Korean Journal of Community Nutrition (대한지역사회영양학회지)

The Korean Society of Community Nutrition (대한지역사회영양학회)
권호 표지
DOI QR코드

DOI QR Code

Evaluation of Consumer Nutrition Education Program to Reduce Sodium Intake Based on Social Cognitive Theory

사회인지론에 근거한 나트륨 섭취 줄이기 소비자 영양교육 프로그램의 효과 평가

  • Ahn, So-Hyun (Department of Food Science & Nutrition, The Catholic University of Korea) ;
  • Kwon, Jong Sook (Department of Food and Nutrition, Shingu College) ;
  • Kim, Kyung Min (Department of Food and Nutrition, Baewha Women's University) ;
  • Yoon, Jin-Sook (Department of Food and Nutrition, Keimyung University) ;
  • Kim, Hye-Kyeong (Department of Food Science & Nutrition, The Catholic University of Korea)
  • 안소현 (가톨릭대학교 식품영양학전공) ;
  • 권종숙 (신구대학교 식품영양과) ;
  • 김경민 (배화여자대학교 식품영양과) ;
  • 윤진숙 (계명대학교 식품영양학과) ;
  • 김혜경 (가톨릭대학교 식품영양학전공)
  • Received : 2015.10.12
  • Accepted : 2015.12.13
  • Published : 2015.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This study was performed to evaluate the consumer education program for reducing sodium intake based on social cognitive theory (SCT) and investigate consumer perceptions of environmental, cognitive and behavioral factors. Methods: Consumers (n=4,439) were recruited nationwide in Korea to participate in a nutrition education program for reducing sodium intake which was targeted on senior housewives (SH), parents (P), and office workers (OW). Questions regarding main factors of SCT were asked both before and after the education program. Results: SH and P recognized external social efforts and information to reduce sodium including nutrition labeling more than OW. The main barriers to practice reducing sodium intake were limited choice of low sodium food and menu, interference with social relationship when dining with others, and limited information, knowledge and skills. SH had lower barriers to practice reducing sodium intake and OW perceived 'preference to soup or stew' and 'preference to Kimchi, salted fish and fermented sauces' as barriers more than other groups at the baseline. Less than 50% of participants knew the relationship between sodium and salt, sodium in nutrition labeling, and recommended sodium intake. In addition, OW had little knowledge for capability to reduce sodium intake and lower self-efficacy to practice compared with SH and P. After education, positive outcome expectations such as lowering blood pressure, prevention of cardiovascular disease and osteoporosis were increased and barriers to practice reducing sodium intake were decreased in all groups (p < 0.05). The knowledge for behavioral capability and self-efficacy to reduce sodium intake were also improved but OW had still lower scores compared with other groups. Conclusions: These results suggested that nutrition education programs could be an effective tool to impact general population by facilitating awareness and increased capability to reduce sodium intake.

