• 대한영양사협회학술지
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• 제19권2호
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• pp.173-181
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• 2013

This study used survey data to identify the use of salimeters and the prevalence of sodium reduction education in the Gyeonggi region. A survey with 211 dietitians working in school foodservice (106 in elementary schools, 69 in middle schools, and 36 in high schools) was conducted from August 6 to August 17, 2012. The data were analyzed using the SPSS program. Though 86.6% of school kitchens had salimeters, the rate for checking the sodium content of soup or stew was just 62.7% and the rate for checking the sodium content of kimchi and solid food was very low. Since salimeters are mostly used to measure sodium in liquid foods, it is urgent to provide an education and manual on using salimeters and to promote salimetry for kimchi and side dishes. It is also important to provide students with nutritional information by clearly posting the sodium content of food on menus and compelling students to notice them. Sodium reduction education for cooks was conducted in the 70.3% of the kitchens; however, the dietitians perceived that the cooks did not understand the importance of the education. Also, sodium reduction education for students was mostly provided through indirect methods, rather than face-to-face education, resulting in poor educational data (only 36.4% comprehending). By providing detailed guidelines for sodium reduction and labelling accurate content of sodium of the menus, we will be able to enforce practices for sodium reduction in school lunches.

• Nutrition Research and Practice
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• 제17권4호
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• pp.812-825
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• 2023

BACKGROUND/OBJECTIVES: This study investigated the importance and performance level of sodium reduction practices in school meal service by school nutrition teachers and dietitians, and compared them according to school level and placement of the school nutrition teacher. SUBJECTS/METHODS: An online survey was conducted with 608 nutrition teachers and dietitians in schools in the Republic of Korea from September 28 to November 12, 2021 (response rate: 57%). The questionnaire comprised 11 items related to sodium reduction practices (purchasing, food preparation and serving, and education). The importance and performance level of each item was rated on a 5-point scale. The mean differences were analyzed using t-tests or one-way analyses of variance and Duncan's post-hoc tests. An importance-performance analysis was performed on sodium reduction practices. RESULTS: Participating in sodium reduction education, sodium reduction education for cooks, and sodium reduction education for students were assessed to have high importance but low performance. Overall, the higher the school level, the lower was the importance level of sodium reduction practices. The performance in kindergartens and elementary schools was higher than that in middle and high schools. The importance in the purchasing category perceived by dietitians was lower as compared to nutrition teachers. In addition, the performance in the purchasing, food preparation and serving, and education categories perceived by dietitians was lower than those of nutrition teachers. CONCLUSION: Sodium reduction education for nutrition teachers and dietitians, cooks, and students should prioritize practicing sodium reduction in school meal service. Specific guidelines for managing sodium reduction at all stages-purchasing, food preparation, and serving-should also be developed. The results could be used as basic data to reduce the sodium content in school meals.

• 대한지역사회영양학회지
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• 제18권6호
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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.

• 대한지역사회영양학회지
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• 제25권5호
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• pp.386-395
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• 2020

Objectives: The aim of this study was to investigate sodium reduction practices in school foodservice in Daegu. Methods: The survey included 199 nutrition teachers and dietitians working at elementary, middle and high schools in Daegu. The survey topics included the following: the frequency of salinity measurement, workers in charge of the measurement, average salinity of the soup and stew served, frequency and difficulties of offering low-sodium meals, Importance-Performance Analysis (IPA) of sodium reduction methods in school foodservice and the need for political support in encouraging sodium reduction. Results: The mean salinity of the soup and stew was higher in high school foodservice than in elementary and middle school foodservice. Middle and high schools have difficulties in offering low-sodium meals due to concerns of decreasing satisfaction for the meals. The results of the IPA of programs to reduce sodium in school meals showed that most of the items in the cooking and serving stages were in the 2nd quadrant (Keep up the good work), and all purchasing and menu planning stages occupied the 3rd quadrant (Low priority). To reduce sodium in school meals, government support is required in developing low-sodium recipes for school foodservice, encouraging education on sodium reduction for school foodservice officials and developing low-sodium food for institutional foodservice. Conclusions: To encourage sodium reduction in school meals, the priority is to make low-sodium recipes available. Also, it is necessary to develop a program that calculates the sodium content in menus and processed foods through National Education Information System and to establish standards for sodium levels in school foodservice.

• 대한지역사회영양학회지
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• 제17권6호
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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.

• Nutrition Research and Practice
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• 제10권6호
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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.

• Journal of Nutrition and Health
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• 제50권5호
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• pp.472-482
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• 2017

