Hye-Jin Lee; Jin Hee Kim; SuJin Song

doi:10.4163/jnh.2019.52.2.194

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Lee, Kim, and Song: Assessment of dietary behaviors among preschoolers in Daejeon: using Nutrition Quotient for Preschoolers (NQ-P)∗

Research Article

J Nutr Health 2019;52(2):194-205.

Published online: 19 January 2019

DOI: https://doi.org/10.4163/jnh.2019.52.2.194

Assessment of dietary behaviors among preschoolers in Daejeon: using Nutrition Quotient for Preschoolers (NQ-P)^∗

Hye-Jin Lee¹, Jin Hee Kim^1,², SuJin Song^2,^†

¹Daedeokgu Center for Children's Foodservice Management, Daejeon 34430, Korea

²Department of Food and Nutrition, Hannam University, Daejeon 34054, Korea

^† To whom correspondence should be addressed. tel: +82-42-629-8791, e-mail: sjsong@hnu.kr

^∗ This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT; Ministry of Science and ICT) (Grant No. NRF-2017R1C1B5017637) and 2018 Hannam University Research fund.

Received 21 January 2019 Revised 19 March 2019 Accepted 25 March 2019

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:

The aim of this study was to evaluate the dietary behaviors of preschoolers in Daejeon using the Nutrition Quotient for Preschoolers (NQ-P).

Methods:

The study subjects were recruited from childcare centers and kindergartens located in Daedeokgu, Daejeon between August and September 2018. A total of 411 preschoolers aged 3~6 years were included in the data analyses. A questionnaire of NQ-P, which consisted of 14 checklist items on dietary behaviors, was completed by the parents or guardians of the study subjects. The NQ-P scores and its three factors, including “balance”, “moderation”, and “environment” factors, were calculated according to sex, age, and weight status. Differences in the NQ-P scores and their factors according to sex, age, and weight status were tested using a student's t-test.

Results:

The mean NQ-P score of the total subjects was 58.5 ± 9.2, which was within the medium-low grade. The NQ-P score was 58.5 ± 9.4 in boys and 58.6 ± 9.0 in girls (p=0.955). The NQ-P score was similar regardless of the age groups (57.8 ± 9.4 in 3~4 years vs. 59.2 ± 9.0 in 5~6 years, p=0.124), whereas subjects aged 5~6 years showed a significantly higher scores of environment factors than those aged 3~4 years (67.9 ± 16.8 vs. 61.7 ± 17.3). The mean score of the moderation factor was lower in the overweight/obese children compared to the non-overweight/obese children (46.6 ± 13.3 vs. 51.0 ± 16.2, p=0.012). Compared to children aged 3~4 years, children aged 5~6 years had higher intakes of vegetable dishes and processed meat. The overweight/obese group showed a higher consumption of processed beverages than the non-overweight/obese group.

Conclusion:

The current study indicates that the dietary behaviors of preschoolers residing in Daejeon need to be improved. These findings suggest that nutrition education or health interventions targeting young children is necessary for improving their nutritional health status.

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Keywords: nutrition quotient, eating behaviors, dietary habits, preschool children, Korean

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Table 1.

Characteristics of the study subjects

Variables	n	%
Sex
Boys	218	53.0
Girls	193	47.0
Age
3 yrs	33	8.0
4 yrs	159	38.7
5 yrs	122	29.7
6 yrs	97	23.6
Mean ± SD	5.1 ± 0.9 yrs
Main meal planner
Mother	324	78.8
Father	6	1.5
Grandparents	43	10.5
Mother and father	26	6.3
Mother and grandparents	11	2.7
Father and grandparents	1	0.2
Physical activity
Never	27	6.6
1 ~ 2 times per week	176	42.8
3 ~ 4 times per week	123	29.9
5 ~ 6 times per week	47	11.4
Every day	38	9.2
Weight status¹⁾
Underweight	31	7.5
Normal weight	299	72.8
Overweight	39	9.5
Obese	42	10.2

1)Weight status for children was categorized into four groups according to sex- and age-specific BMI percentile from the 2017 Korean national growth chart: underweight (body weight < 5^th percentiles), normal weight (5^th ≤ BMI < 85^th percentiles), overweight (85^th ≤ BMI < 95^th percentiles), and obese (BMI ≥ 95^th percentiles).

