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Original Article
- The Association of Food Label Use with Objective and Subjective Obesity among a Korean Population
- In Sook Lee1, Kowoon Lee2
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Journal of Korean Academy of Community Health Nursing 2016;27(3):262-271.
DOI: https://doi.org/10.12799/jkachn.2016.27.3.262
Published online: September 12, 2016
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: July 4, 2016 • Revised: August 29, 2016 • Accepted: September 7, 2016
Copyright © 2016 Korean Academy of Community Health Nursing
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.
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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.
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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.
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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.
Table 1.General Characteristics of the Participants
Table 2.Results of Health Status and Health Behaviors of the Participants
Table 3.Results for Nutrition Intake
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
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- Evaluation of Food Labeling Policy in Korea: Analyzing the Community Health Survey 2014–2017
Heui Sug Jo, Su Mi Jung
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The Association of Food Label Use with Objective and Subjective Obesity among a Korean Population
| 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) |
| 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) |
| 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) | ||
| 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) |
| 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) | ||||
Table 1. General Characteristics of the Participants
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
Table 3. Results for Nutrition Intake
Table 4. Results of Obesity
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
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.
Table 1.
Table 2.
Table 3.
Table 4.
Table 5.
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© Korean Academy of Community Health Nursing.
College of Nursing, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
E-mail: office@rcphn.org
© Korean Academy of Community Health Nursing.