Abstract
The objective of this study is to select a simple and easy measurable food behavior checklist for the development of Nutrition Quotient (NQ) for children, which reflects children's diet quality, as well as to evaluate the validity of the items in the food behavior checklist. The first 36 items in the checklist were established by an expert review, modifying the preliminary 50 items in the checklist, which had been selected by a literature review and the Korean National Health and Nutrition Examination Survey data. 341 children in 5th and 6th grades at an elementary school participated in a one-day dietary record survey, and later responded to 36 food behavior questions of the checklist. Pearson's correlation coefficients between the responses to the food behavior checklist items along with the mean nutrient intakes of the children were calculated. From the result, in which responses of food frequency and food behavior items showed certain association with the dietary record data, a second checklist with 22 items was selected. A survey was conducted by using the second checklist. 1,393 children in the 5th and 6th grades at 12 elementary schools in metropolitan cities, such as Seoul, Busan, Gwangju, Daegu, Daejeon, and Incheon, participated in the survey. Further, an exploratory factor analysis was performed. After the analysis, 19 items (10 items from food frequency and 9 items from food behavior) were finalized as the food behavior checklist items for the NQ. The final 19 food behavior checklist items were composed of 5 factors: ‘Balance’, ‘Diversity’, ‘Moderation’, ‘Regularity’, and ‘Practice’. This study is a significant first trial to establish a comprehensive system for evaluating children's food habit and diet quality. This checklist might need continuous modification and revision reflecting the change of children's dietary life and the social environment.
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Fig. 2.
Percentage of average nutrient intake of the children to recommended nutrient intake (RNI) or adequate intake (AI). ∗: Nutrient intake of male subjects are significantly different from those of female subjects by Student t-test at α = 0.05 level.
![kjn-45-372f2.tif](/upload/SynapseXML/0124kjn/thumb/kjn-45-372f2.gif)
Fig. 3.
Percentage of children below Estimated Average Requirement (EAR). ∗: Nutrient intake of male subjects are significantly different from those of female subjects by Student t-test at α = 0.05 level.
![kjn-45-372f3.tif](/upload/SynapseXML/0124kjn/thumb/kjn-45-372f3.gif)
Table 1.
The first tentative checklist of 36 food frequency and food behavior items for the nutrient survey for children
Table 2.
Anthropometric characteristics of the children
Total (n = 341) | Male (n = 185) | Female (n = 156) | p-value 1) | |
---|---|---|---|---|
Height (cm) | 145.5 ± 10.2 2) | 145.3 ± 7.4 | 145.8 ± 12.8 | NS 3) |
Weight (Kg) | 43.2 ± 10.2 | 44.1 ± 10.6 | 42.2 ± 9.5 | NS |
BMI (Kg/m 2) | 20.1 ± 3.4 | 20.7 ± 3.5∗ | 19.5 ± 3.2 | 0.001 |
% body fat | 26.2 ± 8.0 | 26.4 ± 8.4 | 26.0 ± 7.4 | NS |
Body weight | NS | |||
Under weight (%) | 1.5 | 1.1 | 1.9 | |
Normal (%) | 73.9 | 70.8 | 77.6 | |
Over weight (%) | 12.9 | 14.6 | 10.9 | |
Obesity (%) | 11.7 | 13.5 | 9.6 |
Table 3.