본 연구는 광주광역시와 전라남도에 거주하는 건강한 성인 남성 200명을 대상으로 나트륨 저감화 행동변화단계에 따른 식행동 특성 및 영양교육의 효과를 분석하였으며 주요 결과는 다음과 같았다. 행동 유지단계 대상자의 연령은 고려전단계와 고려 준비단계 대상자에 비해 유의적으로 높았다. 운동과 외식의 빈도 및 짠 음식의 선호도에서 행동변화단계에 따른 유의한 차이가 있었다. 고나트륨 함유 식품의 섭취빈도는 우동, 라면 등 국물음식과 순대의 섭취에서 나트륨 저감화 행동변화 변화단계에 따른 유의적 차이가 있었다. 식행동 점수는 행동 유지 대상자가 고려전, 고려 준비 대상자에 비해 유의하게 높았으며, 나트륨 저감화 영양교육에 의해 고려전단계와 고려 준비단계의 식행동의 점수가 유의적으로 개선되었다. 섭취빈도 관련 식행동 점수에서 행동 유지 대상자는 고려전, 고려 준비 대상자에 비해 유의적으로 높았으나 영양교육에 의한 개선 효과는 없었다. 전체 대상자의 나트륨 관련 영양 지식은 나트륨 저감화 영양 교육 후 정답률이 모든 행동단계 대상자에서 유의적으로 향상되었으며, 대상자들의 행동단계가 고려전단계는 큰 폭으로 감소하고, 행동 유지단계는 증가하였다. 이상의 연구 결과를 종합해 보면 나트륨 저감화를 실천하는 대상자들에 비해 고려전, 고려 준비단계 대상자들은 식행동 및 영양지식이 바람직하지 않은 성향이었으나 나트륨 저감화 영양교육에 의해 식행동과 영양지식이 개선되었다. 본 연구는 단 1회의 나트륨 저감화 단기 교육에 의한 평가로, 그 결과를 일반화하기에 제한점이 있다. 따라서 나트륨 저감화 행동변화단계에 따른 영양교육의 효과를 다양하게 분석하기 위한 추후 연구가 필요할 것이다.

• 동아시아식생활학회지
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• 제22권6호
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• pp.734-743
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• 2012

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.

• 대한지역사회영양학회지
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• 제28권4호
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• pp.269-281
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• 2023

Objectives: This study aimed to examine the frequency of convenience food consumption at convenience stores (CVS) and the CVS usage patterns of middle and high school students as well as to understand students' attitude toward sodium and sugar reduction. Methods: We used an online questionnaire for data collection. The questionnaire comprised five distinct categories: general characteristics, CVS usage, frequency of consumption according to convenience food menus at CVS, attitude toward sodium and sugar reduction, and adherence to dietary guidelines. Results: A total of 75 students from Seoul (14 middle school students and 61 high school students) participated in the study. Most respondents visit CVS 3-5 times a week. CVS are predominantly used during weekdays, mostly during lunch, and dinner. The students mostly checked the caloric content and expiration date as food labeling information. The participants were aware of the need to reduce their sugar and sodium intake. Among frequent CVS convenience food consumers, there was an increased consideration of the need to reduce their sugar and sodium consumption, despite their actual selection of foods with high sugar and sodium content. Additionally, they did not check the sugar and sodium levels indicated in food labeling. Further, the dietary action guide from the Ministry of Health and Welfare were poorly followed by most students. Conclusions: There is a need for nutrition education specifically addressing the sugar and sodium content of the convenience foods predominantly consumed by students. Additionally, educating students with frequent convenience food consumption to actively check the sugar and sodium information on food labels could help promote healthier food choices.

• Journal of Nutrition and Health
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• 제55권1호
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• pp.174-187
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• 2022

본 연구는 가정 내의 식품구매와 조리를 주로 담당하는 주부를 대상으로 나트륨 줄이기 영양교육프로그램을 개발하고 전국적인 교육을 실시한 후 설문지로 교육전·후환경적·인지적·행동적 요인의 변화와 행동변화 단계 분포를 조사하여 교육효과를 분석하였다. 교육에 참여하여 분석된 대상자는 387명으로 평균연령 54세, 고졸이상 학력이 87.6%였다. 교육 후 나트륨 줄이기와 관련된 사회적 노력과 영양표시에 대한 인지 비율이 증가하고 소금, 간장, 치즈, 스낵 및 칩 등의 저나트륨 제품 구매경험이 높아졌다. 나트륨 섭취 줄이기의 긍정적 결과로 골다공증 예방에 대한 기대가 높아졌고, 부정적 장애요인의 평균점수가 낮아졌는데 특히 '가족이나 친구와 함께 식사할 때 사회적 관계의 제한으로 혼자 저나트륨식을 실천하기 어려움', '저나트륨식은 맛이 없음', '나트륨 줄이기 실천을 위한 기술, 정보, 방법을 모름', '국, 찌개 등의 국물음식 선호' (p <0.05)의 항목들이 유의미하게 개선되었다. 나트륨 섭취 줄이기와 관련된 인식 및 영양지식은 모든 항목에서 향상되었으나 나트륨 섭취 줄이기 실행과 관련된 자아효능감은 '가공식품과 인스턴트 식품보다는 신선식품을 구매하겠음' 항목만 유의미한 점수향상을 보였다 (p < 0.05). 또한 교육 후 나트륨 섭취 줄이기와 관련된 식행동도 '국, 찌개나 국수류의 국물을 다 먹는 편이다' (p < 0.05)와 '식품구매나 외식할 때 영양표시의 나트륨 함량을 확인하는 편이다' (p < 0.001)의 항목만 개선되어 한계가 있었다. 나트륨 줄이기 행동변화 단계는 행동전단계가 교육 전 43.2%에서 교육 후 21.5%로 감소하고, 행동단계는 교육 전 19.6%에서 교육 후 43.5%로 증가되었다. 특히 교육 전 행동전단계인 대상자들은 교육 후 모든 부분의 점수가 향상되어 가장 뚜렷한 효과가 나타났다. 결론적으로 나트륨 섭취 줄이기를 위한 식품구매와 조리에 집중하여 주부 대상으로 개발된 본 영양교육 프로그램은 단기간임에도 나트륨 섭취 줄이기에 대한 결과기대와 인식, 영양지식을 향상시키고 나트륨 섭취 줄이기 실행단계를 개선시켜 집단의 행동변화 유도에 효과적이었으며, 식행동개선을 위한 후속 연구의 기초자료를 제공한 점에서 의의가 있다.