Strategies of Improve Elderly Nutrition through Nutrition Education : Evaluation of the Effectivenss of the Program

영양교육에 의한 노인 영양증진전략연구 : 효과분석

The increased number of elderly in Korea presents great challenges for community nutrition programs. Strategies to enhance elderly nutrition are needed, as well as dietary advice that are reality-based and tailored to the need of the elderly. The purpose of this study was to evaluate the overall effectiveness of an elderly nutrition improvement program(ENIP), by assessing changes in nutrition knowledge, attitudes, and behavior after program completion. ENIP was conducted in Suwon for 4 months in 1998 at 5 centers for the elderly. The program provided individual nutrition counseling and brief biweekly group education sessions. To stimulate participation and motivation, the elderly in two centers were served free milk packs(200ml) three time a week during the program(milk＋education group), and the elderly in 3 other centers were served yoghurt on the program day(education group). Altogether, 102 subjects finished the program(milk＋education group 67 ; education group 35). Data about nutrition knowledge, dietary attitudes, diet records(24 hour recall) and dietary habit was collected before(baseline) and after the program(follow-up). The Drop-out rate for the milk＋education group(2.9%) was significantly lower than that for the education group(30.0%)(p<.001). The Nutrition Knowledge fo females milk＋education group increased significantly after the program, but no significant differences were observed in other groups. Over 60% of all the elderly showed positive responses to the healthy eating attitudes. Energy, protein, vitamin A, riboflavin, Calcium and Potassium intakes improved in the male milk＋education group. The Vitamin C intake improved in the male education group. Energy and vitamin A intakes improved in the female milk＋education group and energy, vitamin A, thiamin, riboflavin, niacin, Ca nad P in the female education group. A stepwise multiple regression analysis was performed to examine the effects of food intake changes on overall nutrient quality. For all elderly, the fish intake explained 12.6% of the variance, followed by candy intake and vegetable intake(model $R^2$=19.6%). Dietary habits such as meal time regularity and salty food reduction were markedly improved in both groups. Sixty-one percent of the milk＋education subjects stated their participation was voluntary and active, while 51% of education subjects did. Sixty four percent of the subjects stated their interest on diet increased remarkably through program participation. Considering the results, it is conjectured that ENIP had a great impact on nutrient intake, dietary attitudes and habits. Milk supplement showed no direct effects on elderly nutrition improvement, but it encouraged the program by reducing drop-out rates and inducing voluntary participation. Therefore milk supplement could enhance the community nutrition education program. Moreover it is strongly suggested that the ENIP be expanded to other communities.