This paper presents the status of nutrition education for older adults in Korea, and examines considerations in developing effective nutrition education programs for the elderly based on literature reviews. Finally, strategies of nutrition education for older adults in Korea are examined. Status of nutrition education were examined by surveying 90 senior centers, and 46 public health centers providing nutrition services. Most senior centers(96%) provided health education programs, however, nutrition was only a part of health programs. Among the 41 public health centers which responded to the survey, 73.1% provided nutrition education for older adults. The frequently covered topics were prevention & management of hypertension/stroke, diabetes, nutritional management during later adulthood, and osteoporosis. Common barriers in planning and implementing elderly education were; lack of educational materials for older adults, reliance on lectures, difficulty in following-up. To develop effective nutrition education, four stages consisting of needs assessment, planning and implementation of programs, and evaluation should be carefully done. Needs assessment might be done using quantitative or qualitative assessment. Factors influencing nutrition behavior of older adults can be systematically examined using a theoretical approach such as the PRECEDE-PROCEED framework. Qualitative methods, such as focus group interviews, also provide insightful information regarding the needs of older adults. In planning nutrition education programs, physical and pshychological changes associated with aging should be considered. Literature regarding elderly education suggest that active participation or participatory learning is also effective for older adults. Educational materials are developed following the principle of KISS and pre-tested. Program evaluation has been rarely done in practice, although it provides valuable feedback to the program. Strategies for developing nutrition education for Korean elderly include; performing needs assessment, developing a standard program by topics in a logical and systematic way, developing programs for subgroups of elderly, applying diverse education methods developing educational materials for the elderly, evaluating programs using simple tools, and delivering a nutrition program as a part of health promotion program. Finally, the interaction and communication between researchers and practitioners is strongly recommended to ensure better nutrition education and services to the elderly.
The increased number of elderly in Korea presents great challenges for community nutrition programs. Strategies to enhance elderly nutrition are needed, as well as dietary advice that are reality-based and tailored to the need of the elderly. The purpose of this study was to evaluate the overall effectiveness of an elderly nutrition improvement program(ENIP), by assessing changes in nutrition knowledge, attitudes, and behavior after program completion. ENIP was conducted in Suwon for 4 months in 1998 at 5 centers for the elderly. The program provided individual nutrition counseling and brief biweekly group education sessions. To stimulate participation and motivation, the elderly in two centers were served free milk packs(200ml) three time a week during the program(milk+education group), and the elderly in 3 other centers were served yoghurt on the program day(education group). Altogether, 102 subjects finished the program(milk+education group 67 ; education group 35). Data about nutrition knowledge, dietary attitudes, diet records(24 hour recall) and dietary habit was collected before(baseline) and after the program(follow-up). The Drop-out rate for the milk+education group(2.9%) was significantly lower than that for the education group(30.0%)(p<.001). The Nutrition Knowledge fo females milk+education group increased significantly after the program, but no significant differences were observed in other groups. Over 60% of all the elderly showed positive responses to the healthy eating attitudes. Energy, protein, vitamin A, riboflavin, Calcium and Potassium intakes improved in the male milk+education group. The Vitamin C intake improved in the male education group. Energy and vitamin A intakes improved in the female milk+education group and energy, vitamin A, thiamin, riboflavin, niacin, Ca nad P in the female education group. A stepwise multiple regression analysis was performed to examine the effects of food intake changes on overall nutrient quality. For all elderly, the fish intake explained 12.6% of the variance, followed by candy intake and vegetable intake(model $R^2$=19.6%). Dietary habits such as meal time regularity and salty food reduction were markedly improved in both groups. Sixty-one percent of the milk+education subjects stated their participation was voluntary and active, while 51% of education subjects did. Sixty four percent of the subjects stated their interest on diet increased remarkably through program participation. Considering the results, it is conjectured that ENIP had a great impact on nutrient intake, dietary attitudes and habits. Milk supplement showed no direct effects on elderly nutrition improvement, but it encouraged the program by reducing drop-out rates and inducing voluntary participation. Therefore milk supplement could enhance the community nutrition education program. Moreover it is strongly suggested that the ENIP be expanded to other communities.
