Korean Journal of Community Nutrition (대한지역사회영양학회지)

The Korean Society of Community Nutrition (대한지역사회영양학회)
권호 표지

The Effects of a Nutrition Education Program for Hypertensive Female Elderly at the Public Health Center

고혈압 여자 노인 대상의 보건소 영양교육 효과 분석

  • Yim, Kyeong-Sook (Department of Food and Nutrition, College of Human Ecology, The University of Suwon)
  • 임경숙 (수원대학교 생활과학대학 식품영양학과)
  • Published : 2008.10.30
Download PDF
⟨ Previous Next ⟩

Abstract

Hypertension is among the most common and important risk factors for stroke, heart attack, and heart failure which is considered to be the leading cause of death in Korea. The prevalence rate of hypertension in Korea is 27.9%, according to the 2006 Korea National Health and Nutrition Survey. Since non-pharmacologic nutrition education is recommended as the first step in the management of hypertension, evaluation of nutrition program is needed to form strategies for improving patients' dietary adherence. This study was designed to evaluate the overall effectiveness of a hypertension nutrition education program (HNEP) for reducing the salt intake, at a public health center located in Gyunggi-province. The HNEP was offered for 16 weeks from May to September in 2007. Nutrition education activities included cooking classes, food preparation demonstrations, physical fitness programs, salty taste preference test sessions, games, case-study presentations, planning and evaluation of menus, etc. Forty patients participated fully in the program which had 47 female enrollees. Data about nutrient intake (24-hour recall), nutrition knowledge, food behavior were collected before (baseline) and after the program. Changes after program completion indicated the following: 1) diastolic blood pressure was decreased (p < 0.05), 2) sodium (salt) intake was also decreased (p < 0.01), especially baseline high salt intake group, 3) nutrition knowledge was improved (p<0.001), 4) dietary behaviors for maintaining a low salt diet was improved (p < 0.001), 5) participants preferred cooking class from nutrition education methods. As a conclusion, it appears that a nutrition education program for hypertensive female elderly for reducing the salt intake might effectively decrease blood pressure and salt intake. It also improves nutrition knowledge, dietary behavior, and finally adherence to a recommendable low-sodium diet.

