The Association of Food Label Use with Objective and Subjective Obesity among a Korean Population

In Sook Lee; Kowoon Lee

doi:10.12799/jkachn.2016.27.3.262

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Lee and Lee: The Association of Food Label Use with Objective and Subjective Obesity among a Korean Population

Original Article

J Korean Acad Community Health Nurs 2016;27(3):262-271.

Published online: 12 September 2016

DOI: https://doi.org/10.12799/jkachn.2016.27.3.262

The Association of Food Label Use with Objective and Subjective Obesity among a Korean Population

In Sook Lee¹, Kowoon Lee²

¹College of Nursing, Soeul National University, Seoul, Korea

²Department of Nursing, SuwonWomen's University, Suwon, Korea

Corresponding author: Lee, In Sook College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82-2-740-8828, Fax: +82-2-765-4103, E-mail: lisook@snu.ac.kr

Received 4 July 2016 Revised 29 August 2016 Accepted 7 September 2016

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.

Abstract

Purpose

Using food labels has been related to healthy eating habits and positive health outcomes. The purpose of this study is to describe the prevalence of food labels utilization and the association between food label use and obesity related factors.

Methods

We conducted a self-reported population-based survey including health behaviors, 24-hour recalls, measurements of body mass indices with 6,266 Koreans aged 10 or older. x²-test and ANOVA examined differences in demographic factors, health behavioral factors, and nutrition factors in tandem with food label use categories. Multivariates logistic regression was used to estimate association between food label use and obesity factors.

Results

The percentages of food label users and non-users who perceive food labels were 21.8% and 48.5% respectively. In the multivariate logistic regression, food label use had significant positive associations with women, age, income, education attainment, and subjective obesity. After adjusting for socioeconomic factors and dietetic treatments, the positive associations between food label use and subjective obesity, weight control, and subjective obesity with objective normal weight remained.

Conclusion

In order to improve eating habits and weight management, the obesity population that does not use food labels needs to receive proper nutrition education including food choice and body image correction.

Keywords: Obesity, Body image, Food labelling

References

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Table 1.

General Characteristics of the Participants

Characteristics	Categories	Total participants	Group 1	Group 2	Group 3	p
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	D n (%) or M±SD	p
Gender		6,266 (100.0)	1,366 (21.8)	3,040 (48.5)	1,860 (29.7)	＜.001
	Male	2,695 (43.0)	371 (13.8)	1,437 (53.3)	887 (32.9)
	Female	3,571 (57.0)	995 (27.9)	1,603 (44.9)	973 (27.2)
Age (year)		45.6±179.74	38.2±15.24	41.0±19.75	60.1±21.82	＜.001
Age groups	＜20	1,011 (16.1)	182 (18.0)	621 (61.4)	208 (20.6)	＜.001
	20~29	508 (8.1)	202 (39.8)	283 (55.7)	23 (4.5)
	30~39	908 (14.5)	354 (39.0)	499 (55.0)	55 (6.0)
	40~49	898 (14.3)	304 (33.8)	501 (55.8)	93 (10.4)
	50~59	993 (15.9)	207 (20.9)	539 (54.3)	247 (24.8)
	60~69	921 (14.7)	89 (9.7)	372 (40.3)	460 (50.0)
	＞70	1,027 (16.4)	28 (2.7)	225 (21.9)	774 (75.4)
Equal income	25%	1,552 (24.9)	277 (17.9)	701 (45.1)	574 (37.0)	＜.001
	50%	1,566 (25.1)	340 (21.7)	745 (47.6)	481 (30.7)
	75%	1,545 (24.8)	350 (22.7)	767 (49.6)	428 (27.7)
	100%	1,572 (25.2)	396 (25.2)	817 (52.0)	359 (22.8)
Educational level	≤Elementary school	1,797 (33.7)	142 (7.9)	699 (38.9)	956 (53.2)	＜.001
	Middle school	675 (12.7)	114 (16.9)	355 (52.6)	206 (30.5)
	High school	1,457 (27.3)	410 (28.1)	811 (55.7)	236 (16.2)
	≥College	1,404 (26.3)	514 (36.6)	760 (54.1)	130 (9.3)

Group 1: A person who perceived food label and use food label when he (she) chooses a food; Group 2: A person who perceived food label. But he (she) doesn't use food label; Group 3: A person who do not perceive food label.

