• Korean Journal of Community Nutrition
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• v.27 no.1
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• pp.27-35
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• 2022

Objectives: The purposes of this study were to compare the degree of sodium reduction practice and estimate sodium intake by salty food preference. Methods: Sodium reduction practices, salty food preferences and estimated sodium intake were surveyed for restaurant owners (n = 80), employees (n = 82) and customers (n = 727) at the restaurants participating in the sodium reduction project in Daegu, Korea. Estimated sodium intake was performed by examining sex, age, body mass index (BMI), salty eating habit and dietary behaviors. Results: The degree of sodium reduction practice was significantly higher in salinity meter use (P < 0.001), low salt seasonings (P < 0.001) and efforts to make the foods as bland as possible overall (P < 0.001) in the restaurants participating in sodium reduction project than in homes (P < 0.001). The degree of sodium reduction practice appeared lower in the high salty food preference group than in the low-preference group in such items as efforts to make the foods as bland as possible overall (P < 0.05) and washing the salty taste and then cooking (P < 0.05). The high-preference group showed high-salt dietary behavior, including eating all the soup until nothing was left (P < 0.05) more than the low-preference group, but low-salt dietary behavior included checking the sodium content in processed foods (P < 0 .0 5) less than the low-preference group. The high-preference group was higher in the soup and stew intake frequency than the low-preference group (P < 0.05) and much lower in nuts (P < 0.05) and fruits (P < 0.05) intake frequency. The high-preference group had a higher salty eating habit (P < 0.05), salty taste assessment (P < 0.05) and estimated sodium intake (P < 0.05) than the low-preference group. Conclusions: The present study showed that the salty food preference was strongly associated with lower sodium reduction practice and higher estimated sodium intake.

• Nutrition Research and Practice
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• v.14 no.5
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• pp.540-552
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• 2020

BACKGROUND/OBJECTIVES: Hypertension is the major risk factor for cardiovascular disease, a leading cause of deaths in Korea. The objective of this study was to evaluate the effect of a nutrition education in reducing sodium intake and increasing potassium intake in hypertensive adults. SUBJECTS/METHODS: Subjects who participated in this study were 88 adults (28 males and 60 females) who were pre-hypertension or untreated hypertensive patients aged ≥ 30 yrs in Gyeonggi Province, Korea. These subjects were divided into 2 groups: a lowsodium education (LS) group and a low-sodium high-potassium education (LSHP) group. Nutrition education of 3 sessions for 12 weeks was conducted. Blood pressure, blood and urine components, nutrient intake, and dietary behavior were compared between the two education groups. RESULT: Blood pressure was decreased in both groups after the nutrition education (P < 0.05). In the LSHP group, levels of blood glucose (P < 0.05), total cholesterol (P < 0.01), and lowdensity lipoprotein-cholesterol (P < 0.05) were decreased after the program completion. Sodium intake was decreased in both groups after the nutrition education (P < 0.05). However, Na/K ratio was only decreased in the LS group (P < 0.05). Intake frequency of fish & shellfish was only significantly reduced in the LS group (P < 0.05), while intake frequencies of cooked rice, noodles & dumplings, breads & snacks, stew, kimchi, and fish & shellfish were reduced in the LSHP group (P < 0.05). Total score of dietary behavior appeared to be effectively decreased in both groups after the education program (P < 0.001). CONCLUSIONS: This education for reducing sodium intake was effective in reducing blood pressure and sodium intake. The education for enhancing potassium intake resulted in positive changes in blood glucose and serum cholesterol levels.

