• Korean Journal of Community Nutrition
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• v.18 no.6
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• pp.626-643
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• 2013

This study was performed to evaluate the differences in blood pressure, sodium intake and dietary behavior changes according to the extent of session attendance on sodium reduction education program for pre-hypertensive adults in a public health center. Sodium reduction education program consisted of 8 sessions for 8 weeks. Fifty three patients who completed the pre and post nutritional assessments were classified into 2 groups according to the session attendance rate. Nineteen participants who attended the education program 3 times or less (${\leq}3$) were categorized into the less attendance (LA) group and 34 participants attended 4 times or more (${\geq}4$) into the more attendance (MA) group. Blood pressure, anthropometric measurements, serum lipid profile, nutrient intakes including sodium, nutrition knowledge and dietary behavior score were assessed before and after the nutrition education program. Mean sodium intakes (p<0.001), systolic/diastolic blood pressure (p<0.001), and weight (p<0.001) were significantly decreased in the MA group after sodium reduction education program. Compared to the MA group, mean sodium intakes, systolic/diastolic blood pressure were not significantly changed after the education program even with significantly increased nutrition knowledge (p<0.05) and dietary behavior score (p<0.01) in the LA group. It appears that pre-hypertensive adults need to attend the sodium reduction education program for at least 4 times or more to gain beneficial effects from the intervention. Positive feedback of healthcare team or offering more cooking classes may be needed to raise the attendance rate in the sodium reduction education program.

• Korean Journal of Community Nutrition
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• v.17 no.6
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• pp.752-771
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• 2012

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.

• Journal of the Korean Dietetic Association
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• v.19 no.2
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• pp.173-181
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• 2013

This study used survey data to identify the use of salimeters and the prevalence of sodium reduction education in the Gyeonggi region. A survey with 211 dietitians working in school foodservice (106 in elementary schools, 69 in middle schools, and 36 in high schools) was conducted from August 6 to August 17, 2012. The data were analyzed using the SPSS program. Though 86.6% of school kitchens had salimeters, the rate for checking the sodium content of soup or stew was just 62.7% and the rate for checking the sodium content of kimchi and solid food was very low. Since salimeters are mostly used to measure sodium in liquid foods, it is urgent to provide an education and manual on using salimeters and to promote salimetry for kimchi and side dishes. It is also important to provide students with nutritional information by clearly posting the sodium content of food on menus and compelling students to notice them. Sodium reduction education for cooks was conducted in the 70.3% of the kitchens; however, the dietitians perceived that the cooks did not understand the importance of the education. Also, sodium reduction education for students was mostly provided through indirect methods, rather than face-to-face education, resulting in poor educational data (only 36.4% comprehending). By providing detailed guidelines for sodium reduction and labelling accurate content of sodium of the menus, we will be able to enforce practices for sodium reduction in school lunches.

• Korean Journal of Community Nutrition
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• v.25 no.5
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• pp.386-395
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• 2020

Objectives: The aim of this study was to investigate sodium reduction practices in school foodservice in Daegu. Methods: The survey included 199 nutrition teachers and dietitians working at elementary, middle and high schools in Daegu. The survey topics included the following: the frequency of salinity measurement, workers in charge of the measurement, average salinity of the soup and stew served, frequency and difficulties of offering low-sodium meals, Importance-Performance Analysis (IPA) of sodium reduction methods in school foodservice and the need for political support in encouraging sodium reduction. Results: The mean salinity of the soup and stew was higher in high school foodservice than in elementary and middle school foodservice. Middle and high schools have difficulties in offering low-sodium meals due to concerns of decreasing satisfaction for the meals. The results of the IPA of programs to reduce sodium in school meals showed that most of the items in the cooking and serving stages were in the 2nd quadrant (Keep up the good work), and all purchasing and menu planning stages occupied the 3rd quadrant (Low priority). To reduce sodium in school meals, government support is required in developing low-sodium recipes for school foodservice, encouraging education on sodium reduction for school foodservice officials and developing low-sodium food for institutional foodservice. Conclusions: To encourage sodium reduction in school meals, the priority is to make low-sodium recipes available. Also, it is necessary to develop a program that calculates the sodium content in menus and processed foods through National Education Information System and to establish standards for sodium levels in school foodservice.

