Narae Yang

Hong JY, et al. Nutr Res Pract. 2024 Apr;18(2):165-179. https://doi.org/10.4162/nrp.2024.18.2.165

As the community food environment is known to be an important factor in healthy food choices, it needs to be measured, to increase awareness and improve healthy eating. The objective of this study was to develop a perceived community food accessibility measurement (P-CFAM) questionnaire applicable to older adults in Korea and evaluate its reliability and validity. The questionnaire was developed based on community food environment factors that were found to affect food choices in previous studies. We evaluated the internal consistency reliability, construct validity, and criterion-related validity. The subjects were 188 older adults for validity. The Cronbach’s alpha value for the reliability measure was 0.9. The confirmatory factor analysis to evaluate the construct validity of the questionnaire showed values close to those of the optimal model (GFI = 0.983, AGFI = 0.948, RMR = 0.004, NFI = 0.987, CFI = 0.996). Regarding the criterion-related validity, the P-CFAM questionnaire results were significantly related to objective measurement indicators such as the number of grocery stores, the travel time to a grocery store, and the intake of vegetables and fruit. In conclusion, the developed P-CFAM questionnaire was shown to be reliable and valid, and useful for assessing older adults’ perceptions of community food accessibility in Korea.

Aim: To investigate the relationship of energy and macronutrients with physical frailty in Korean older individuals who had a high proportion of energy intake from carbohydrates.Methods: This study included 954 adults aged 70 to 84 years and used baseline data from the Korean Frailty and Aging Cohort Study (KFACS) collected in 2016. The relationship between energy or macronutrients and frailty was evaluated using multivariable logistic regression models and multivariable nutrient density models.Results: A high carbohydrate intake was related to a higher prevalence of frailty (odds ratio [OR] = 2.01, 95% confidence interval [CI] = 1.03–3.93). In the participants who had low energy intake, replacement of 10% energy from fats with isocaloric carbohydrates was related to a higher prevalence of frailty (10%, OR = 1.59, 95% CI = 1.03–2.43). Regarding proteins, we found no evidence for a relationship between the replacement of the energy of carbohydrates or fats with isocaloric protein and the prevalence of frailty in older adults.Conclusions: This study showed that the optimal proportion of energy intake from macronutrients may be an important nutritional intervention factor for reducing the risk of frailty among people who are likely to have low energy intake. Geriatr Gerontol Int 2023; 23: 478–485.

Bu SY, et al. Nutr Res Pract. 2022 May;16(Suppl 1):S89-S112. https://doi.org/10.4162/nrp.2022.16.S1.S89

This study aimed to identify food environment factors in the local community that could affect the levels of nutritional status and frailty in 372 older adults (at least 65 years old) experiencing food insecurity and enrolled in the integrated Community Health Promotion Program (CHPP) in two districts of Seoul. The local food environment was assessed using perceived food store accessibility questionnaires. In order to quantify nutrient intake, the 24-h recall method was applied. Malnutrition was measured using the Mini Nutritional Assessment tool, while frailty was assessed using the Frailty Measurement Questionnaire developed for the CHPP. Malnourished or frail elderly adults commonly had a lower intake of cereals and potatoes, meats, and vegetables than those who were not, and their resulting intake levels of energy, protein, iron, and vitamin groups were also significantly lower (all p-values < 0.05). Among the local community food store environment factors, the sufficiency of food stores (odds ratio (OR) = 1.988, 95% confidence interval (CI] = 1.211–3.262), freshness of foods (OR = 1.767, 95% CI = 1.075–2.886), and variety in foods (OR = 1.961, 95% CI = 1.197–3.212) were significant factors affecting the risk of malnutrition. For frailty, the freshness of foods (OR = 1.997, 95% CI = 1.053–3.788), variety in foods (OR = 2.440, 95% CI = 1.277–4.661), and small purchase of foods (OR = 2.645, 95% CI = 1.362–5.139) were significant environmental factors. In conclusion, we found that the perceived food store environment in the local community can influence the occurrence of malnutrition and frailty in vulnerable, urban older adults.

Background: Few investigations have studied the relationship between home and school food environments, fruit intakes, and prevalence of overweight in children and adolescents from disadvantaged backgrounds. This study aimed to determine whether food environments for fruit intake at household and school levels affect fruit intakes and risk of overweight among children and adolescents with low household income. Methods: Students (n = 3148) in Seoul, Korea completed questionnaires pertaining to select aspects of their food environments, frequency of fruit intakes, and weight status. Chi-square tests and logistic regressions evaluated associations between the aforementioned variables. Results: Participants consumed fruit an average of 0.77 times per day, though its frequency increased when fruit accessibility was perceived positively. The percentage of overweight participants was 23.5% for boys and 22.8% for girls. Generally, fruit intake frequency was linked to a lower prevalence of overweight. Regular provision of fruit in school lunches was associated with a reduced risk of overweight among elementary school girls (odds ratio (OR): 0.52, 95% confidence interval (CI): 0.30–0.92), and having someone at home to prepare fruit was associated with a reduced risk of overweight in elementary school boys (OR: 0.64, 95% CI: 0.43–0.94) and girls (OR: 0.63, 95% CI: 0.43–0.93). Conclusions: The frequency of fruit intake was low among disadvantaged youth. Increasing access to fruit in their food environments appears to enhance consumption and lower the risk of overweight, especially for elementary school girls.

이예연, et al. J Nutr Health. 2020 Aug;53(4):416-430. https://doi.org/10.4163/jnh.2020.53.4.416

Yang N, et al. Korean J Community Nutr. 2020 Apr;25(2):137-149. https://doi.org/10.5720/kjcn.2020.25.2.137

Yang N, et al. Korean J Community Nutr. 2018 Oct;23(5):444-455. https://doi.org/10.5720/kjcn.2018.23.5.444