Nutrient intakes of the children
Total (n = 341) | Male (n = 185) | Female (n = 156) | p-value 1) | |
---|---|---|---|---|
Energy (kcal) | 1579 ± 406 2) | 1631 ± 442 | 1517 ± 350 | 0.009 |
Protein (g) | 58.1 ± 20.4 | 60.9 ± 22.8 | 54.7 ± 16.5 | 0.004 |
Fat (g) | 44.7 ± 19.1 | 46.1 ± 20.0 | 42.9 ± 18.0 | NS 3) |
Carbohydrate (g) | 236.0 ± 57.5 | 242.8 ± 60.3 | 228.1 ± 53.1 | 0.018 |
Dietary Fiber (g) | 12.8 ± 3.8 | 12.7 ± 3.9 | 12.9 ± 3.7 | NS |
Ca (mg) | 545.6 ± 219.2 | 568.9 ± 234.6 | 517.9 ± 196.6 | 0.030 |
P (mg) | 836.8 ± 265.3 | 868.5 ± 282.8 | 799.2 ± 238.3 | 0.015 |
Fe (mg) | 9.8 ± 5.5 | 9.9 ± 4.6 | 9.8 ± 6.5 | NS |
Na (mg) | 2509 ± 971 | 2526 ± 1045 | 2489 ± 878 | NS |
K (mg) | 1956 ± 597 | 1979 ± 656 | 1928 ± 518 | NS |
Zn (mg) | 7.5 ± 2.5 | 7.8 ± 2.7 | 7.2 ± 2.1 | 0.012 |
Vitamin A (μgRE) | 567.6 ± 361.1 | 596.8 ± 456.5 | 533.0 ± 191.0 | NS |
Vitamin B1 (mg) | 0.98 ± 0.44 | 0.99 ± 0.44 | 0.97 ± 0.44 | NS |
Vitamin B2 (mg) | 1.06 ± 0.42 | 1.10 ± 0.46 | 1.01 ± 0.37 | NS |
Vitamin B6 (mg) | 1.96 ± 0.91 | 1.96 ± 0.96 | 1.97 ± 0.85 | NS |
Niacin (mg) | 11.8 ± 5.9 | 12.2 ± 6.7 | 11.5 ± 4.6 | NS |
Vitamin C (mg) | 49.5 ± 31.4 | 47.8 ± 30.9 | 51.6 ± 32.1 | NS |
Folate (μg DFE) | 153.2 ± 68.7 | 152.3 ± 75.7 | 154.2 ± 59.5 | NS |
Vitamin E (mg) | 9.0 ± 4.5 | 9.3 ± 4.5 | 8.8 ± 4.5 | NS |
Cholesterol (mg) | 299.2 ± 180.1 | 317.7 ± 192.7 | 277.3 ± 161.8 | 0.036 |
Table 4.
Nutrient intakes per 1,000 kcal of the children
Total (n = 341) | Male (n = 185) | Female (n = 156) | p-value 1) | |
---|---|---|---|---|
Protein (g) | 36.6 ± 7.0 2) | 37.2 ± 7.7 | 36.0 ± 6.0 | NS 3) |
Fat (g) | 27.6 ± 7.1 | 27.5 ± 6.7 | 27.7 ± 7.6 | NS |
Carbohydrate (g) | 151.3 ± 19.3 | 150.8 ± 18.3 | 151.8 ± 20.4 | NS |
Dietary Fiber (g) | 8.3 ± 2.2 | 8.0 ± 2.1 | 8.6 ± 2.2 | 0.004 |
Ca (mg) | 353.6 ± 125.7 | 359.8 ± 132.3 | 346.3 ± 117.6 | NS |
P (mg) | 533.0 ± 104.4 | 536.7 ± 105.2 | 528.5 ± 103.6 | NS |
Fe (mg) | 6.3 ± 3.3 | 6.1 ± 2.1 | 6.5 ± 4.2 | NS |
Na (mg) | 1612 ± 510 | 1576 ± 534 | 1653 ± 480 | NS |
K (mg) | 1268 ± 352 | 1237 ± 328 | 1304 ± 377 | NS |
Zn (mg) | 4.8 ± 0.9 | 4.8 ± 1.0 | 4.8 ± 0.8 | NS |
Vitamin A (μgRE) | 368.1 ± 198.8 | 377.0 ± 247.9 | 357.5 ± 116.3 | NS |
Vitamin B1 (mg) | 0.61 ± 0.19 | 0.61 ± 0.18 | 0.63 ± 0.20 | NS |
Vitamin B2 (mg) | 0.67 ± 0.18 | 0.67 ± 0.19 | 0.67 ± 0.17 | NS |
Vitamin B6 (mg) | 1.24 ± 0.47 | 1.19 ± 0.43 | 1.30 ± 0.50 | 0.034 |
Niacin (mg) | 7.4 ± 2.5 | 7.3 ± 2.9 | 7.5 ± 2.0 | NS |
Vitamin C (mg) | 32.5 ± 21.3 | 30.7 ± 21.2 | 34.6 ± 21.3 | NS |
Folate (μg DFE) | 99.8 ± 42.7 | 96.2 ± 44.6 | 104.1 ± 40.0 | NS |
Vitamin E (mg) | 5.8 ± 2.6 | 5.8 ± 2.5 | 5.8 ± 2.7 | NS |
Cholesterol (mg) | 187.9 ± 102.6 | 191.5 ± 104.0 | 183.6 ± 101.0 | NS |
Table 5.
