Journal List > J Korean Acad Community Health Nurs > v.27(3) > 1058427

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

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.

References

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Table 1.
General Characteristics of the Participants
Characteristics Categories Total participants
Group 1
Group 2
Group 3
p
n (%) or M±SD n (%) or M±SD n (%) or M±SD D n (%) or M±SD
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
n(%) n(%) n(%) n(%)
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
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
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
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
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
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
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
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
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
n (%) or M±SD n (%) or M±SD n (%) or M±SD n (%) or M±SD
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
n (%) or M±SD n (%) or M±SD n (%) or M±SD n (%) or M±SD
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)  
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
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
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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