The purpose of this study was to evaluate the effect of nutrition education on dietary knowledge, dietary attitudes, and dietary behavior of elderly by analyzing changes before and after nutrition education. This study was conducted in Seoul from March 2022 to December 2022 for 50 elderly (6 male, 44 female) who participated in nutrition education for 8 weeks at three senior welfare centers (Seodaemun, Seongbuk, Jongno). A total of 35 responses were used in the final analysis. Statistical analysis was conducted using descriptive statistics, paired t-test, and Wilcoxon's signed rank test by age, hypertension, and dislipidemia to find effect of nutrition education on their nutritional knowledge, dietary attitudes, and dietary behavior. Results showed that nutrition education had a significant effect on the elderly. In particular, for those with chronic diseases such as hypertension and dislipidemia, the difference after education was significant, indicating significant changes in dietary habits. This study is expected to provide basic data for the development of a systematic nutrition education program for the elderly in the future.
This study aim to evaluate dietary quality and nutritional status according to the consumption of health functional food using Nutrition Quotient for Korean elderly (NQ-E) for 288 elderly people attending senior welfare centers in Gyeonggi-do. The questionnaire consisted of items about general information, health functional food, and Nutrition Quotient for Korean elderly (NQ-E). Chi-squared test, Fisher's exact tests, and Analysis of Covariance (ANCOVA) were performed using the SAS program ver. 9.4. Among the male and female subjects, the female subjects consumed more health functional food. The results of the dietary quality and nutritional status difference according to the intake of health functional food showed significant differences only in the areas of variety and abstinence among nutrition quotient factors for men, while no significant differences were observed in any of the nutrition quotient factors for women. In conclusion, focused-nutrition education program and useful guideline is needed for promoting adequate consumption of health functional foods in elderly.
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.
Low energy intakes, poor nutritional quality, and low food diversity are among the factors affecting the nutritional status of elderly in Korea. Therefore, a nutrition counseling and education program was conducted to promote dietary change and to improve nutritional status of elderly. The 7 step program consisted of a individual nutrition counseling and weekly or biweekly group nutrition education programs. Pre- and post-test measurings of dietary behaviors, attitudes, nutrition knowledge, and 24-hour dietary recall data were collected. Positive changes in the attitude related to diet were noted, whereas nutritional knowledge scores were not improved. Significant increases were noted in the frequency of vegetable consumption in female and diversity of food consumption in male. The densities of vitamin C(male & female), $B_1$, $B_2$, and niacin, calculated using the INQ(Index of Nutritional Quality), were significantly improved by nutrition counseling and education programs. These results suggest the appropriateness of nutrition intervention programs for the improvement of elderly nutrition.
This study was conducted to assess improvements in nutritional status following the application of nutrition education to elderly patients in a long-term care hospital. The study was carried out from January to May 2009, during which a preliminary survey, a pretest, the application of nutrition education, and a post-test were applied in stages. The number of subjects at pretest was 81, and the number of participants included in the final analysis was 61 (18 men, 43 women), all of whom participated in both the nutrition education program and the post-test. The survey consisted of general demographic items, health behaviors, dietary behaviors, the Nutrition Screening Initiative checklist, and nutrient intake assessment (24 hour recall method). The nutrition education program lasted for four weeks. It included a basic education program, provided once a week, and mini-education program, which was offered daily during lunch times. The survey was conducted before and after the education program using the same assessment method, although some items were included only at pretest. When analyzing the changes in elderly patients after the nutritional education program, we found that, among subjective dietary behaviors, self-rated perceptions of health (P<0.001) and of depression (P<0.001) improved significantly and that dietary behavior scores also improved significantly (P<0.001), while nutritional risk levels decreased. In terms of nutrient intake, subjects' intake of energy, protein, fat, carbohydrate, calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C all increased significantly (P<0.001). These results indicated that nutritional education is effective in improving the nutritional status of elderly patients. We hope that the results of this study can be used as preliminary data for establishing guidelines for nutrition management tailored to elderly patients in long-term care hospitals.