Table 2.

Scores of Nutrition Quotient for Preschoolers (NQ-P) and its factors by sex, age, and weight status

Variables	Total	Boys	Girls	p-value¹⁾	3 ~ 4 yrs	5 ~ 6 yrs	p-value¹⁾	Non-OW/OB	OW/OB	p-value¹⁾
	(n = 411)	(n = 218)	(n = 193)		(n = 192)	(n = 219)		(n = 330)	(n = 81)
	Mean ± SD	Mean ± SD	Mean ± SD		Mean ± SD	Mean ± SD		Mean ± SD	Mean ± SD
NQ-P score	58.5 ± 9.2	58.5 ± 9.4	58.6 ± 9.0	0.955	57.8 ± 9.4	59.2 ± 9.0	0.124	58.8 ± 9.5	57.4 ± 7.7	0.150
Balance	60.5 ± 12.6	61.0 ± 12.8	60.0 ± 12.3	0.436	60.2 ± 12.2	60.8 ± 12.9	0.670	60.3 ± 12.9	61.6 ± 11.3	0.396
Moderation	50.2 ± 15.7	49.9 ± 15.9	50.4 ± 15.6	0.767	50.9 ± 16.3	49.5 ± 15.2	0.360	51.0 ± 16.2	46.6 ± 13.3	0.012
Environment	65.0 ± 17.3	64.4 ± 16.8	65.7 ± 17.9	0.421	61.7 ± 17.3	67.9 ± 16.8	< 0.001	65.6 ± 17.3	62.6 ± 17.1	0.171

OW/OB, overweight/obese

1) p-values were obtained from the t-test.

Table 3.

Checklist items for the balance factor by sex, age, and weight status

Variables	Total		Boys		Girls		p-value¹⁾	3 ~ 4 yrs		5 ~ 6 yrs		p-value¹⁾	Non-OW/OB		OW/OB		p-value¹⁾
	(n = 411)		(n = 218)		(n = 193)			(n = 192)		(n = 219)			(n = 330)		(n = 81)
	n	%	n	%	n	%		n	%	n	%		n	%	n	%
Number of vegetable dishes at each meal (including Kimchi)
≤ 1	100	24.3	58	26.6	42	21.8	0.689	59	30.7	41	18.7	0.030	76	23.0	24	29.6	0.549
2	201	48.9	102	46.8	99	51.3		88	45.8	113	51.6		165	50.0	36	44.4
3	94	22.9	50	22.9	44	22.8		40	20.8	54	24.7		75	22.7	19	23.5
≥ 4	16	3.9	8	3.7	8	4.2		5	2.6	11	5.0		14	4.2	2	2.5
Intake frequency of white milk
Never	19	4.6	10	4.6	9	4.7	0.573	8	4.2	11	5.0	0.333	16	4.9	3	3.7	0.207
Once per week	45	11.0	22	10.1	23	11.9		24	12.5	21	9.6		37	11.2	8	9.9
3 ~ 4 times per week	136	33.1	69	31.7	67	34.7		58	30.2	78	35.6		110	33.3	26	32.1
1 ~ 2 times a day	174	42.3	92	42.2	82	42.5		84	43.8	90	41.1		138	41.8	36	44.4
3 times a day	23	5.6	16	7.3	7	3.6		14	7.3	9	4.1		15	4.6	8	9.9
≥ 4 times a day	14	3.4	9	4.1	5	2.6		4	2.1	10	4.6		14	4.2	0	0.0
Intake frequency of beans and bean products
Never	26	6.3	15	6.9	11	5.7	0.549	17	8.9	9	4.1	0.231	25	7.6	1	1.2	0.422
Once per month	23	5.6	11	5.1	12	6.2		10	5.2	13	5.9		19	5.8	4	4.9
Once every 2 weeks	43	10.5	27	12.4	16	8.3		24	12.5	19	8.7		33	10.0	10	12.4
Once per week	151	36.7	80	36.7	71	36.8		69	35.9	82	37.4		119	36.1	32	39.5
3 ~ 4 times per week	142	34.6	69	31.7	73	37.8		59	30.7	83	37.9		114	34.6	28	34.6
≥ Once a day	26	6.3	16	7.3	10	5.2		13	6.8	13	5.9		20	6.1	6	7.4
Intake frequency of meat
Never	1	0.2	1	0.5	0	0.0	0.217	0	0.0	1	0.5	0.361	0	0.0	1	1.2	0.176
Once per month	10	2.4	5	2.3	5	2.6		4	2.1	6	2.7		10	3.0	0	0.0
Once every 2 weeks	13	3.2	7	3.2	6	3.1		3	1.6	10	4.6		9	2.7	4	4.9
Once per week	91	22.1	39	17.9	52	26.9		39	20.3	52	23.7		76	23.0	15	18.5
3 ~ 4 times per week	241	58.6	132	60.6	109	56.5		118	61.5	123	56.2		191	57.9	50	61.7
≥ Once a day	55	13.4	34	15.6	21	10.9		28	14.6	27	12.3		44	13.3	11	13.6
Intake frequency of fish
Never	5	1.2	3	1.4	2	1.0	0.180	3	1.6	2	0.9	0.693	4	1.2	1	1.2	0.940
Once per month	42	10.2	24	11.0	18	9.3		17	8.9	25	11.4		34	10.3	8	9.9
Once every 2 weeks	85	20.7	42	19.3	43	22.3		38	19.8	47	21.5		69	20.9	16	19.8
Once per week	185	45.0	96	44.0	89	46.1		93	48.4	92	42.0		146	44.2	39	48.2
3 ~ 4 times per week	87	21.2	46	21.1	41	21.2		39	20.3	48	21.9		72	21.8	15	18.5
≥ Once a day	7	1.7	7	3.2	0	0.0		2	1.0	5	2.3		5	1.5	2	2.5