• Journal of Nutrition and Health
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• v.55 no.1
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• pp.174-187
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• 2022

Purpose: This study was performed to evaluate an education program for housewives to reduce sodium intake based on the social cognitive theory. Methods: Housewives (n = 387) received 2 education sessions focused on food purchase and cooking, and completed a questionnaire on their perceptions of environmental, cognitive, and behavioral factors and the stages of behavioral change to reducing sodium intake both before and after the education program. Results: After the education program, the recognition of social efforts for sodium reduction and sodium labeling and experience with low-sodium products increased. Positive expectancies for the prevention of osteoporosis by the reduction of sodium were enhanced while the main barriers in practicing sodium reduction decreased, especially 'interrupting social relationships when dining with others', 'bad taste', 'preference for soup or stew', and 'limited knowledge and skills to practice'. In addition, cognition and nutrition knowledge related to reducing sodium intake were improved on all scores, but the effect on self-efficacy and dietary behavior was limited to only a few items. The percentage of participants in the pre-action stage (including pre-contemplation, contemplation, and preparation stages) for reducing sodium intake decreased from 43.2% before education to 21.5% after education, while that in the action stage increased from 19.6% before education to 43.5% after education (p < 0.001). The education program had the most significant impact on participants who were in the pre-action stage and showed improved scores in all sections. Conclusion: These results suggest that a customized education program for housewives could be an effective tool to reduce sodium intake by improving personal expectancies, cognition, and nutrition knowledge regarding sodium reduction and enabling a greater section of the population to move to the action stage of reducing sodium intake.

• Nutrition Research and Practice
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• v.10 no.6
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• pp.635-640
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• 2016

BACKGROUND/OBJECTIVES: This study was conducted to evaluate the feasibility of a sodium reduction program at local restaurants through nutrition education and examination of the health of restaurant owners and cooks.SUBJECTS/METHODS: The study was a single-arm pilot intervention using a pre-post design in one business district with densely populated restaurants in Seoul, South Korea. The intervention focused on improving nutrition behaviors and psychosocial factors through education, health examination, and counseling of restaurant personnel. Forty-eight restaurant owners and cooks completed the baseline survey and participated in the intervention. Forty participants completed the post-intervention survey. RESULTS: The overweight and obesity prevalences were 25.6% and 39.5%, respectively, and 74.4% of participants had elevated blood pressure. After health examination, counseling, and nutrition education, several nutrition behaviors related to sodium intake showed improvement. In addition, those who consumed less salt in their baseline diet (measured with urine dipsticks) were more likely to agree that providing healthy foods to their customers is necessary. This study demonstrated the potential to reduce the sodium contents of restaurant foods by improving restaurant owners' and cooks' psychological factors and their own health behaviors. CONCLUSIONS: This small pilot study demonstrated that working with restaurant owners and cooks to improve their own health and sodium intake may have an effect on participation in restaurant-based sodium reduction initiatives. Future intervention studies with a larger sample size and comparison group can focus on improving the health and perceptions of restaurant personnel in order to increase the feasibility and efficacy of restaurant-based sodium reduction programs and policies.

• Journal of the Korean Society of Food Science and Nutrition
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• v.46 no.10
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• pp.1243-1252
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• 2017

There are limited programs for low sodium intake based on the nutrition education model for housewives who cook family meals. The objective of this study was to evaluate the effects of model-based nutrition programs for low sodium intake among housewives residing in Seoul by incorporating social cognitive theory. A questionnaire survey before and after education was conducted on 140 housewives who participated in the 'Low Sodium Nutritional Education Program' delivered by a district public health center for 12 weeks from November 2015 to January 2016. The contents of the nutrition education program and program evaluation items were based on the action plans for 'Less Sodium Healthy Practice' suggested by the Ministry of Food and Drug Safety. The results show that program participants showed a lower preference for sodium, higher selection of low sodium dishes from restaurants or cafeteria if available, and increased awareness of the need of restaurants to serve low sodium dishes compared to before. In terms of behavioral changes, there were significant improvements in checking nutrition labeling and selection of foods with low sodium, use of low sodium food products, use of natural seasonings to reduce salt intake, and consumption of fast foods and processed foods. On the other hand, requesting less salty meals when ordering and introducing restaurants or cafeterias with healthy and low sodium menus turned out to be difficult to put into practice. In conclusion, the nutrition education program for sodium intake reduction for housewives was effective in increasing knowledge, environment recognition, and behaviors related to low sodium intake but not behaviors related to physical environmental factors. Therefore, further nutrition education programs and practices for sodium intake reduction should be comprehensively implemented with improvement of physical environments for low sodium intake.

