Journal of the East Asian Society of Dietary Life (동아시아식생활학회지)

The East Asian Society of Dietary Life (동아시아식생활학회)
권호 표지

Awareness and Practice of Sodium Reduction by Elementary, Middle and High School Dietitians in Gyeonggi Area

경기지역 초.중.고등학교 영양(교)사의 나트륨 저감화에 대한 인식도 및 실천도

  • Lee, Joung-Hee (Nutrition Education, Graduate School of Education, Kyonggi University)
  • 이정희 (경기대학교 교육대학원 영양교육전공)
  • Received : 2012.11.05
  • Accepted : 2012.12.11
  • Published : 2012.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

High sodium consumption is a significant nutrition problem in South Korea; however, few studies have examined the awareness and practice of dietitians with respect to low sodium diet in schools. In this study, we collected data from 211 dietitians in 2012. Most respondents indicated that sodium reduction was important in school meals (very important 40.5%, somewhat important 55.6%); however, they rarely checked the sodium content in the nutrition labels of processed foods (never/rarely 74.2%, sometimes 18.7%, always/often 7.2%). The main reason for not checking the sodium content was 'no nutrition table on some processed foods' (38.5%). The most important barrier to sodium reduction in school meals was overcoming the negative taste of students related to a reduced-sodium diet (70.4%). The most frequently used processed foods were processed meat (e.g. ham, bacon) (48.3%), frozen dumplings and noodles (33.8%), and sausage and dressing (14.5%) in school meals. The proportion of dietitians who used processed food ${\geq}$ 2 times per week for the school menu was 72.2% in high school, 28.4% in middle school and 12.4% in elementary school (p<0.05). Upon ranking of the importance of nutrients in school menus, calories received the highest score (4.35 points), followed by macronutrient ratios (4.30), calcium (4.06), iron (3.44) and sodium (3.20). Although most dietitians recognized that sodium reduction was important in school menu planning, they had poor dietary practices. It is suggested that we educate dietitians as well as students about the importance and practice of a reduced sodium diet. Furthermore, it is critical to develop diverse low sodium recipes and have a required nutrition labeling system for all processed foods. Overall, the results of this study could serve as a guide to planning effective nutrition programs to reduce sodium consumption in school feeding programs.