Mean scores and significant correlations of the food frequency checklist items with dietary quality variables by the 10 to 11 years-old children 1)
Food frequency items | Mean scores (± SD)(n = 341) | Correlation coefficients with nutrient intakes 56) and other variables (n = 341) |
---|---|---|
Intake frequency of cooked rice with | 2.64 ± 0.99 2) | 0.130 (Dietary fiber) 5) |
whole grain | 0.120 (Potassium) 5) | |
Number of vegetables in each meal | 3.54 ± 0.63 2) | 0.130 (Sodium) 5) |
0.131 (Vitamin C) 6) | ||
Intake frequency of Kimchi | 4.50 ± 0.87 3) | 0.130 (Energy) |
0.107 (Dietary fiber) 6) | ||
0.131 (Calcium) 6) | ||
0.143 (Sodium)6) | ||
0.108 (Potassium) 6) | ||
0.137 (Vitamin C) 6) | ||
0.111 (Folate) 5) | ||
0.173 (DVS) 7) | ||
Intake frequency of fruits | 3.56 ± 1.11 3) | 0.131 (Dietary fiber) 5) |
0.115 (Calcium) 6) | ||
0.150 (Potassium) 5) | ||
0.186 (Vitamin C)5) | ||
-0.120 (% body fat) | ||
0.168 (DVS) | ||
0.155 (DDS) 8) | ||
Intake frequency of white milk | 4.04 ± 0.94 3) | 0.316 (Calcium)5) |
0.160 (Potassium) 5) | ||
0.262 (Riboflavin) 5) | ||
0.139 (DDS) | ||
Intake frequency of legumes | 2.79 ± 1.12 2) | 0.120 (Sodium)5) |
0.150 (Potassium)5) | ||
0.107 (Riboflavin) 5) | ||
0.140 (Vitamin C) 5) | ||
Intake frequency of fish or shellfish | 2.30 ± 0.79 2) | 0.108 (Sodium)6) |
Intake frequency of egg | 2.75 ± 0.94 2) | 0.170 (Energy) |
-0.121 (Dietary fiber) 5) | ||
0.131 (Protein)6) | ||
0.206 (Calcium) 6) | ||
0.136 (Sodium) 6) | ||
0.122 (Potassium) 6) | ||
0.124 (Vitamin A) 6) | ||
0.122 (Riboflavin)6) | ||
Intake frequency of sweet food | 3.36 ± 0.95 3,4) | -0.151 (Energy) |
(cookies, chocolate, candy etc.) | -0.140 (Dietary fiber) 6) | |
0.186 (Protein) 5) | ||
0.192 (Calcium)5) | ||
0.116 (Vitamin A)5) | ||
Intake frequency of fast food | 4.52 ± 0.65 3,4) | -0.126 (DVS) -0.202 (Energy) |
(Pizza, hamburger etc.) | 0.126 (Protein) 5) | |
0.194 (Calcium)5) | ||
0.170 (Potassium) 5) | ||
0.128 (Vitamin A) 5) | ||
0.126 (Vitamin C) 5) | ||
Intake frequency of oily food | 4.04 ± 0.60 3,4) | -0.130 (Energy) |
(bacon, fried food, fried chicken etc.) | 0.197 (Dietary fiber) 5) | |
0.130 (Sodium) 5) | ||
0.180 (Potassium) 5) | ||
0.121 (Vitamin C) 5) | ||
0.145 (Folate)5) | ||
Intake frequency of ramyeon | 3.93 ± 0.66 3,4) | -0.110 (Energy) |
0.170 (Dietary fiber) 5) | ||
0.138 (Calcium)5) | ||
0.190 (Potassium) 5) | ||
0.163 (Vitamin A)5) | ||
0.111 (Vitamin C) 5) |
Table 6.
