COVID-19 and changes in Korean consumers' dietary attitudes and behaviors

Changes in food sufficiency among Korean adults in urban and rural areas during the COVID-19 pandemic: an analysis of the 7th and 8th Korea National Health and Nutrition Examination Survey

OBJECTIVES

Understanding changes in food sufficiency within various demographic groups during emergency situations, such as the global coronavirus disease 2019 (COVID-19) pandemic, is crucial in formulating public health policies for future preparedness. This study investigated potential differences between urban and rural residents in food sufficiency trends during the COVID-19 pandemic and examined how these changes varied according to socio-demographic factors.

METHODS

This cross-sectional study analyzed data from 19,724 adults aged 20 years and older, utilizing information from the 7th-8th Korea National Health and Nutrition Examination Survey (2018-2021).

RESULTS

In urban areas, across all subpopulations, food sufficiency improved significantly during the COVID-19 period relative to pre-pandemic levels (p<0.001). However, in rural regions, a significant increase in food sufficiency during the COVID-19 era was observed only among female, with an odds ratio of 1.42 (95% confidence interval, 1.06 to 1.89). Nevertheless, no significant interaction terms were found between region and various socio-demographic factors regarding changes in food sufficiency during the COVID-19 period.

CONCLUSIONS

During the COVID-19 pandemic, food sufficiency among urban residents improved compared to the pre-pandemic era, whereas their rural counterparts saw no such improvement. Additionally, no significant interaction was detected between urban versus rural areas and changes in food sufficiency during the COVID-19 period. These findings indicate the need for targeted food policies to prepare for potential future pandemics, particularly in rural areas, where food sufficiency did not improve.

Development of a semi-quantitative food frequency questionnaire for dietary intake of elementary school children: data from the Seventh Korea National Health and Nutrition Examination Survey

BACKGROUND/OBJECTIVES

In Korea, studies of diet in elementary school children are hindered by the need for a comprehensive dietary assessment tool. Thus, the aim of this study was to develop a semi-quantitative food frequency questionnaire (FFQ) for Korean elementary school children.

SUBJECTS/METHODS

The 24-h recall data for 1,624 subjects aged 6-11 yrs from the seventh Korea National Health and Nutrition Examination Survey were used to extract the items included in the questionnaire. The FFQ items were developed by selecting major dishes based on the results of nutritional contribution and between-person variability for energy and 14 nutrients (carbohydrate, protein, fat, crude fiber, calcium, phosphorous, iron, sodium, potassium, vitamin A, thiamin, riboflavin, niacin, and vitamin C). We selected the major dishes with over 90% of the total contribution to each nutrient and with over 90% of the accumulated R² for each nutrient. Among the 452 dishes, we selected 248 dishes contributing more than 1% of the total consumption.

RESULTS

Finally, the FFQ included 107 items combined from 248 dishes based on nutrient profile and recipe. The FFQ items accounted for an average of 88.6% of the energy, 14 nutrient intakes, and 91.4% of the between-person variability. Quantities of dietary intake were assessed by 9 categories of frequency and 3 categories of portion size. Percentages of coverage for energy, protein, fat, carbohydrate, and calcium were 90.2%, 87.8%, 89.9%, 90.8%, and 88.7%, respectively.

CONCLUSIONS

We developed a dish-based, semi-quantitative FFQ comprising 107 items for Korean elementary school children aged 6 to 11. Further studies are needed to evaluate the reproducibility and validity of this FFQ for elementary school children.

Korean consumers' use and concerns about food delivery service

BACKGROUND/OBJECTIVES

Despite the rapid growth of the online food delivery service market since the outbreak of coronavirus disease 2019, little research has focused on how consumers are using food delivery service and what they are concerned about when using food delivery service. Moreover, previous studies have not paid adequate attention to how these concerns are related to consumers' intention to use food delivery service. Therefore, our study examines behaviors and concerns regarding food delivery service and identifies the key factors in consumers' intention to use food delivery service.

SUBJECTS/METHODS

Using data collected from 549 Korean consumers, we conducted descriptive analysis, exploratory factor analysis, and multiple regressions.