• Journal of Nutrition and Health
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• v.42 no.4
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• pp.350-357
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• 2009

The purpose of this paper was to evaluate the effectiveness of a salt reduction education program. Subjects participating in this study were 251 employees (166 in the "educated" group, 85 in the "non-educated" group) at 8 hospital and industry food service operations in Daegu. After the salt reduction education program was carried out, a salty taste assessment of both groups was conducted. The educated group had statistically significant differences and the noneducated group did not have statistically significant differences. In terms of nutrition knowledge, while the nutrition knowledge of the educated group was increased (p < 0.001), that of the non-educated group rose at a rate of 0.92. In terms of dietary attitude, the educated group exhibited increased preference toward less salty foods when compared to the noneducated group (p < 0.001). Regarding dietary behavior, the score of the educated group was improved (p < 0.001), thereby indicating a preference for less salty taste. This means that nutrition education had influence on dietary behavior. However, after education, sodium excretion for the educated group was not significantly decreased, compared to before education. The results show that there was a positive correlation between salty taste assessment and dietary attitude and behavior for a high-salt diet. There was a positive relationship between attitude for a high-salt diet and sodium intake; when people prefere a more salty taste, they eat more sodium. Therefore, in order to change dietary preference away from salty taste and to decrease sodium intake, a nationwide, systematic and continuous salt reduction education program is needed.

• Korean Journal of Community Nutrition
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• v.13 no.2
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• pp.216-227
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• 2008

The purpose of this study was to develop a nutrition education program for dietary salt reduction using various nutrition education materials. The effect of a 5-week nutrition education program on salty taste assessment, nutrition knowledge, salt attitude for a high-salt diet, salt content in food, and individual satisfaction with the salt concentration of meals during the education period was evaluated. Nutrition education materials included two animations, a pamphlet, panels, and a website, as well as other training resources. Subjects participating in this study were 335 employees (164 male, 171 female) at 15 foodservice operations in Daegu. Preference for higher levels of salty taste and food containing higher amounts of salt were lowered. Knowledge regarding the necessity for dietary salt reduction was higher (p < 0.001) than before nutrition education, and salt content in a meal was reduced. As the program progressed, average salt concentrations of soups were significantly lowered (p < 0.05), and there was greater satisfaction with the lower concentration (p < 0.001). This was a positive indication of the program's success. In addition, it was found that subjects who participated in the program several times have changed their preference to lower levels of salty taste and have increased their nutrition knowledge (p < 0.05, p < 0.001). Thus, the positive effect of this 5-week nutrition education program developed for, and applied to, foodservice employees, concerning dietary salt reduction was confirmed.

• Journal of the Korean Society of Food Culture
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• v.29 no.2
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• pp.212-221
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• 2014

Korean style DASH (Dietary Approaches to Stop Hypertension) and a dietary education program for sodium reduction were developed. Reduced sodium diets (15 and 30% reductions) were developed from general diets for 3 consecutive weeks from Monday through Saturday. Subjects (19 total) were classified into two groups according to dietary education. Experimental period was from June 24 to July 23, 2012. Total sum of adaptation scores for low sodium diets significantly increased in the group that underwent dietary education compared to that without (p<0.05). After the experiment, both groups showed significantly increased values in terms of food group balance, sodium-related nutrition knowledge, attitude, and practice by paired t-test. Especially, group that underwent dietary education showed significantly higher values for attitudes by ANCOVA pre-test as a variation (p<0.01). For the results of the nutrient intake survey, group that underwent dietary education showed significantly increased values for dietary fiber (p<0.01), vitamin A (p<0.001), vitamin K (p<0.001), vitamin C (p<0.01), Folic acid (p<0.001), vitamin B12 (p<0.01), calcium (p<0.01), iron (p<0.05), and zinc (p<0.05) and significantly decreased values for sodium (p<0.05) and chloride (p<0.005). Subjects adapted to reduced sodium diets showed apparent improvements in sodium-related knowledge, attitude, practice and intake of nutrient, and these improvements were even higher in the group that underwent dietary education compared to that without. Thus, adaptation to low sodium diet combined with dietary education can improve dietary habits.