• Nutrition Research and Practice
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• v.14 no.5
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• pp.501-518
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• 2020

BACKGROUND/OBJECTIVES: Sodium intake is positively associated with blood pressure, which may increase the risk for cardiovascular disease (CVD). Therefore, we assessed the disease burden of CVD attributable to sodium intakes above 2,000 mg/day and prospectively investigated the association between dietary/urinary sodium levels and the risk of all-cause and CVD-mortality using the Korea National Health and Nutrition Examination Survey (KNHNES). SUBJECTS/METHODS: A total of 68,578 and 33,113 participants were included for comparative risk assessment (CRA) analysis and mortality analysis, respectively, and mean follow-up time for mortality was 5.4 years. CRA analysis was used to quantify attributable incidences of stroke, ischemic heart disease (IHD), and deaths attributable to sodium intake between 1998 and 2016. Cox proportional hazard regression model was used to determine the association between sodium intake and all-cause and CVD-mortality. RESULTS: Mean dietary sodium intake decreased over time, reaching 3,647 mg/day in 2016. Similarly, the population attributable fractions of stroke and IHD, and the number of CVD-associated deaths attributable to high sodium intake/excretion also decreased. In terms of association with mortality, when participants were grouped into quartiles (Q) by energy-adjusted sodium intake, those in Q2 had a lower risk of all-cause mortality than those in Q1 with lower intakes. The risk of CVD-associated mortality was higher only in females with high sodium intake in Q4 than those in Q1. CONCLUSIONS: This nationwide data indicates that, in line with previous studies of multiple cohorts, both low and high sodium intakes may be associated with an increased risk of mortality; therefore, the optimal sodium intake for Koreans needs to be revised.

• 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.

• Korean Journal of Community Nutrition
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• v.17 no.1
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• pp.38-48
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• 2012

The purpose of this study was to compare regional differences in salty taste assessments, nutrition knowledge, dietary attitudes and dietary behaviors associated with high-salt diets in four national regions in Korea (Region 1: Seoul, Sokcho, Region 2: Buyeo, Jecheon, Gong Ju, Region 3: Daegu, Gyeongsan, Region 4: Jeon Ju). Subjects were 860 persons who participated in sodium reduction campaign. The result of the salty taste assessment by region was not significantly different. The nutrition knowledge score of subjects in Region 1 was the highest. Dietary attitude scores that showed preference for high-salt diets of Region 2 and Region 4 subjects were higher than those of Regions 1 and 3 subjects (p < 0.001). Dietary behavior scores were not significantly different among regions. The correlation between sodium intake and salty taste assessment was significant (p < 0.01). Older subjects who had high blood pressure levels and lower nutrition knowledge were more likely to have high sodium intakes. Even though the salty taste assessment and dietary behavior scores by region were not significantly different, the salty taste assessment scores had a significant negative correlation with nutrition knowledge and had a significant positive correlation with dietary attitude and dietary behavior in terms of preference for high-salt diets. Therefore, nationwide education regarding salt intake reduction and health and a campaign to encourage favorable attitudes and behavioral changes regarding consumption of a no-salt / low-salt diet is needed.

• Korean Journal of Community Nutrition
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• v.19 no.4
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• pp.342-360
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• 2014

Objectives: This study aimed to develop nutrition education program for consumers to reduce sodium intake based on social cognitive theory (SCT). Methods: The main factors of SCT related to low sodium diet were investigated by using focus group interview (FGI) with 30 women who participated in consumer organizations. Results: The main target groups for the education program were housewives (H), parents (P), and the office workers (OW), for which we considered their influences on other people and the surroundings. According to the results of FGI, in carrying out low sodium diet, 'positive outcome expectation' were prevention of chronic disease and healthy dietary habit, and 'negative outcome expectation' were low palatability of foods, difficulty in cooking meals, and limited choice of foods. The contents of the program and education materials were individualized by each group to raise self-efficacy and behavioral capability, which reflected the results of the FGI. The program included 'salt intake and health' to raise positive outcome expectation. For improving the ability to practice low-sodium diet, the program contained the contents that focused on 'cooking' and 'food purchasing' for H, on 'purchasing and selection of low-sodium food with the children' for P, and on 'way of selecting restaurant menu' for OW. Also the program included 'way of choosing the low-sodium foods when eating out' with suggestions on sodium content of the dishes and snacks. Further, 'dietary guidelines to reduce sodium intake' was also suggested to help self-regulation. Conclusions: This nutrition education program and education materials could be utilized for the community education and provide the basis for further consumer targeted education program for reducing sodium intake.