Mean scores and significant correlations of the food behavior checklist items with dietary quality variables by the 10 to 11 years-old children 1)
Food behavior items | Mean scores (± SD)(n = 341) | Correlation coefficients with nutrient intakes 5,6) and other variables (n = 341) |
---|---|---|
Eating breakfast | 3.49 ± 0.92 2) | -0.110 (Energy) |
-0.112 (Protein) 6) | ||
-0.116 (Sodium) 6) | ||
-0.119 (BMI) | ||
-0.118 (DVS) | ||
Meal regularity | 2.94 ± 0.85 2) | -0.173 (Calcium) 5) |
-0.119 (Sodium)6) | ||
-0.146 (Potassium) 6) | ||
Diverse side dishes | 3.08 ± 0.79 2) | -0.122 (Dietary fiber) 5) |
-0.140 (Sodium)5) | ||
-0.117 (Vitamin C) 5) | ||
Chewing well | 3.17 ± 0.82 2) | -0.110 (Energy) 5) |
-0.116 (Calcium)5) | ||
-0.120 (Potassium) 5) | ||
-0.133 (Zinc)5) | ||
-0.148 (BMI) | ||
Frequent eating late-night snack | 3.21 ± 0.97 2,4) | -0.127 (Protein) 5) |
-0.137 (Calcium) 5) | ||
Time for TV watching & | 1.93 ± 0.89 2,4) | -0.160 (Energy) |
computer game | -0.116 (Dietary fiber) 5) | |
-0.212 (Calcium) 5) | ||
Frequency of eating street food | 3.12 ± 0.82 2,4) | -0.210 (Energy) |
-0.117 (Protein)6) | ||
-0.114 (Fat) 5) | ||
-0.122 (Calcium)5) | ||
-0.134 (Iron) 6) | ||
-0.151 (Sodium)6) | ||
-0.117 (Zinc) 6) | ||
-0.125 (Vitamin A)5) | ||
-0.117 (Riboflavin) 6) | ||
Checking nutrition labeling | 2.15 ± 0.91 2) | -0.158 (Calcium) 5) |
-0.132 (BMI) | ||
-0.136 (% body fat) | ||
Washing hands before meal | 3.27 ± 0.75 2) | -0.116 (Protein) 5) |
-0.140 (Calcium) 5) | ||
-0.140 (Potassium) 5) | ||
-0.133 (Vitamin C) 5) | ||
Time for exercise | 3.22 ± 0.83 2) | -0.134 (Vitamin C) 6) |
1) The following 8 of the 18 food behavior checklist items did not show correlations with nutrients intake per 1,000 kcal or % Korean DRI (RNI or AI) of the nutrient intakes of the children: proper amount of meal, eating at table, enough meal time, eating alone, enjoying meal time, frequency of snacks, taking dietary supplements, taking nutrition education class
Table 7.
Factor loading coefficients of the survey data with 22 checklist items for NQ
Table 8.
Factor loading coefficients of final 19 NQ checklist items