Korean Journal of Community Nutrition (대한지역사회영양학회지)

The Korean Society of Community Nutrition (대한지역사회영양학회)
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The Effect of Sodium Reduction Education Program of a Public Health Center on the Blood Pressure, Blood Biochemical Profile and Sodium Intake of Hypertensive Adults

고혈압 환자 대상 저나트륨 식생활에 대한 보건소 영양교육이 혈압, 혈액 성상 및 나트륨섭취에 미치는 영향

  • Jung, Eun Jin (Department of Food Science & Nutrition, The Catholic University of Korea) ;
  • Son, Sook Mee (Department of Food Science & Nutrition, The Catholic University of Korea) ;
  • Kwon, Jong-Sook (Department of Food & Nutrition, Shingu College)
  • 정은진 (가톨릭대학교 생활과학부 식품영양학전공) ;
  • 손숙미 (가톨릭대학교 생활과학부 식품영양학전공) ;
  • 권종숙 (신구대학교 식품영양과)
  • Received : 2012.11.06
  • Accepted : 2012.12.04
  • Published : 2012.12.31
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Abstract

This study was conducted to investigate the effect of sodium reduction education program of a public health center on the blood pressure, blood biochemical profile and sodium intake of hypertensive adults. The program continued for 16 weeks with an 8-week nutrition education and an 8-week follow-up to forty two subjects, 6 males and 36 females aged 46 to 80 years. Subjects received nutrition education including lectures, activities, cooking classes and nutrition counseling. Physical fitness, management of stress, and nutrition counseling were provided during the follow-up. The program was evaluated three times, before and after the nutrition education, and after the follow-up. Systolic blood pressure (p < 0.0001) and diastolic blood pressure (p < 0.001) were decreased after completion of the program. Body weight (p < 0.005), percent body fat (p < 0.005) and body mass index (p < 0.001) were decreased, too. There were no significant differences in blood glucose, HDL-cholesterol and triglycerides, while elevated levels of total cholesterol (p < 0.001) and LDL-cholesterol (p < 0.001) appeared after the program completion. Decreased intakes of vitamin A (p < 0.05), ${\beta}$-carotene (p < 0.001) and sodium (p < 0.001) were observed. Consumption frequency of noodles, soups, stews, kimchi, fishes/shellfish, seasoned vegetables, and salted seafoods/pickles (p < 0.05~p < 0.001) were decreased, while that of all food groups were not changed during the follow-up. Total score of nutrition knowledge related to sodium intake and hypertension (p < 0.001), and that of dietary behavior associated with high sodium intakes were changed positively (p < 0.001) only during the nutrition education. This sodium reduction education program, including the follow-up study showed positive effects on the blood pressure, sodium intake, nutrition knowledge and dietary behavior of hypertensive adults.