OW/OB, overweight/obese

1) p-values were obtained from the chi-square test.

Table 4.

Checklist items for the moderation factor by sex, age, and weight status

Variables	Total		Boys		Girls		p-value¹⁾	3 ~ 4 yrs		5 ~ 6 yrs		p-value¹⁾	Non-OW/OB		OW/OB		p-value¹⁾
	(n = 411)		(n = 218)		(n = 193)			(n = 192)		(n = 219)			(n = 330)		(n = 81)
	n	%	n	%	n	%		n	%	n	%		n	%	n	%
Intake frequency of processed meat such as ham and sausage
Never	15	3.7	11	5.1	4	2.1	0.258	13	6.8	2	0.9	0.043	14	4.2	1	1.2	0.650
Once per month	36	8.8	17	7.8	19	9.8		18	9.4	18	8.2		28	8.5	8	9.9
Once per 2 weeks	62	15.1	27	12.4	35	18.1		29	15.1	33	15.1		53	16.1	9	11.1
Once per week	180	43.8	97	44.5	83	43.0		82	42.7	98	44.8		143	43.3	37	45.7
3 ~ 4 times per week	108	26.3	59	27.1	49	25.4		47	24.5	61	27.9		84	25.5	24	29.6
≥ Once a day	10	2.4	7	3.2	3	1.6		3	1.6	7	3.2		8	2.4	2	2.5
Intake frequency of fast foods such as pizza and hamburger
Never	62	15.1	27	12.4	35	18.1	0.361	33	17.2	29	13.2	0.340	51	15.5	11	13.6	0.933
Once per month	205	49.9	116	53.2	89	46.1		99	51.6	106	48.4		162	49.1	43	53.1
Once per 2 weeks	95	23.1	50	22.9	45	23.3		41	21.4	54	24.7		78	23.6	17	21.0
Once per week	48	11.7	24	11.0	24	12.4		18	9.4	30	13.7		38	11.5	10	12.4
3 ~ 4 times per week	1	0.2	1	0.5	0	0.0		1	0.5	0	0.0		1	0.3	0	0.0
Intake frequency of snacks, sweet, and greasy baked goods
Never	4	1.0	2	0.9	2	1.0	0.901	2	1.0	2	0.9	0.268	3	0.9	1	1.2	0.579
Once per week	94	22.9	54	24.8	40	20.7		38	19.8	56	25.6		80	24.2	14	17.3
3 ~ 4 times per week	165	40.2	84	38.5	81	42.0		75	39.1	90	41.1		130	39.4	35	43.2
Once a day	125	30.4	66	30.3	59	30.6		62	32.3	63	28.8		100	30.3	25	30.9
≥ 2 times a day	23	5.6	12	5.5	11	5.7		15	7.8	8	3.7		17	5.2	6	7.4
Intake frequency of processed beverages
Never	28	6.8	17	7.8	11	5.7	0.210	15	7.8	13	5.9	0.817	25	7.6	3	3.7	0.018
Once per month	77	18.7	43	19.7	34	17.6		36	18.8	41	18.7		67	20.3	10	12.4
Once per 2 weeks	73	17.8	32	14.7	41	21.2		35	18.2	38	17.4		64	19.4	9	11.1
Once per week	143	34.8	75	34.4	68	35.2		65	33.9	78	35.6		111	33.6	32	39.5
3 ~ 4 times per week	65	15.8	33	15.1	32	16.6		27	14.1	38	17.4		44	13.3	21	25.9
≥ Once a day	25	6.1	18	8.3	7	3.6		14	7.3	11	5.0		19	5.8	6	7.4

