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      Development of a Korean Diet Score (KDS) and its application assessing adherence to Korean healthy diet based on the Korean Food Guide Wheels

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          Abstract

          The most critical point in the assessment of adherence to dietary guidelines is the development of a practical definition for adherence, such as a dietary pattern score. The purpose of this study was to develop the Korean Diet Score (KDS) based on the Korean Food Balance Wheel and to examine the association of KDS with various lifestyle characteristics and biochemical factors. The dietary data of 5,320 subjects from the 4th Korean National Health and Nutritional Examination Survey were used for the final analysis. The food guide was composed of six food group categories; 'grain dishes', 'fish and meat dishes', 'vegetable dishes', 'fruits', 'milk' and 'oils and sugars'. Based on the recommended serving numbers for each group, the scores measuring adherence to this food guide were calculated from the dietary information from the 24-hour dietary recall questionnaire, and then its correlation with various characteristics was assessed. KDS was significantly associated with several clinical, lifestyle and socioeconomic factors as well as diagnosed disease history. The higher quintile group of KDS showed a significantly lower level in fasting blood glucose, systolic blood pressure, triglycerides, current smoking and drinking as well as higher leisure time activity, house income and education. Furthermore, the KDS quintile group of women was inversely associated with hypertension, osteoporosis and diabetes. A higher KDS quintile was characterized with a higher intake of several critical nutrients, such as Ca, Fe and vitamins as well as a desirable nutrition balance such as the ratio of macronutrients. Our results demonstrate that KDS is a beneficial tool in assessing the adherence to a healthy diet based on the Korean dietary guidelines. We suggest that KDS could be a useful indicator for evaluating the dietary balance of the Korean population.

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          Most cited references14

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          The glycemic index: physiological mechanisms relating to obesity, diabetes, and cardiovascular disease.

          The glycemic index was proposed in 1981 as an alternative system for classifying carbohydrate-containing food. Since then, several hundred scientific articles and numerous popular diet books have been published on the topic. However, the clinical significance of the glycemic index remains the subject of debate. The purpose of this review is to examine the physiological effects of the glycemic index and the relevance of these effects in preventing and treating obesity, diabetes, and cardiovascular disease.
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            Dietary Reference Intakes for Koreans

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              Concept of a nutritious food: toward a nutrient density score.

              The American diet is said to be increasingly energy-rich but nutrient-poor. To help improve the nutrient-to-energy ratio, the 2005 Dietary Guidelines for Americans recommend that consumers replace some foods in their diets with more nutrient-dense options. Such dietary guidance presupposes the existence of a nutrient density standard. However, a review of the literature shows that the concept of a nutritious food is not based on any consistent standards or criteria. In many cases, healthful foods are defined by the absence of problematic ingredients-fat, sugar, and sodium-rather than by the presence of any beneficial nutrients they might contain. Past attempts to quantify the nutrient density of foods have been based on a variety of calories-to-nutrient scores, nutrients-per-calorie indexes, and nutrient-to-nutrient ratios. The naturally nutrient rich (NNR) score, which is based on mean percentage daily values (DVs) for 14 nutrients in 2000 kcal food, can be used to assign nutrient density values to foods within and across food groups. Use of the NNR score allows consumers to identify and select nutrient-dense foods while permitting some flexibility where the discretionary calories are concerned. This approach has implications for food labeling, nutritional policy making, and consumer education. The Food and Drug Administration has considered approving nutrient claims based on the ratio of a beneficial nutrient to the food's energy content, as opposed to a specified minimum amount of a nutrient per serving size. Given the current dietary trends, the nutrient density approach can be a valuable tool for nutrition education and dietary guidance.
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                Author and article information

                Journal
                Nutr Res Pract
                Nutr Res Pract
                NRP
                Nutrition Research and Practice
                The Korean Nutrition Society and the Korean Society of Community Nutrition
                1976-1457
                2005-6168
                February 2013
                04 February 2013
                : 7
                : 1
                : 49-58
                Affiliations
                [1 ]Research Institute of Obesity Sciences and Department of Food and Nutrition, Sungshin Women's University, Seoul 136-742, Korea.
                [2 ]Clinical Trial Center and Clinical Trial Center for Functional Foods, Chonbuk National University Hospital & Medical school, Jeonbuk 561-712, Korea.
                [3 ]Department of Food Science and Human Nutrition, Obesity Research Center, Chonbuk National University, Jeonbuk 561-756, Korea.
                [4 ]Department of Nutritional Sciences and Food Management, College of Health Science, Ewha Womans University, Seoul 120-7501, Korea.
                [5 ]Carcinogenesis Branch, Division of Cancer Epidemiology and Prevention, National Cancer Center, Madu-1-dong, Ilsandong-gu, Goyang 410-769, Korea.
                Author notes
                Corresponding Author: Mi Kyung Kim, Tel. 82-31-920-2202, Fax. 82-31-920-2006, alrud@ 123456ncc.re.kr
                Article
                10.4162/nrp.2013.7.1.49
                3572226
                23424060
                e60b93a7-e605-47d9-8710-52306a174455
                ©2013 The Korean Nutrition Society and the Korean Society of Community Nutrition

                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.

                History
                : 20 August 2012
                : 09 January 2013
                : 09 January 2013
                Categories
                Original Research

                Nutrition & Dietetics
                kds,knhanes,dietary guidelines,dietary patterns,korea
                Nutrition & Dietetics
                kds, knhanes, dietary guidelines, dietary patterns, korea

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