• Korean Journal of Community Nutrition
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• v.6 no.4
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• pp.668-677
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• 2001

This study conducted to assess the effectiveness of nutrition education program for elderly females with various diseases. Forty subjects(hypertension ; 20, diabetes ; 12, hyperlipidemia ; 8) out of 56 completed the 7 weeks nutrition education program. The nutrition education program was based for healthy food habits and dietary guidelines for each specific disease. It also included practicing individualized menu planning and exercising program. Energy, calcium, iron, vitamin A and ash intakes significantly increased in the hypertension group. total sodium intake did not decrease, however sodium intake per kcal decreased significantly(p〈0.05). Elderly with diabetes did not show any changes in dietary intakes. Dietary protein, plant fat, ash, and sodium intakes were significantly elevated(p〈0.05), but cholesterol intakes significantly decreased(p〈0.05) in the hyperlipidemic group. Elderly with hypertension agreed strongly with changes of food habits such as increasing milk intake, and decreasing Kimchi, soup, pickles and salty food, and table salt intakes after nutrition education. Diabetic elderly showed significantly improved food habit scores in decreasing white rice intake, sugar intake and increasing sea-weed consumption, vegetable consumption and exercise. Hyperlipidemic elderly did not show much improvement in food habit scores except in biochemical indices. However, mean serum glucose and atherogenic index decreased in the diabetic and hyperlipidemic groups after education, respectively.

• Nutrition Research and Practice
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• v.9 no.2
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• pp.180-185
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• 2015

BACKGROUND/OBJECTIVES: The aims of the present study are: 1) to quantify sodium consumption of patients with unstable or uncontrolled hypertension, 2) to investigate if reduced sodium intake can lower BP in these patients, and 3), to assess the acceptability and feasibility of this approach. SUBJECTS/METHODS: This study included 25 adults (age: 50+ years) with frequently elevated BP or patients with uncontrolled, uncomplicated hypertension despite drug treatment in a general practice setting. BP and salt intake (24h urinary excretion and food records) were measured at baseline and after a sodium reduced diet. RESULTS: Mean (${\pm}SD$) systolic (SBP) over diastolic (DBP) blood pressure (mmHg) at baseline was $150.7({\pm}9.5)$/$84.149({\pm}5.6)$. Mean urinary sodium excretion was 146 mmol/24h. A reduction of 28 mmol sodium excretion decreased SBP/DBP to $135.5({\pm}13.0)$/$82.5({\pm}12.8)$ (P < 0.001). After one month of no dietary advice, only in 48%, SBP was still ${\leq}140mmHg$. CONCLUSION: Assessment of sodium intake using food records, 24h urine collections and probing questions to identify use of sodium containing supplements or drugs are essential for tailored advice targeted at sodium intake reduction. The results of the present study indicate that reduced sodium intake can lower BP after 4 weeks in unstable or uncontrolled hypertensive patients.

• The Korean Journal of Food And Nutrition
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• v.33 no.5
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• pp.447-458
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• 2020

This study assessed yearly trends of food and nutrient intake among high school students aged 16 to 18 years (n=2,377) using the 2007~2015 Korea National Health and Nutrition Examination Survey (KNHANES). Yearly trends of food or nutrient intake were analyzed via logistic regression analysis. The results showed that consumption of sugars & sweets, and beverages & alcohols was increased rapidly during this period (p<0.0001). Intake of meat & meat products, and fish & shellfish also was increased (p=0.0008). Intake of grains and grain products was increased until year 2011 but declined after 2012 (p=0.0025). Consumption of vegetables, and milk & milk products was decreased (p=0.0395). Intake of protein, fat, thiamin, riboflavin, niacin, and iron was increased (p=0.0445). Carbohydrate energy ratio was decreased, whereas fat energy ratio was increased (p=0.0235). Most nutrient intakes satisfied the dietary reference intakes for Koreans except dietary fiber (19.6~26.2%), calcium (46.9~55.2%) and sodium (more than 221.4%) during this period. There was a significant positive correlation between most food group intakes and most nutrient intakes (p=0.0468). Therefore, it is crucial to increase dietary fiber and calcium intake and decrease consumption of sugars, fats and sodium through diverse eating of food groups to ensure balanced nutrition of subjects.