Keywords

References

  1. Beauchamp GK (1981): Ontogenesis of taste preferences. In: Kretchmer WD, eds. Food, Nutrition and Evolution, pp. 49-57, New York, Masson
  2. Choi MS, Han KH, Park KS (2001) : Comparison of Dietary Intakes by 24-hr Dietary Recall, Dietary Record and Food Frequency Questionnaire among Elderly People. Korean J Nutr 34(6): 688-700
  3. Choi YJ, Kim C, Park YS (2007): The Effect of Nutrition Education Program in Physical Health, Nutritional Status and Health-Related Quality of Life of the Elderly in Seoul. Korean J Nutr 40(3): 270-280
  4. Contento IR, Michela JL, Williams SS (1995): Adolescent food choice criteria: role of weight and dieting status. Appetite 25(1): 51-76 https://doi.org/10.1006/appe.1995.0041
  5. Cook NR, Cohen J, Hebert PR, Taylor JO, Hennekens CH (1995): Implications of small reductions in diastolic blood pressure for primary prevention. Arch Intern Med 155(7): 701-709 https://doi.org/10.1001/archinte.155.7.701
  6. Downie RS, Tannahill C, Tannahill A (1996): Health promotion. Models and values, 2nd ed., pp. 120-137, Oxford Univ. Press, Oxford
  7. Eum SO, Kim SD, Lee JS (2007): Effects of Hypertension Education Programs on Knowledge, Attitude and Practice in Hypertension Patients. Korean Public Health Research 33(2): 162-174
  8. Ferrini R, Edelstein S, Barrett-Connor E (1994): The association between health beliefs and health behavior change in older adults. Prev Med 23(1): 1-5 https://doi.org/10.1006/pmed.1994.1001
  9. Finnegan JR,Viswanath K (1997): Communication theory and health behavior change. The media studies framework. In : Glanz K, Lewis FM, Rimer BK eds. Health behavior and health education. Theory, research and practice. 2nd ed., pp. 313-328, Jossey-Bass Pub., SF
  10. Frost CD, Law MR, Wald NJ (1991): By how much does dietary salt reduction lower blood pressure? II-Analysis of observational data within populations. BMJ 302(6780): 815-818 https://doi.org/10.1136/bmj.302.6780.815
  11. Fuchs FD, Gus M, Moreira WD, Moreira LB, Moraes RS, Rosito GA, Sorucco A, Atanazio P, Machado R (1997): Blood pressure effects of antihypertensive drugs and changes in lifestyle in a Brazilian hypertensive cohort. J Hypertens 15(7): 783-792 https://doi.org/10.1097/00004872-199715070-00011
  12. Geleijnse JM, Kok FJ, Grobbee DE (2003): Blood pressure response to changes in sodium and potassium intake: a metaregression analysis of randomised trials. J Hum Hypertens 17(7): 471-480 https://doi.org/10.1038/sj.jhh.1001575
  13. Glanz K (1985): Nutrition education for risk factor reduction and patient education, A review. Preventive Med 14(6): 721-752 https://doi.org/10.1016/0091-7435(85)90069-6
  14. Guthrie HA, Scheer JC (1981): Validity of a dietary score for assessing nutrient adequacy. J Am Diet Assoc 78(3): 240-245
  15. Hansen RG, Wyse BW (1980): Expression of nutrient allowances per 1,000 kilocalories. J Am Diet Assoc 76(3): 223-227
  16. He FJ, MacGregor GA (2002): Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. J Hum Hypertens 16(11): 761-770 https://doi.org/10.1038/sj.jhh.1001459
  17. Houston MC (2005): Nutraceuticals, vitamins, antioxidants, and minerals in the prevention and treatment of hypertension. Prog Cardiovasc Dis 47(6): 396-449 https://doi.org/10.1016/j.pcad.2005.01.004
  18. Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (1993): The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure(JNC V). Arch Intern Med 153(2): 154-183 https://doi.org/10.1001/archinte.153.2.154
  19. Kang NE, Lee YJ (2005): Original Articles : The Analysis of Effect on Nutrition Education Program for the Elderly in Sung-nam Area. Korean J Food & Nutr 18(4): 357-366
  20. Kaplan NM (2002): Hypertension and diabetes. J Hum Hypertens 6(S1): S56-S60
  21. Khan NA, Hemmelgarn B, Padwal R, Larochelle P, Mahon JL, Lewanczuk RZ, McAlister FA, Rabkin SW, Hill MD, Feldman RD, Schiffrin EL, Campbell NR, Logan AG, Arnold M, Moe G, Campbell TS, Milot A, Stone JA, Jones C, Leiter LA, Ogilvie RI, Herman RJ, Hamet P, Fodor G, Carruthers G, Culleton B, Burns KD, Ruzicka M, deChamplain J, Pylypchuk G, Gledhill N, Petrella R, Boulanger JM, Trudeau L, Hegele RA, Woo V, McFarlane P, Touyz RM, Tobe SW: (2007): The 2007 Canadian Hypertension Education Program recommendations for the management of hypertension: part 2 - therapy. Can J Cardiol 23(7): 539-550 https://doi.org/10.1016/S0828-282X(07)70798-5
  22. Kim KN, Lee KS (1996): Nutrition Knowledge, Dietary Attitudes, and Food Behaviors of College Students. Korean J Community Nutr 1(1): 89-99
