• 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.

• 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.

• 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.19 no.5
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• pp.425-435
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• 2014

Objectives: The purpose of this study was to develop a Na-reduction education program and apply it for cooks who prepare meals in day-care centers. To development of the program was based on increasing the self-awareness of salinity, eating behaviors and enforcing skills of low-Na cooking. Methods: The study was carried out from April to October in 2013, fifty five cooks participated in this program. The Na reduction program composed of 4 sessions of education which included a 90-minute lecture and self-reevaluation of personal salt-sensitivity degree and three low Na recipe cooking classes. In order to measure the effectiveness of the program, the pretest and posttest of salinity of the soups provided by day care centers was conducted at registration and 5 month after the program with the same menu. Results: After the conduct of the program, salimeter using rate was increased from 8.2% to 94.6% after the program and the other measuring instruments using rate was gradually increased. We observed that the score on eating behaviors increased 1.51 points from 38.80 to 40.31 after the intervention program (p < 0.001). Further, increased knowledge and skill provided by the intervention program resulted in improved Na-reduction cooking capability. According to the results from analyzing the soup salinity, the salinity in watery soup was significant reduced from 0.556 to 0.449 0.107 and soybean-paste soup was significant reduced from 0.669 to 0.551 after the intervention program (p < 0.001). Conclusions: As the result of fact, the intervention programs that was based on self-reevaluation, to enforce practical skill and consciousness was effective to serve low sodium menu at day care centers.

• Korean Journal of Community Nutrition
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• v.17 no.5
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• pp.623-636
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• 2012

Health Belief Model is a socio-psychological theory of decision making to individual health-related behaviors. This study was aimed to develop an effective education program for hypertension based on health belief model. The main factors of health belief model were investigated by focus group interview (FGI) with 23 hypertensive or prehypertensive subjects aged over fifty years. 'Perceived susceptibility' to hypertension was family history, neglect of health care, preference for salty food, broth of soup and stew. Lifelong medication, complications, and medical costs were reported as 'perceived severity' of hypertension. 'Perceived benefits' of hypertension management were decrease of medicinal dose, reduction of medical costs, and healthy eating habits of the family, while 'perceived barriers' were lack of palatability of low salt diet, convenience-oriented dietary habits, and limited choice of foods when eating out. Subjects mentioned TV health programs, public health center programs, and advice from doctors and family as 'cues to action' of hypertension management. These qualitative information provided basis for developing a nutrition education program for hypertension which could be implemented in the public health center. Eight week program was composed of understanding hypertension, risk factor management (eating habits, weight), low salt diet (principles, cooking), advanced management for healthy diet in 2 sessions, and summary. Each session was designed to alert the susceptibility and severity, to emphasize the benefits, and to reduce the barriers by providing dietary monitoring, practical advice, and action tips.

• Korean Journal of Community Nutrition
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• v.14 no.6
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• pp.746-755
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• 2009

This study was to develop and evaluate a nutrition education program to reduce dietary sodium. The school children (218 boys, 226 girls), from 8 elementary schools in the city of Daegu, Korea, were involved in this study. This research was based on the data from two groups of elementary school children, the "education" group (n = 240), and "no-education" group (n = 204). Educational media and programs were developed to educate the education group for four weeks and were presented on the web (www.saltdown.com). After education, the preference for a non-salty taste in the education group increased 10%, compared with those who preferred a non-salty taste before education. There was a significant change away from a preference for a salty taste and a rise in the mean score for nutrition knowledge and dietary attitude in the education group compared to the no-education group (p < 0.05). This study indicates that school children can reduce their dependency on preference for a salty taste and change their high-salt dietary behavior after the education.

• Journal of the Korean Dietetic Association
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• v.6 no.2
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• pp.125-135
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• 2000

Hypertension is a well-known degenerative disease whose prevalence rate increases with age. Management of high blood pressure is a critical concern in preventive strategies to reduce the morbidity and mortality for cardiovascular disease. The purpose of this study was to examine the dietary characteristics of hypertensive program participants, and to establish strategies based on their nutritional needs. Hypertensive patients were enrolled in the program in a public health center or in a local elderly center, at Suwon, in 1999-2000. Trained dietitians interviewed 62 enrollees(24-hour recall) and related variables. Mean body mass index of the subjects was 25.0kg/m². 30.7% of the subjects had a family history of hypertension. The majority of them ate regularly and partook of all available side dishes. They consumed grains and vegetables regularly, but seldom ate dairy products or food prepared with oil. Male enrollees frequently consumed more processed food and animal fat than did female enrollees(p<0.05). An analysis of the percentage of RDA(Recommended Dietary Allowances of Korea 1995) showed that but for ascorbic acid, enrollees consumed nutrients below the RDA. The food group intake pattern was not diverse, thus only 8.1% of enrollees consumed all food groups in a day. An analysis of eating attitude showed that 64.5% of enrollees always added salt to beef soup. Male enrollees showed low food-related self-efficacy compared to female enrollees, especially with reference to reduction of instant food intake(p<0.01), increase in vegetable intake(p<0.01), reduction of monosodium glutamate(MSG) intake(p<0.01). and not overeating(p<0.05). Their perceived barriers for participating in hypertension nutrition programs included lack of time, program necessity non-recognition, and program comprehension difficulty. These results suggest that nutrition education program necessity non-recognition, and program comprehension difficulty. These results suggest that nutrition education programs for community hypertensive patients should focus on increasing participant consumption of foods, expecially dairy products, and desirable eating attitudes. It also suggests that the program should consider should consider encouraging self-efficacy in changing eating behavior.

• 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.

• Korean Journal of Community Nutrition
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• v.20 no.2
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• pp.109-119
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• 2015

Objectives: The purpose of this study was to compare and analyze the results of salty taste assessment, dietary attitudes, and dietary behaviors among adult and senior women by region and by age. The results generated from this was expected to provide fundamental data for implementing a nationwide salt reduction education program. Methods: The salty taste assessment tool was applied to 4,064 subjects from 15 areas in Korea. Also, a survey of dietary attitude and dietary behavior related to salt intake was conducted for all subjects participated in this study. Results: The salty taste assessment scores by region and by age were the lowest in capital (p < 0.01) and was highest among the 70+ year age group (p < 0.01). The dietary attitude scores and dietary behavior scores showed that Gyeongsang was the highest (p < 0.001) and the capital was the lowest. The dietary attitude scores were highest at 20&30's followed by 40's and 70's group (p < 0.001). Dietary behavior scores showed that 20's~30's and 40's groups were higher than the other age groups (p < 0.001). The score of 'I like kimchi' was $3.46{\pm}0.88$, which was the highest among 10 dietary behavior questions. The score of 'I eat a lot of kimchi' was $3.30{\pm}0.90$, which was the highest among 10 dietary behavior questions related to salt intake. The scores of salty taste assessment had significant positive correlations between the scores of dietary attitude (p < 0.001), dietary behavior (p < 0.001) and self-awareness (p < 0.001). Conclusions: Based on the results of salty taste assessment, we observed a tendency that older people and regions except the capital had higher preference for salty taste. Our results suggested the necessity for a nationwide salty reduction education program tailored for regions and for different age groups.

• 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.