The aim of this study was to evaluate the effects of a nutrition education program for the elderly at a public health center located in Jinhae city. The one group pretest and posttest design was conducted using self-administered questionnaire survey. Nutrition education lessons based on social cognitive theory (2 hours/lesson, 3 times) were provided to 27 female elderly(${\geq}65$ yrs) for a month. After the nutrition education, number of exercise increased and preference for sweetness decreased significantly (p<0.05). The outcome expectations, the knowledge of nutrition (p<0.001), and behavioral capability (p<0.05) score were significantly increased. There were significant increases in all nutrient intake. NAR was increased significantly in protein, calcium and vitamin C (p<0.01), dietary fiber, iron, zinc, thiamin, niacin and folic acid (p<0.001), and riboflavin (p<0.05). INQ was increased significantly in thiamin, vitamin B6 and niacin (p<0.05), and dietary fiber (p<0.01). The score of nutrition education satisfaction was high (4.52). The results of this study suggested that the nutritional education program based on social cognitive theory had a positive effect on dietary behavior changes, and nutrition intake status among female elderly even after short-term intervention.
This study aimed to plan nutrition support programs for the elderly living alone whose nutrition status were seriously concerned, conducted seven stages nutrition intervention program on a trial basis, and evaluated the effectiveness of the program of the Elderly Nutrition Support Project. Subjects were selected for personalized nutrition management based on nutritional risk score and nutrition intervention were tailored to the problems occurred. The elderly nutrition support program targets were 44 senior citizens who lived alone with low income. The 33 (as Type 1) of the subjects with whom milk, tofu, seaweed, eggs, black beans have been supported, and also provide nutrition education, and the rest 11 persons (as Type 2) to whom food was not supported but provide nutrition education programs. As a result, all subjects showed that compared with pre and post program implementation, their daily exercise time and milk and protein consumption level were increased and some improvement was observed regular meals consumption and low-salt diets. Their nutrient intake level such as calories, protein, calcium, iron improved after implementation. In addition, NSL DETERMINE scores significantly improved from 13.21 to 7.24 in Type 1 and 11.27 to 9.91 in Type 2. As positive dietary behavioral changes were observed as in that they purchased more protein and calcium rich foods.
This study was performed to investigate the effects oi nutrition education program in physical health, nutritional status and health-related quality of life (HRQoL) of the Elderly in Seoul. Nutrition education program was consisted of healthy eating, prevention and diet therapy of obesity, diabetes, cardiovascular disease, and osteoporosis. Seventy eight free-living elderly people (13 male, 65 female), aged ${\geq}60 $ years participated in this program. Before and after nutrition education program, we surveyed the general characteristics, physical health, general health, nutrition status, and health-related quality of life to the subjects. All the subjects were divided into program completers (N=47) and noncompleters (N=31). All the data were analyzed by student t-test, chi-square test, paired t-test, and marginal homogeneity test using SPSS 9.0 version at p<0.05. After nutrition education program, physical activity and ADL maintained, however IADL improved in program noncompleters. In eating habits, 'slow eating' significantly improved in program completers in program completers. Nutrition knowledge and recognition scores were significantly increased in both groups, and accuracy score was significantly increased in program completers. However, nutrient-intakes of %RDA were not significantly changed in both groups, and it seemed to be more influenced by other factors such as 'family income' or 'family type' than by the nutrition education program. In HRQoL, social functioning was improved after nutrition education program in both groups (p<0.05). The nutrition education program has more effects on the program completers than on the noncompleters, and it is also needed social supports for the Elderly to fulfill their nutrient requirements.
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