Keywords

References

  1. Appel LH, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM, Lin PH, Karanja N (1997): A clinical trial of the effects of dietary patterns on blood pressure. DASH collaborative research group. N Engl J Med 336(16): 1117-1124
  2. Blaustein MP, Hamlyn JM (1991): Pathogenesis of essential hypertension : A link between dietary salt and high blood pressure. Hypertension 18(55): 184-195
  3. Choi MK (2005): Relation among mineral(Ca, P, Fe, Na, K, Zn) intakes, blood pressure, and blood lipids in Korean adults. Korean J Nutr 38(10): 827-835
  4. 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
  5. Chu KO, So HY (2008): Effects of the nutrition education program on self-efficacy, diet behavior pattern and cardiovascular risk factors for the patients with cardiovascular disease. J Korean Acad Nurs 38(1): 64-73
  6. Elliott P, Stamler J, Nichols R, Dyer AR, Stamler R, Kesteloot H, Marmot M (1996): Intersalt revisited : Further analyses of 24 hour sodium excretion and blood pressure within and across populations. Intersalt cooperative research group. Br Med J 312(7041): 1249-1253
  7. Eum SO, Kim SD, Lee JS (2007): Effects of hypertension education programs on knowledge, attitude and practice in hypertension patients. Korean Public Health Res 33(2): 162-174
  8. Glanz K, Lewis FM, Romer BK (1997): The scope of health education. In: Glanz K, Lewis FM, Romer BK eds. Health behavior and health education. Theory, research, and practice. 2nd ed., Jossey-Bass Pub, San Francisco. pp.3-18
  9. Hagberg JM, Montain SJ, Martin WH, Ehsani AA (1989): Effects of exercise training in 60- to 69-year-old persons with essential hypertension. Am J Cardiol 64(5): 348-353
  10. He FJ, MacGreger GA (2008): A comprehensive review on salt and health and current experience of worldwide salt reduction programs. J Hum Hypertens 23(6): 363-384
  11. Jeon SM (2005): A study of nutrition counseling effect in hypertension patients. MS thesis, Keimyung University, pp 27-59
  12. Kim MY, Han SY, Jeong JH, Kim SH, Lee JK, Park ES, Zhang X, Seo JS (2009): Effectiveness of nutrition-exercise education program on weight control of adult women. Korean J Community Nutr 14(2): 168-174
  13. Kolasa KM (2003): Summary of the JNC 7 guidelines for the prevention and treatment of high blood pressure. J Nutr Educ Behav 35(5): 226-227
  14. Korean Nutrition Society (2010): Dietary reference intake for Koreans. Korean Nutrition Society, Seoul
  15. Krauss RM, Eckel RH, Howard B, APPLE LJ, Daniels SR, Deckelbaum RJ, Erdman JW, Etherton PK, Goldberg IJ, Kotchen TA, Lichtenstein AH, Mitch WE, Mullis R, Robinson K, Wylie- Rosett J, St. Jeor S, Suttie J, Tribble DL, Bazzarre TL (2000): AHA dietary guidelines : revision 2000: A statement for healthcare professionals from the nutrition committee of the American Heart Association. Circulation 102: 2284-2299
  16. Krishna GG (1989): Increased blood pressure during potassium depletion in normotensive men. N Engl J Med 320: 1177-1182
  17. Lee JW Lee EY, Lee BK (1999): Effect of calcium supplementation on blood pressure response to dietary sodium level in normotensive young Korean women with family history of hypertension. Korean J Nutr 32(6): 661-670
  18. Lee JY, Kim CB (2000): Direction of community health promotion in Korea. Korean J Health Prom 2(1): 3-12
  19. Lee YK, Sung CJ, Choi MK, Lee YS (2002): Short term effects of sodium intakes on serum lipids and glucose in adult women. J Korean Soc Food Sci Nutr 31(6): 1035-1042
  20. Marmot MG, Kogevinas M, Elston MA (1991): Socioeconomic status and disease. WHO Reg Publ Eur Ser 37:113-146
  21. Meloche J (2003): Cooking with class: participation soars with hands-on learning and take-aways. J Nutr Educ Behav 35(2): 107
  22. Ministry of Health and Welfare/Korea Centers for Disease Control & Prevention (2011): Korea Health Statistics 2010: Korea National Health and Nutrition Examination Survey(KNHANES V-1) 2010
  23. Ministry of Health and Welfare/Korea Health Industry Develpment Institute (2011): National Food & Nutrition Statistics: based on 2009 Korea National Health and Nutrition Examination Survey
  24. Moon EH (2005): Implementation and evaluation of nutrition education program for hypertensive patients among adults aged 50 and over. MS thesis, Seoul Women's University, pp.18-53
  25. Moon EH, Kim KW (2011): Evaluation of nutrition education program for hypertension patients aged 50 and over. Korean J Community Nutr 16(1): 62-74
  26. Moon HK, Lee HJ, Park Y (2007): Comparison of health status and dietary habits by percent body fat (PBT) change for adult women in the weight control program by the community health center. Korean J Community Nutr 12(4): 477-488
  27. 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
  28. Rhee M-Y, Yang SJ, Oh SW, Park Y, Kim C-i, Park H-K, Park SW, Park C-Y (2011): Novel genetic variations associated with salt sensitivity in the Korean population. Hypertens Res 34(5): 606- 611
  29. Rhie SK, Park YJ (1997): A study on nutrition education for rural elderly of Kyungki province in Korea. Korean J Community Living Sci 8(1): 25-33
  30. Ruppert M, Diehl J, Kolloch R, Overlack A, Kratf K, Gobel B, Hitte N, Stumpe KO (1991): Short term dietary sodium restriction increases serum lipids and insulin in salt-sensitive and saltresistant normotensive adults. Klin Wonchenschr 69: 51-57
  31. Sacks FM, Obarzanek E, Windhauser MM, Svetkey LP, Vollmer WM, McCollough M, Karanja N, Lin PH, Steele P, Proschan MA (1995): Rationale and design of the dietary approaches to stop hypertension trial. A multicenter controlled-feeding study of dietary patterns to lower blood pressure. Ann Epidemiol 5(2): 108-118
  32. Sacks FM, Svetkey LP, Vollmer WM, Appel LJ, Bray GA, Harspha D, Obarzanek E, Conlin PR, Miller ER, Simons-Morton DG, Karanja N, Lin P-W, Alckin M, Most-windhaucer MM, Moore TJ, Proschan MA, Cutler JA for the DASH-sodium collaborative research group (2001): Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet : DASH-sodium collaborative research group. N Engl J Med 344: 3-10
  33. 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
  34. 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
  35. Son SM, Huh GY, Lee HS (2005): Development and evaluation of validity of dish frequency questionnaire (DFQ) and short DFQ using Na index for estimation of habitual sodium Intakes. Korean J Community Nutr 10(5): 677-692
  36. Son SM, Huh GY (2006) : Dietary risk factors associated with hypertension in patients. Korean J Community Nutr 11(5): 661- 672
  37. Son SM, Park YS, Lim HJ, Kim SB, Jeong YS (2007): Sodium intakes of Korean adults with 24-hour urine analysis and dish frequency questionnaire and comparison of sodium intakes according to the regional area and dish group. Korean J Community Nutr 12(5):545-558
  38. Statistics Korea (2011): Annual report on the cause of death statistics (2010). Available from http://kostat.go.kr [cited 2011 September 8]
  39. Suter PM, Sierro C, Vetter W (2002): Nutritional factors in control of blood pressure and hypertension. Nutr Clin Care 5(1): 9-19
  40. Svetkey LP, Harsha DW, Vollmer WM, Stevens VJ, Obarzanek E, Elmer PJ (2003): PREMIER: A clinical trial of comprehensive lifestyle modification for blood pressure control: Rationale, design and baseline characteristics. Ann Epidemiol 13: 462-471
  41. Weder AB, Egan BM (1991): Potential deleterious impact of dietary salt restriction on cardiovascular risk factors. Klin Wonchenschr 69(suppl 25): 45-50
  42. 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
  43. Yim KS (2008): The effects of a nutrition education program for hypertensive female elderly at the public health center. Korean J Community Nutr 13(5):640-652
  44. Yoon JS, Jeong YH, Park JA, Oh HM (2002): The effect of individualized nutritional education on adults having two or more symptoms of chronic degenerative disease. Korean J Community Nutr 7(6): 794-802

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