Keywords

References

  1. Antonios TF, MacGregor GA. Deleterious effects of salt intake other than effects on blood pressure. Clin Exp Pharmacol Physiol 1995; 22(3): 180-184. https://doi.org/10.1111/j.1440-1681.1995.tb01976.x
  2. He FJ, Li J, MacGregor GA. Effects of longer term modest salt reduction on blood pressure. Cochrane systematic review and meta-analysis of randomised trials. BMJ 2013; 346: f1325. https://doi.org/10.1136/bmj.f1325
  3. Mozaffarian D, Fahimi S, Singh GM, Micha R, Khatibzadeh S, Engell RE et al. Global sodium consumption and death from cardiovascular causes. New England J Med 2014; 371(7): 624-634. https://doi.org/10.1056/NEJMoa1304127
  4. Webster JL, Dunford EK, Hawkes C, Neal B. Salt reduction initiatives around the world. J Hypertension 2011; 29(6): 1043-1050. https://doi.org/10.1097/HJH.0b013e328345ed83
  5. Asaria P, Chisholm D, Mathers C, Ezzati M, Beaglehole R. Chronic disease prevention: health effects and financial costs of strategies to reduce salt intake and control tobacco use. Lancet 2007; 370(9604): 2044-2053. https://doi.org/10.1016/S0140-6736(07)61698-5
  6. Cobiac LJ, Vos T, Veerman JL. Cost-effectiveness of interventions to reduce dietary intake. Heart 2010; 96(23): 1920-1925. https://doi.org/10.1136/hrt.2010.199240
  7. World Health Organization. Guideline: sodium intake for adults and children [internet]. 2012 [cited 2015 Jan 12]. Available from: http://www.who.int/nutrition/publications/guidelines/sodium_intake_printversion.pdf/.
  8. Elliott P, Brown I. Sodium intakes around the world [internet]. 2007 [cited 2015 Jan 13]. Available from: www.who.int/dietphysicalactivity/Elliot-brown-2007.pdf/.
  9. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2013: Korea National Health and Nutritional Examination Survey (KNHANES V-2) [internet]. 2014 [cited 2015 Jan 13]. Available from: https://knhanes.cdc.go.kr/knhanes/index.do/.
  10. Dotsch M, Busch J, Batenberg M, Liem G, Tareilus E, Mueller R et al. Strategies to reduce sodium consumption: A food industry perspective. Crit Rev Food Sci Nutr 2009; 49(10): 841-851. https://doi.org/10.1080/10408390903044297
  11. Paik HY. Nutritional review of salt. Proceedings of Spring Symposium of The Korean Society of Food Science and Nutrition; 1987 Jun 13; 92-106.
  12. Kim SM. A baseline study on housewife-consumer education in the information society. Korean J Hum Ecol 2004; 13(3): 425-440.
  13. Park NR, Sohn SH. The effects of food safety education on children's food safety knowledge, belief, attitude, and behavior. Consum Policy Educ Rev 2010; 6(1): 47-66.
  14. Jung EJ, Son SM, Kwon JS. 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. Korean J Community Nutr 2012; 17(6): 751-771.
  15. Glanz K, Rimer BK, Viswanath K. Health behavior and health education: theory, research, and practice. 4th ed. San Francisco (CA): Joseey-Bass; 2008. p. 45-62.
  16. Ahn SH, Kim HK, Kim KM, Yoon JS, Kwon JS. Development of nutrition education program for consumers to reduce sodium intake applying the social cognitive theory -based on focus group interviews-. Korean J Community Nutr 2014; 19(4): 342-360. https://doi.org/10.5720/kjcn.2014.19.4.342
  17. Yim KS. The effects of a nutrition education program for hypertensive female elderly at the public health center. Korean J Community Nutr 2008; 13(5): 640-652.
  18. Jung EJ, Son SM, Kwon JS. 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. Korean J Community Nutr 2012; 17(6): 752-771. https://doi.org/10.5720/kjcn.2012.17.6.752
  19. Deyo RA, Diehr P, Patrick DL. Reproducibility and responsiveness of health status measures statistics and strategies for evaluation. Control Clin Trials 1991; 12(4 Suppl): S142-S158. https://doi.org/10.1016/S0197-2456(05)80019-4
  20. Cohen HW, Hailpern SM, Fang J, Alderman MH. Sodium intake and mortality in the NHANES II follow-up study. Am J Med 2006; 119(3): 275-e7.
  21. Lee KC, Lee JE. Theory and practice of consumer education. 2nd ed. Paju: Kyomunsa; 2012. p.19-25.
  22. Kim MK, Lee KG. Consumer awareness and interest toward sodium reduction trends in Korea. J Food Sci 2014; 79(7): S1416-S1423. https://doi.org/10.1111/1750-3841.12503
  23. Park YS, Son SM, Lim WJ, Kim SB, Chung YS. Comparison of dietary behaviors related to sodium intake by gender and age. Korean J Community Nutr 2008; 13(1): 1-12.
  24. Grimes CA, Riddell LJ, Nowson CA. Consumer knowledge and attitudes to salt intake and labelled salt information. Appetite 2009; 53(2): 189-194. https://doi.org/10.1016/j.appet.2009.06.007
  25. Sarmugam R, Worsley A. Current levels of salt knowledge: A review of the literature. Nutr 2014; 6(12): 5534-5559. https://doi.org/10.3390/nu6125534
  26. Anderson ES, Winett RA, Wojcik JR. Self-regulation, selfefficacy, outcome expectations, and social support: Social cognitive theory and nutrition behavior. Ann Behav Med 2007; 34(3): 304-312. https://doi.org/10.1007/BF02874555
  27. Yon MY, Lee YN, Kim DH, Lee JY, Koh EM, Nam EJ et al. Major sources of sodium intake of the Korean population at prepared dish level -Based on the KNHANES 2008 & 2009-. Korean J Community Nutr 2011; 16(4): 473-487. https://doi.org/10.5720/kjcn.2011.16.4.473
  28. Kemm J. Health education and the problem of knowledge. Health Promot Int 1991; 6(4): 291-296. https://doi.org/10.1093/heapro/6.4.291
  29. Newson RS, Elmadfa I, Biro G, Cheng Y, Prakash V, Rust P et al. Barriers for progress in salt reduction in the general population. An international study. Appetite 2013; 71(1): 22-31. https://doi.org/10.1016/j.appet.2013.07.003
  30. Sarmugam R, Worsley A, Flood V. Development and validation of a salt knowledge questionnaire. Public Health Nutr 2014; 17(5): 1061-1068. https://doi.org/10.1017/S1368980013000517
  31. Zhang J, Xu AQ, Ma JX, Shi XM, Guo XL, Engelgau M et al. Dietary sodium intake: Knowledge, attitudes and practices in Shandong province, China, 2011. PloS one 2013; 8(3): e58973. https://doi.org/10.1371/journal.pone.0058973
  32. Land MA, Webster J, Christoforou A, Johnson C, Trevena H, Hodgins F et al. The association of knowledge, attitudes and behaviours related to salt with 24-hour urinary sodium excretion. Int J Behav Nutr Phys Act 2014; 11(1): 47. https://doi.org/10.1186/1479-5868-11-47
  33. Kim HY. Activation of nutrition labeling in food and restaurant industry for sodium reduction. Food Sci Ind 2011; 44(1): 28-38.
  34. Yim KS. The effects of a nutrition education program for hypertensive female elderly at the public health center. Korean J Community Nutr 2008; 13(5): 640-652.

Cited by

  1. 가공식품의 나트륨함량표시 개선을 위한 소비자 인식도 조사 vol.32, pp.3, 2015, https://doi.org/10.7318/kjfc/2017.32.3.244
  2. 일상화 과정 이론에 근거한 결혼이주여성 대상 식생활 교육 프로그램 일상화 과정에 대한 질적 연구 vol.34, pp.3, 2015, https://doi.org/10.7318/kjfc/2019.34.3.325
  3. 서울지역 산업체 급식소 고객의 급식 나트륨 저감화 운영 및 필요성에 대한 인식 vol.25, pp.1, 2020, https://doi.org/10.5720/kjcn.2020.25.1.21