Table 2.

Results of Health Status and Health Behaviors of the Participants

Variables	Categories	Total participants	Group 1	Group 2	Group 3	p
Variables	Categories	n(%)	n(%)	n(%)	n(%)	p
Smoking	Current smoker	825 (15.0)	131 (15.9)	452 (54.8)	242 (29.3)	＜.001
	Past smoker	897 (16.3)	142 (15.8)	411 (45.8)	344 (38.4)
	Non-smoker	3,781 (68.7)	941 (24.9)	1,856 (49.1)	984 (26.0)
Alcohol consumption	No	2,672 (52.6)	611 (22.9)	1,237 (46.3)	824 (30.8)	＜.001
Alcohol consumption	Yes	2,409 (47.4)	561 (23.3)	1,257 (52.2)	591 (24.5)
Walking habit	No	2,942 (60.0)	649 (22.1)	1,424 (48.4)	869 (29.5)	＜.001
Walking habit	Yes	1,957 (40.0)	486 (24.8)	974 (49.8)	497 (25.4)
Stress	No	3,875 (76.4)	828 (21.4)	1,918 (49.5)	1,129 (29.1)	＜.001
Stress	Yes	1,197 (23.6)	344 (28.7)	575 (48.0)	278 (23.3)
Subjective health	No	3,492 (64.9)	729 (20.9)	1,611 (46.1)	1,152 (33.0)	＜.001
Subjective health	Yes	1,886 (35.1)	451 (23.9)	1,019 (54.0)	416 (22.1)
Hypertension	No	3,120 (69.3)	871 (27.9)	1,586 (50.8)	663 (21.3)	＜.001
Hypertension	Yes	1,385 (30.7)	161 (11.6)	510 (36.8)	714 (51.6)
Hypercholesterolemia	No	3,845 (85.9)	939 (24.4)	1,974 (51.3)	932 (24.3)	＜.001
Hypercholesterolemia	Yes	632 (14.1)	120 (19.0)	278 (44.0)	234 (37.0)
Hypertriglyceridemia	No	3,280 (86.2)	800 (24.4)	1,609 (49.1)	871 (26.5)	＜.001
Hypertriglyceridemia	Yes	524 (13.8)	94 (17.9)	255 (48.7)	175 (33.4)
Anemia	No	4,535 (92.6)	1,065 (23.5)	2,305 (50.8)	1,165 (25.7)	＜.001
Anemia	Yes	362 (7.4)	88 (24.3)	141 (39.0)	133 (36.7)

Table 3.

Results for Nutrition Intake

Variables		Total participants	Group 1	Group 2	Group 3	p
Variables		n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	p
Total energy (kcal)		1,999.81±176.34	2,024.36±839.98	2,102.82±926.56	1,815.80±864.67	＜.001
Water (mL)		1,086.24±124.51	1,191.33±653.57	1,158.26±717.28	893.66±633.71	＜.001
Protein (g)		68.88±139.07	71.98±36.15	74.15±42.10	58.13±34.11	＜.001
Fat (g)		44.03±98.92	49.99±33.55	48.94±36.54	31.73±31.07	＜.001
Carbohydrate (g)		311.00±188.75	303.67±126.05	318.66±133.72	304.08±127.90	＜.001
Calcium (mg)		481.52±122.37	502.03±287.89	507.73±316.51	424.64±313.56	＜.001
Sodium (mg)		3,780.40±100.39	3,860.42±2,639.42	4,051.73±3,370.20	3,286.19±2,440.10	＜.001
Vitamin C (mg)		102.33±65.51	113.22±142.82	104.86±121.09	90.33±111.61	＜.001
Dietetic	Yes	1,291 (20.6)	427 (33.1)	573 (44.4)	291 (22.5)	＜.001
treatment	No	4,965 (79.4)	939 (18.9)	2,458 (49.5)	1,568 (31.6)
Nutritional	No	5,801 (92.6)	1,245 (21.5)	2,787 (48.0)	1,769 (30.5)	＜.001
education	Yes	465 (7.4)	121 (26.0)	253 (54.4)	91 (19.6)
Meal	One	89 (2.6)	34 (38.2)	43 (48.3)	12 (13.5)	＜.001
frequency	Two	1,462 (42.8)	468 (32.0)	828 (56.6)	166 (11.4)
	≥Three	1,863 (54.6)	547 (29.4)	999 (53.6)	317 (17.0)

Table 4.