  23. Korea National Statistics Office (2007): Annual report on the cause of death statistics
  24. Krinke UB (1990): nutrition information topic and format preferences of adults. J Nutr Educ 22(6): 292-297 https://doi.org/10.1016/S0022-3182(12)80110-5
  25. Law MR, Frost CD, Wald NJ (1991): Dietary salt and blood pressure. J Hypertens Suppl 9(6): S37-S41
  26. Lee HJ, Lee HS, Lee Y, Jang Y A, Moon JJ, Kim CI (2007): Nutritional Environment Influences Hypertension in the Middleaged Korean Adults - based on 1998 & 2001 National Health and Nutrition Survey. Korean J Community Nutr 12(3): 272-283
  27. Lee YY, Lee MS, Na BJ, Bae SK, Hwang HJ, Kim DK, Kim KY, Lee IS (2007): A Development of Standard Contents of Hypertension Education for Adults. J Korea Sport Research 18(2): 127-139
  28. Meloche J (2003): Cooking with class: participation soars with hands-on learning and take-aways. J Nutr Educ Behav 35(2): 107 https://doi.org/10.1016/S1499-4046(06)60048-1
  29. Marmot MG, Kogevinas M, Elston MA (1991): Socioeconomic status and disease. WHO Reg Publ Eur Ser 37: 113-146
  30. Ministry of Health and Welfare (2006): The Third Korea National Health and Nutrion Examination Survey (KNHANES III), 2005, Seou
  31. Moon HK, Joung H (1999): Dietary Risk Factors of Hypertension in the Elderly. Korean J Nutr 32(1): 90-100
  32. Moon HK, Park JH (2007): Comparative Analysis and Evaluation of Dietary Intake between with and without Hypertension Using 2001 Korea National Health and Nutrition Examination Survey (KNHANES). Korean J Nutr 40(4): 347-361
  33. Padwal R, Campbell N, Touyz RM: Canadian Hypertension Education Program (2005): Applying the 2005 Canadian Hypertension Education Program recommendations: 3. Lifestyle modifications to prevent and treat hypertension. CMAJ 173(7): 749-751 https://doi.org/10.1503/cmaj.050186
  34. Park EY, Park YJ, Kim KW (2000): A Study of Sodium Consumption and Related Psychosocial Factors among Hypertensive and Normal Adults. Korean J Nutr 33(8): 833-839
  35. Sackett DL, Chambers LW, MacPherson AS, Goldsmith CH, Mcauley RG (1977): The development and application of indices of health: general methods and a summary of results. Am J Public Health 67(5): 423-428 https://doi.org/10.2105/AJPH.67.5.423
  36. Sheahan SL, Fields B (2008): Sodium dietary restriction, knowledge, beliefs, and decision-making behavior of older females. J Am Acad Nurse Pract 20(4): 217-224 https://doi.org/10.1111/j.1745-7599.2008.00307.x
  37. Slavin RE (1995): Best evidence synthesis: an intelligent alternative to meta-analysis. J Clin Epidemiol 48(1): 9-18 https://doi.org/10.1016/0895-4356(94)00097-A
  38. Sleight P (1996): Primary prevention of coronary heart disease in hypertension. J Hypertens Suppl 14(2): S35-S38 https://doi.org/10.1097/00004872-199609002-00009
  39. Son EJ, Moon HK (2002): The Relationship of Nutritional Satus to the Degree of Hypertension in Residents of Kangbuk-gu, Seoul. Korean J Community Nutr 7(3): 304-315
  40. Son SM & Huh GY (2000): Characteristic of Anthropometric Data and Biochemical Nutritional Status of Hypertensive Patients before Treatment. Korean J Community Nutr 5(4): 624-632
  41. Son SM & Huh GY (2006): Dietary risk factors associated with hypertension in patients. Korean J Community Nutr 11(5): 661-672
  42. Son SM, Kim MJ (2001): The Effect of Nutrition Education Program for Various Chronic Disease in Elderly Visiting Public Health Center. Korean J Community Nutr 6(4): 668-677
  43. The Korean Nutrition Society (2005): Dietary reference intakes for Koreans. Seoul
  44. Touyz RM, Campbell N, Logan A, Gledhill N, Petrella R, Padwal R, Canadian Hypertension Education Program (2004): The 2004 Canadian recommendations for the management of hypertension: Part III - Lifestyle modifications to prevent and control hypertension. Can J Cardiol 20(1): 55-59
  45. Woo MK, Jegal SA, Kim SA (1998): Development and Evaluation of Nutrition Education Program for Middle Aged Men at Worksite. Korean J Community Nutr 3(2): 261-272
  46. Yim KS (2000): Evaluation of the Effectiveness of a Nutrition Education Program for Hypertensive Patients at the Community Level. Korean J Community Nutr 5(4): 654-661
  47. Yim KS, Min YH, Lee TY (1997): Evaluations of the Elderly Nutrition Improvement Program in the community health center : Effects of nutrition counseling and education program on elderly dietary behavior. J Kor Diet Assoc 3(2): 197-210