OW/OB, overweight/obese

1) p-values were obtained from the chi-square test.

Table 5.

Checklist items for the environment factor by sex, age, and weight status

Variables	Total		Boys		Girls		p-value¹⁾	3 ~ 4 yrs		5 ~ 6 yrs		p-value¹⁾	Non-OW/OB		OW/OB		p-value¹⁾
	(n = 411)		(n = 218)		(n = 193)			(n = 192)		(n = 219)			(n = 330)		(n = 81)
	n	%	n	%	n	%		n	%	n	%		n	%	n	%
Breakfast eating frequency
Never	38	9.3	18	8.3	20	10.4	0.889	19	9.9	19	8.7	0.268	28	8.5	10	12.4	0.105
1 ~ 2 times per week	41	10.0	21	9.6	20	10.4		25	13.0	16	7.3		30	9.1	11	13.6
3 ~ 4 times per week	79	19.2	45	20.6	34	17.6		38	19.8	41	18.7		58	17.6	21	25.9
5 ~ 6 times per week	72	17.5	37	17.0	35	18.1		34	17.7	38	17.4		61	18.5	11	13.6
Every day	181	44.0	97	44.5	84	43.5		76	39.6	105	48.0		153	46.4	28	34.6
Not moving around while eating
Never	11	2.7	7	3.2	4	2.1	0.112	8	4.2	3	1.4	< 0.001	9	2.7	2	2.5	0.046
Seldom	55	13.4	32	14.7	23	11.9		39	20.3	16	7.3		47	14.2	8	9.9
Normal	154	37.5	91	41.7	63	32.6		74	38.5	80	36.5		133	40.3	21	25.9
Often	119	29.0	57	26.2	62	32.1		49	25.5	70	32.0		87	26.4	32	39.5
Always	72	17.5	31	14.2	41	21.2		22	11.5	50	22.8		54	16.4	18	22.2
Efforts to have healthy eating habits
Never	1	0.2	0	0.0	1	0.5	0.136	0	0.0	1	0.5	0.166	0	0.0	1	1.2	0.164
Seldom	4	1.0	1	0.5	3	1.6		2	1.0	2	0.9		3	0.9	1	1.2
Normal	131	31.9	78	35.8	53	27.5		63	32.8	68	31.1		106	32.1	25	30.9
Often	206	50.1	108	49.5	98	50.8		103	53.7	103	47.0		161	48.8	45	55.6
Always	69	16.8	31	14.2	38	19.7		24	12.5	45	20.6		60	18.2	9	11.1
Washing hands before meals
Never	1	0.2	1	0.5	0	0.0	0.239	1	0.5	0	0.0	0.428	1	0.3	0	0.0	0.148
Seldom	19	4.6	9	4.1	10	5.2		11	5.7	8	3.7		17	5.2	2	2.5
Normal	111	27.0	62	28.4	49	25.4		52	27.1	59	26.9		90	27.3	21	25.9
Often	204	49.6	99	45.4	105	54.4		98	51.0	106	48.4		155	47.0	49	60.5
Always	76	18.5	47	21.6	29	15.0		30	15.6	46	21.0		67	20.3	9	11.1
Screen time (watching TV, using smart phones or computer game)
Never	11	2.7	7	3.2	4	2.1	0.429	8	4.2	3	1.4	0.227	11	3.3	0	0.0	0.361
30 min	69	16.8	30	13.8	39	20.2		29	15.1	40	18.3		57	17.3	12	14.8
1 h	126	30.7	71	32.6	55	28.5		57	29.7	69	31.5		103	31.2	23	28.4
2 h	150	36.5	79	36.2	71	36.8		76	39.6	74	33.8		115	34.9	35	43.2
≥ 3 h	55	13.4	31	14.2	24	12.4		22	11.5	33	15.1		44	13.3	11	13.6

