Characteristics and dietary intake of Korean adolescents from food insecure households

Abstract

Adolescents are among the individuals who are most susceptible to the nutri-tional consequences of food insecurity. The purpose of this study was to iden-tify adolescents from food insecure households in Korea and assess their characteristics, dietary intake and habits, in comparison to adolescents from food secure households. This study used the 6th KNHANES data for the period of 2013-2015. Food security status was determined using the 18-item ques-tionnaire. In order to evaluate dietary intake, several methods of assessing nu-trient and food intake were used. Macronutrient contribution to energy, nutri-ent density, nutrient adequacy ratios (NARs), prevalence of insufficient or ex-cessive intake of selected nutrients and meeting acceptable macronutrient dis-tribution ranges (AMDRs) were used to examine nutrient intake. Food intake was evaluated using food group servings and dietary diversity score (DDS). Dietary habits including several snacking characteristics (frequency of snack-ing, total calories from snacks and food group servings consumed as snacks), as well as frequency of eating out, and frequency of meal skipping were ana-lysed. Multiple logistic regression was used to examine the association be-tween food insecurity and household characteristics. ANCOVA was used to compare the means of food secure and food insecure groups in case of con-tinuous variables with food security status as the binary independent variable and age and sex as covariates. Chi-square test and multiple logistic regression models adjusted by age and sex were used in case of categorical variables to compare food secure and food insecure groups. Among the 1,453 adolescents included in the study, 695 were middle school-aged (12-14 years old) and 758 were high school-aged (15-18 years old). About 11.1% of middle school-aged adolescents and 16.8% of high school-aged adolescents were identified as be-ing food insecure. Factors associated with the risk of food insecurity included reception of basic livelihood security, household income level, and age and education level of the house head. Middle school-aged food insecure adoles-cents consumed a higher percentage of energy from carbohydrate (p=0.006), but lower percentage of energy from fat (p=0.010) and saturated fatty acids (p=0.005) than food secure adolescents in spite of the average intake of both groups being within the recommended AMDR for these nutrients. Results from NAR show that high school-aged food insecure adolescents had a higher risk of vitamin A deficiency compared to food secure high school-aged ado-lescents (p=0.038). Both food secure and food insecure adolescents demon-strated a risk of vitamin A, vitamin C and calcium deficiencies. In addition, adolescents exhibited high prevalence of excessive intake of sodium and low prevalence of meeting AMDRs for carbohydrate and sugar. Consumption of vegetable, fruits and dairy was low in both food secure and food insecure groups. The percentage of adolescents who had skipped breakfast was higher among food insecure adolescents compared with food secure adolescents. A lower percentage of high school-aged food insecure adolescents was associat-ed with frequently eating out compared to food secure high school-aged ado-lescents (p=0.047). There were only a few differences between food secure and food insecure adolescents regarding dietary intake. However, food inse-cure adolescents came from socio-economically disadvantaged households and skipped breakfast frequently. Also, in the case of high school-aged ado-lescents, food insecure adolescents had a higher risk of vitamin A deficiency compared with food secure high school-aged adolescents. Therefore, there is need to continue monitoring and make efforts to improve the dietary intake and habits of food insecure adolescents in Korea.