RESULTS

We found that using food delivery service is not only for main meals at home or the office but also to meet a variety of dietary needs and occasions. The findings indicated that Korean consumers are most concerned about the sustainability of food delivery service, followed by health, hygiene, hedonic, and usability aspects of the service. Hygiene concerns and a hedonic aspect of the service were negatively associated with consumers' intention to use food delivery service among users, while health concerns decreased the intention of non-users.

CONCLUSION

The findings have implications for practitioners and policy makers in food delivery service. To further propel market growth, they should help reduce health concerns of non-users, as well as hygiene and hedonic concerns of existing users.

Association between diet quality and type of meal companion: the 2013-2015 Korea National Health and Nutrition Examination Survey (KNHANES)

BACKGROUND/OBJECTIVES

A meal companion is an important social determinant of eating behaviors and is related to what and how much a person will eat within the social context. This study examined the difference in diet quality according to the type of dining companion.

SUBJECTS/METHODS

This study included 15,074 adults (6,180 men and 8,894 women, ≥ 19 years) who participated in the 6th (2013-2015) Korea National Health and Nutrition Examination Survey. Korean Healthy Eating Index (KHEI) scores were calculated using the food frequency questionnaire data. Survey multivariate linear regression analysis was used to assess the association of dining companions (ordinary type, eating with family members, eating alone, and eating with others) and the total and component scores of KHEI.

RESULTS

People who exclusively ate with someone other than family or exclusively ate alone had lower total KHEI scores in both men (57.23 ± 0.67, 58.56 ± 0.73 vs. 62.71 ± 0.26) and women (57.6 3±0.97, 63.89±0.58 vs. 65.79±0.22) compared to people with the ordinary type (all P < 0.05). Both men and women who ate exclusively with someone other than family had lower KHEI component scores for breakfast, whole grains, and fruit, excluding juice, compared to the ordinary type and family eating group. Compared to the eating alone group, the component scores for breakfast and whole grains were lower in the eating with others group.

CONCLUSION

The diet quality differed according to the meal companion type. People who always ate with someone other than family members and men who ate alone showed lower diet quality scores than the ordinary type. More research will be needed to improve their adherence to dietary recommendations.

Epidemiologic and Clinical Features of Campylobacter Enteritis Before and During COVID-19 in Korea

BACKGROUND

With the increase in meals at home due to coronavirus disease 2019 (COVID-19), the pattern and incidence of enteritis seemed to change. Some types of enteritis, such as Campylobacter enteritis, appear to have increased. Our study aimed to evaluate the change in the trend of enteritis, especially Campylobacter enteritis, before COVID-19 (2016-2019) and at the present time during COVID-19 in South Korea.

METHODS

We analyzed data from the Health Insurance Review and Assessment Service. From 2016 to 2020, the International Classification of Diseases codes related to enteritis were examined to distinguish bacterial and viral enteritis and the trends of each were analyzed. The aspects of enteritis, before and after the COVID-19 outbreak, were compared.

RESULTS

Both bacterial and viral enteritis declined in all age groups from 2016 to 2020 (P < 0.001). In 2020, the reduction rate of viral enteritis was higher than that of bacterial enteritis. However, unlike other causes of enteritis, even after COVID-19, Campylobacter enteritis increased in all age groups. An increase of Campylobacter enteritis in 2020 was particularly noticeable in children and adolescents. The prevalence of viral and bacterial enteritis was higher in urban areas than in rural areas (P < 0.001). Campylobacter enteritis was more common in the rural areas (P < 0.001).

CONCLUSION

Although the prevalence of bacterial and viral enteritis have decreased in COVID-19, Campylobacter enteritis has increased in all age groups and in rural areas compared to urban areas. Recognizing that the trend of Campylobacter enteritis before and during COVID-19 is helpful for future public health measures and interventions.

Who has experienced better or worse health conditions since the outbreak of COVID-19?: results from a representative cross-sectional survey in Seoul

BACKGROUND/OBJECTIVES

The coronavirus disease 2019 (COVID-19) pandemic has affected the entire world population in many ways. This study aimed to analyze the patterns of changes in eating, food purchasing and preparation, physical activity, and subjective health after COVID-19 outbreak by various sociodemographic factors and to understand the factors associated with changes in subjective health.