OW/OB, overweight/obese

1) p-values were obtained from the chi-square test.

Table 6.

Nutrition Quotient for Preschoolers (NQ-P) grade by sex, age, and weight status

Variables	Total		Boys		Girls		p-value¹⁾	3 ~ 4 yrs		5 ~ 6 yrs		p-value¹⁾	Non-OW/OB		OW/OB		p-value¹⁾
	(n = 411)		(n = 218)		(n = 193)			(n = 192)		(n = 219)			(n = 330)		(n = 81)
	n	%	n	%	n	%		n	%	n	%		n	%	n	%
NQ-P²⁾
Low	113	27.5	61	28.0	52	26.9	0.963	55	28.7	58	26.5	0.595	86	26.1	27	33.3	0.229
Medium-low	136	33.1	72	33.0	64	33.2		68	35.4	68	31.1		107	32.4	29	35.8
Medium-high	81	19.7	41	18.8	40	20.7		34	17.7	47	21.5		66	20.0	15	18.5
High	81	19.7	44	20.2	37	19.2		35	18.2	46	21.0		71	21.5	10	12.4
Balance³⁾
Low	120	29.2	61	28.0	59	30.6	0.102	59	30.7	61	27.9	0.387	98	29.7	22	27.2	0.109
Medium-low	85	20.7	38	17.4	47	24.4		34	17.7	51	23.3		71	21.5	14	17.3
Medium-high	82	20.0	52	23.9	30	15.5		43	22.4	39	17.8		58	17.6	24	29.6
High	124	30.2	67	30.7	57	29.5		56	29.2	68	31.1		103	31.2	21	25.9
Moderation⁴⁾
Low	78	19.0	42	19.3	36	18.7	0.882	33	17.2	45	20.6	0.655	62	18.8	16	19.8	0.004
Medium-low	117	28.5	61	28.0	56	29.0		52	27.1	65	29.7		84	25.5	33	40.7
Medium-high	113	27.5	63	28.9	50	25.9		57	29.7	56	25.6		90	27.3	23	28.4
High	103	25.1	52	23.9	51	26.4		50	26.0	53	24.2		94	28.5	9	11.1
Environment⁵⁾
Low	154	37.5	86	39.5	68	35.2	0.421	88	45.8	66	30.1	0.006	116	35.2	38	46.9	0.117
Medium-low	122	29.7	62	28.4	60	31.1		54	28.1	68	31.1		105	31.8	17	21.0
Medium-high	77	18.7	44	20.2	33	17.1		30	15.6	47	21.5		60	18.2	17	21.0
High	58	14.1	26	11.9	32	16.6		20	10.4	38	17.4		49	14.9	9	11.1

OW/OB, overweight/obese

¹⁾ p-values were obtained from the chi-square test.

²⁾ Low: 0 ~ 53.7, Medium-low: 53.8 ~ 60.7, Medium-high: 60.8 ~ 66.3, High: 66.4 ~ 100

³⁾ Low: 0 ~ 55.0, Medium-low: 55.1 ~ 61.8, Medium-high: 61.9 ~ 67.6, High: 67.7 ~ 100

⁴⁾ Low: 0 ~ 38.2, Medium-low: 38.3 ~ 49.4, Medium-high: 49.5 ~ 61.0, High: 61.1 ~ 100

⁵⁾ Low: 0 ~ 61.4, Medium-low: 61.5 ~ 73.8, Medium-high: 73.9 ~ 83.3, High: 83.4 ~ 100

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