Results of Obesity

Variables	Categories	Total participants	Group 1	Group 2	Group 3	p
Variables	Categories	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	p
BMI		23.08±3.77	23.02±3.69	22.97±3.87	23.24±3.69	.070
Subjective obesity	Lower weight	1,061 (19.3)	162 (15.3)	520 (49.0)	379 (35.7)	＜.001
	Normal weight	2,253 (40.9)	486 (21.6)	1,072 (47.5)	695 (30.9)
	Obesity	2,194 (39.8)	566 (25.8)	1,127 (51.4)	501 (22.8)
Objective obesity	Lower weight	211 (4.2)	59 (28.0)	100 (47.4)	52 (24.6)	＜.001
	Normal weight	3,194 (64.1)	774 (24.2)	1,444 (45.2)	976 (30.6)
	Obesity	1,575 (31.7)	281 (17.8)	746 (47.4)	548 (34.8)
Agreement of obesity^†	Obesity-obesity	1,196 (25.9)	240 (20.1)	611 (51.0)	345 (28.9)	＜.001
	Obesity-normal	256 (5.6)	21 (8.2)	90 (35.2)	145 (56.6)
	Normal-obesity	739 (16.0)	256 (34.6)	367 (49.7)	116 (15.7)
	Normal-normal	2,420 (52.5)	538 (22.2)	1,103 (45.6)	779 (32.2)
Weight control	No	2,045 (37.1)	247 (12.1)	986 (48.2)	812 (39.7)
Weight control	Yes	3,462 (62.9)	967 (27.9)	1,733 (50.1)	762 (22.0)

^† Agreement of obesity; the agreement between subjective and objective obesity; Obesity-obesity: the person who is objective obesity and subjective obesity; Obesity-normal: the person who is objective obesity and subjective normal weight; Normal-obesity: the person who is objective normal weight and subjective obesity; Normal-normal: the person who is objective normal weight and normal weight.

Table 5.

Association between Food Labels Utilization and Obesity

Variables	Categories	Model 1		Model 2		Model 3
Variables	Categories	OR (95%CI)	p	OR (95%CI)	p	OR (95%CI)	p
Subjective obesity	Lower weight	0.75 (0.65~0.86)	＜.001	0.83 (0.69~1.01)	＜.001	0.81 (0.70~0.95)	＜.001
	Normal weight	ref		ref		ref
	Obesity	1.39 (1.24~1.56)		1.28 (1.08~1.50)		1.13 (1.01~1.27)
Objective obesity	Lower weight	1.28 (0.99~1.66)	＜.001	1.00 (0.61~1.64)	.110	0.80 (0.59~1.09)	＜.001
	Normal weight	ref		ref		ref
	Obesity	0.77 (0.69~0.86)		0.92 (0.78~1.09)		0.89 (0.78~1.01)
Agreement of obesity	Obesity-obesity	1.04 (0.91~1.19)	＜.001	1.06 (0.87~1.28)	＜.001	1.00 (0.86~1.15)	.005
	Obesity-normal	0.34 (0.27~0.44)		0.76 (0.55~1.03)		0.71 (0.53~0.94)
	Normal-obesity	2.13 (1.82~2.49)		1.46 (1.11~1.91)		1.23 (1.03~1.47)
	nOrmal-normal	ref		ref		ref
Weight control	No	ref	＜.001	ref	＜.001	ref	＜.001
Weight control	Yes	2.49 (2.24~2.77)		1.56 (1.35~1.81)		1.67 (1.48~1.88)

OR=odds ratio; CI=confidential interval; Model 1: unadjusted model; Model 2: adjusted for age, sex, income and education level; Model 3: adjusted for age, sex, income, education level and dietetic treatment.

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