0.05 2.79 ± 0.02 2.66 ± 0.02 2.77 ± 0.01 2.66 ± 0.02
p-value2) < 0.001 < 0.004 < 0.012 < 0.001 < 0.001 < 0.141 < 0.001 < 0.001
Snack 1.55 ± 0.06 1.94 ± 0.06 1.53 ± 0.06 1.85 ± 0.06 1.65 ± 0.07 7 2.03 ± 0.06 1.47 ± 0.07 1.77 ± 0.08 1.42 ± 0.07 1 1.82 ± 0.08 1.40 ± 0.09 1.94 ± 0.11 1.58 ± 0.06 1.89 ± 0.05 1.54 ± 0.05 1.90 ± 0.05
p-value2) < 0.001 < 0.001 < 0.001 < 0.004 < 0.001 < 0.001 < 0.001 < 0.001

1) Weights for nutrition surveys were applied for all estimates

2) by t-test

Distribution of number of meals in 1998 and in 20091).

Distribution of meal pattern in 1998 and in 20091)

Gender Age group Residential Area
Meal2) Male Female Elementary school-aged Middle school-aged High school-aged Rural Urban Total
pattern 1998 2009 1998 2009 1998 2009 1998 2009 1998 2009 1998 2009 1998 2009 1998 2009
  (n = 984) (n = 839) (n = 907) (n = 788) (n = 911) (n = 889) (n = 448) (n = 425) (n = 532) (n = 313) (n = 610) (n = 261) (n = 1,281) (n = 1,366) (n = 1,891) (n = 1,627)
                  %              
B + L + D 80.1 69.8 75.7 67.4 85.6 80.6 76.8 63.7 67.2 53.5 74.1 66.7 79.0 69.1 78.0 68.7
B + L 3.5 2.9 4.2 5.5 2.9 3.0 3.0 3.6 5.9 6.6 4.2 3.1 3.7 4.3 3.8 4.1
B + D 3.5 3.1 4.0 5.8 2.6 3.8 4.2 4.8 5.3 5.0 6.6 4.7 3.0 4.3 3.8 4.4
L + D 11.8 21.1 13.1 18.4 7.7 11.9 14.1 24.2 18.4 28.7 12.8 22.7 12.4 19.3 12.5 19.8
Others 1.0 3.0 3.0 2.8 1.2 0.6 1.9 3.6 3.2 6.3 2.3 2.8 1.9 3.0 2.0 2.9
p-value3) < 0.001 0.026 0.052 0.005 0.002 0.062 < 0.001 < 0.001

1) Weights for nutrition surveys were applied for all estimates, 2) B: Breakfast, L: Lunch, D: Dinner, Others: ≤ 1 meal, 3) by chi-square test

Distribution of eating place in 1998 and in 20091)

Gender Age group Residential Area
Location Male Female Elementary school-aged Middle school-aged High school-aged Rural Urban Total
  1998 2009 1998 2009 1998 2009 1998 2009 1998 2009 1998 2009 1998 2009 1998 2009
  (n = 984) (n = 839) (n = 907) (n = 788) (n = 911) (n = 889) (n = 448) (n = 425) (n = 532) (n = 313) (n = 610) (n = 261) (n = 1,281) ) (n = 1,366) (n = 1,891) (n = 1,627)
Breakfast %
Skipped 12.7 23.8 15.4 21.0 8.7 12.5 15.7 27.4 20.8 34.2 14.7 24.7 13.8 22.1 14.0 22.5
Home2) 85.0 74.0 83.1 76.6 90.5 86.7 82.2 71.1 75.7 59.8 83.1 71.9 84.3 75.8 84.1 75.2
Away from home3) 2.3 2.3 1.5 2.4 0.8 0.8 2.1 1.5 3.5 6.0 2.2 3.5 1.8 2.1 1.9 2.3
p-value4) < 0.001 0.025 0.070 0.001 < 0.001 0.048 < 0.001 < 0.001
Lunch
Skipped 4.1 4.6 5.9 7.5 3.6 4.0 4.9 6.3 7.2 9.2 7.7 6.5 4.3 5.9 5.0 6.0
Home2) 32.0 34.2 24.8 34.0 25.9 30.9 26.5 36.1 34.3 37.3 28.5 32.8 28.6 34.3 28.6 34.1
Away from home3) 63.9 61.2 69.2 58.5 70.5 65.1 68.5 57.6 58.5 53.5 63.8 60.7 67.2 59.8 66.5 59.9
p-value4) < 0.082 0.005 0.299 0.056 < 0.416 0.630 < 0.066 < 0.079
Dinner
Skipped 4.1 4.8 6.2 6.9 3.4 3.5 4.5 6.1 8.2 9.4 5.8 4.9 4.9 5.9 5.1 5.8
Home2) 87.7 77.9 81.6 79.3 92.7 86.9 85.6 78.9 72.0 63.4 86.1 79.6 84.5 78.4 84.8 78.6
Away from home3) 8.2 17.3 12.2 13.8 3.9 9.6 9.9 14.9 19.8 27.2 8.1 15.5 10.6 15.7 10.1 15.7
p-value4) < 0.001 0.604 0.001 0.102 < 0.061 0.008 < 0.006 < 0.001

1) Weights for nutrition surveys were applied for all estimates

2) Includes home, neighbors’ houses, and relatives’ houses

3) Includes institutions (including schools), restaurants, snack bars, convenience stores, bakeries, ect.

4) by chi-square test