Keywords

References

  1. Chang SO (2006) The amount of sodium in the processed foods, the use of sodium information on the nutrition label and the acceptance of sodium reduced ramen in the female college students. Korean J Nutr 39: 585-591.
  2. Cho MK (2008) Development of education materials for lowing sodium intake and analysis of educational effects for elementary students. MS Thesis Changwon National University, Changwon. pp 62-64.
  3. Cook NR, Cutler JA, Obarzanek E, Buring JE, Rexrode KM, Kumanyika SK, Appel LJ, Whelton PK (2007) Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP). BMJ 334: 885-888. https://doi.org/10.1136/bmj.39147.604896.55
  4. He FJ, MacGregor GA (2007) Salt, blood pressure and cardiovascular disease. Curr Opin Cardiol 22: 298-305. https://doi.org/10.1097/HCO.0b013e32814f1d8c
  5. He FJ, Markandu ND, Sagnella GA, MacGregor GA (2001) Effect of salt intake on renal excretion of water in humans. Hypertension 38: 317-320. https://doi.org/10.1161/01.HYP.38.3.317
  6. He FJ, Marrero NM, MacGregor GA (2008) Salt intake is related to soft drink consumption in children and adolescents: a link to obesity. Hypertension 51: 629-634. https://doi.org/10.1161/HYPERTENSIONAHA.107.100990
  7. Jang MR, Kim MH (2003) Job satisfaction of dietitians between elementary and high school. J Korean Diet Assoc 9: 13-21.
  8. Jang YJ (2008) Analysis on the practical use and cognition toward processed foods in the school meal service in Daejeon. MS Thesis Kongju National University, Kongju. pp 7-35.
  9. Jo SK (2011) Effects of the perception and education about sodium on children's dietary habits. MS Thesis Kyunghee University, Seoul. pp 45-46.
  10. Kim CI, Cho HY, Heo S, Kim JW, Kang BW, Yon MY, Lee YN, Kim DH, Lee JY, Koh EM, Nam EJ, Shin HH (2011) Major sources of sodium intake of the Korean population at prepared dish level- based on the KNHANES 2008 & 2009 -. Korean J Community Nutrition 16: 473-487. https://doi.org/10.5720/kjcn.2011.16.4.473
  11. Kim HH, Jung YY, Lee YK (2012) A comparison of salty taste assessments and dietary attitudes and dietary behaviors associated with high-salt diets in four regions in Korea. Korean J Community Nutrition 17: 38-48. https://doi.org/10.5720/kjcn.2012.17.1.38
  12. Korea Center for Disease Control and Prevention (2011) Korea health statistics 2010: Korea national health examination survey V-1. Ministry of Health & Welfare. p 335.
  13. Korea Food and Drug Administration (2009a) Study on extension of dietary exposure assessment system: On dietary intake database and food & nutrient content database. pp 79-80.
  14. Korea Food and Drug Administration (2011) Developing nutrition education model for reducing sodium intake and evaluation. pp 160-161.
  15. Korea Food Drug Administration (2009b) Low sodium and low sugar recipes for school menus. pp 9-39.
  16. Lee EM, Park YG, Jung WY, Kim MR, Seo EC, Jung RS, Na MA, Lee JH, Heo OS (2010) Survey on sodium and potassium content of school meals as well as sodium and potassium intake by students in the Daejeon and Chungcheong area. J East Asian Soc Dietary Life 20: 853-862.
  17. Lee HJ (2011) Sodium in middle school meals and eating habits of middle school students. MS Thesis Ulsan University, Ulsan. pp 9-15.
  18. Lee MK (2009) Sodium intake of students and sodium content of processed foods used in the school meal service. MS Thesis Wonkwang University, Iksan. pp 77-80.
  19. Lee SK, Chang EJ, Choi JC, Bahn KN, Kim MH (2010) Current assessment of sodium and potassium intakes in elementary and middle school students through school meals. Korean J Food Sci Technol 42: 578-585.
  20. Lee SS (2004) A study on dietary behavior of children according to their preferences for fast food. Korean J Community Nutrition 9: 204-213.
  21. Lim HJ (2000) A study on the food intake, sodium and potassium intakes and urinary excretion of preschool children in Pusan. Korean J Nutr 33: 647-659.
  22. Mattes RD (1997) The taste for salt in humans. Am J Clin Nutr 65(2uppl): 692S-697S. https://doi.org/10.1093/ajcn/65.2.692S
  23. Mattes RD, Donnelly D (1991) Relative contributions of dietary sodium sources. J Am Coll Nutr 10: 383-393. https://doi.org/10.1080/07315724.1991.10718167
  24. Meneton P, Jeunemaitre X, de Wardener HE, MacGregor GA (2005) Links between dietary salt intake, renal salt handling, blood pressure, and cardiovascular diseases. Physiol Rev 85: 679-715. https://doi.org/10.1152/physrev.00056.2003
  25. Min JH (2011) Analysis on dietary related factors by sodium intake in adults- using the data from 2007, 2008 Korean National Health and Nutrition Survey. MS Thesis Dankook University, Yongin. pp 222-229.
  26. Ministry of Education, Science and Technology (2012) Current state of school meals for year 2011. pp 1-2.
  27. Morino T, Langford HG (1978) Salivary sodium correlates with salt recognition threshold. Physiol Behav 21: 45-8. https://doi.org/10.1016/0031-9384(78)90275-5
  28. Park HN (2011) The effectiveness of sugar, sodium education program in elementary school: Six month follow-up study. MS Thesis Kyungwon University, Sungnam. pp 43-49.
  29. Park YS, Lee AR (2011) Sodium levels of ready-to-eat foods and snacks. Soonchunhyang J Nat Sci 17: 129-134.
  30. Park YS, Son SM, Lim WJ, Kim SB, Chung YS (2008) Comparison of dietary behaviors related to sodium intake by gender and age. Korea J Community Nutrition 13: 1-12.
  31. Shin EK (2008) Education program for sodium reduction based on analysis of sodium intake. Ph D Dissertation Kyungpook National University, Daegu. pp 105-108.
  32. Shin JH (2010) Perception of dietitians for reduced sodium intake in food service and development of sodium-restricted recipes. MS Thesis Catholic University of Daegu, Gyeongsan. pp 90-91.
  33. Son SM, Park YS, Lim HJ, Kim SB (2006) Pilot study for low salt consumption projects for Korean people. Catholic University, Seoul. pp 283-385.
  34. Swift PA, Markandu ND, Sagnella GA, He FJ, MacGregor GA (2005) Modest salt reduction reduces blood pressure and urine protein excretion in black hypertensives: a randomized control trial. Hypertension 46: 308-312. https://doi.org/10.1161/01.HYP.0000172662.12480.7f
  35. The Korean Nutrition Society (2010) Dietary reference intakes for Koreans. pp 367-381.
  36. Tuomilehto J, Jousilahti P, Rastenyte D, Moltchanov V, Tanskanen A, Pietinen P, Nissinen A (2001) Urinary sodium excretion and cardiovascular mortality in Finland: A prospective study. Lancet 357: 848-851. https://doi.org/10.1016/S0140-6736(00)04199-4
  37. U.S. Food and Drug Administration (2009) Guide to nutrition labeling and education act (NLEA) requirements. Md: US Govt. Printing Office, College Park.