SUBJECTS/METHODS

A cross-sectional survey using a representative sample from Seoul was used for the analysis. The data collection was conducted from September to October 2020. A total of 3,833 citizens aged more than 18 years old participated in the Seoul Food Survey. Descriptive statistics and generalized ordinal logistic regression models were used to understand the changes in health behaviors, health indicators, and subjective general health by various socioeconomic status.

RESULTS

It was shown that the changes in household income, food expenditure, food consumption and physical activities differed significantly by age, education, occupation, income, weight, and food security status. Low-income and food-insecure households were affected more severely by the pandemic. Older age, household food insecurity, income reduction, increased home cooking and frequency of having instant foods, decreased physical activity and weight gain were significant factors explaining worse perceived health during the COVID-19 pandemic.

CONCLUSIONS

The results suggest that focusing on older populations and low-income families with food insecurity should be prioritized during infectious disease outbreaks. In addition, the role of physical activities and instant food consumption in explaining perceived health should be investigated further in this prolonged battle with the pandemic situation.

COVID-19-related anxiety and lifestyle changes

This study aimed to identify factors that affect lifestyle changes and focused on coronavirus disease (COVID-19)-related anxiety since the COVID-19 outbreak in South Korea. Data from 213,848 individuals from the 2020 Korean Community Health Survey were analyzed using a complex sampling design. Descriptive statistics, t-tests, one-way ANOVA, and multiple regression analyses were performed. Participants reported a high level of COVID-19-related anxiety, with a score of 19.28 out of 25. The score of healthy behavioral change index was -0.51, indicating negative changes in physical activity, dietary habits, and sleep patterns. A slight positive change was reported for addictive behavioral change index, such as smoking and alcohol consumption, at 0.27 scores, indicating a decrease in these behaviors. COVID-19-related anxiety was an important factor that negatively affected health behavior. The high-risk groups that were vulnerable to anxiety included older adults and those who have little social support or few social encounters. Thus, identifying high-risk groups with the potential for worsened health behavior and providing interventions to reduce the anxiety caused by COVID-19 are necessary.

Sustainable Home Meal Replacement (HMR) Consumption in Korea: Exploring Service Strategies Using a Modified Importance-Performance Analysis

The COVID-19 pandemic has changed traditional consumer consumption behavior and requires a new service strategy to cope with sustainable consumption. Moreover, it is necessary to focus academic attention on consumer behavior to cook and eat more easily amid Korea’s socioeconomic changes such as the increase in single-person households, aging, rising prices, and continuing economic recession. In this study, we used a revised importance–performance analysis (IPA) to identify specific measures to improve consumer satisfaction with home meal replacements (HMRs). An online survey of Korean adults who had purchased HMRs was conducted based on a convenience sampling method. According to the results, items that could be intensively improved were the ‘introduction of new dishes’, ‘creation of various flavors’, ‘cost-effectiveness, and ‘reasonable price’, whereas ‘easy to prepare’, ‘easily available’, and ‘identified country of origin’ received favorable assessments. With the growth of the non-face-to-face economy due to COVID-19, our findings suggest marketing strategies for sustainable HMR consumption.

Impacts of Delivery Charge on the Possibility of Consumers Using Online Food Delivery

With the maturity of the online food delivery (OFD) industry in China, the growth of the market in recent years is mainly driven by the increase of the usage frequency of existing users rather than the number of new users. The usage frequency of users is affected by various factors, with the delivery charge as one of the most significant ones. The purpose of this study is to examine the impact of delivery charge and other factors on the probability of consumers choosing to use OFD service. In this study, 391 questionnaire records from China were collected, based on which a logistic regression model was established. The results of the model show that age, occupation, monthly income, city tier of residence, location and time period of usage, and delivery charges all play a role on the probability of consumers using the service, and the delivery charge has the greatest impact. For every one yuan increase in the delivery charge, consumers will be less likely to choose “certainly” of using OFD (OR: 0.435; 95% CI: 0.415, 0.455). Sensitivity analysis shows that when the delivery charge changes between 2~5 yuan, it has the greatest impact on the probability of consumers using the service. The analysis further shows that delivery charge has different impacts under different scenarios composed of three key factors, i.e., the city tier of residence, locations of usage, and time period of usage. From a management perspective, these findings help to understand the behavior of OFD consumers and provide insights for the OFD operators to establish best pricing strategies for long-term economic sustainability.