• Journal of the Korean Dietetic Association
• /
• v.19 no.2
• /
• pp.173-181
• /
• 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
• /
• v.17 no.4
• /
• pp.812-825
• /
• 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.

• Korean Journal of Community Nutrition
• /
• v.18 no.6
• /
• pp.626-643
• /
• 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
• /
• v.25 no.5
• /
• pp.386-395
• /
• 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.

• Korean Journal of Community Nutrition
• /
• v.17 no.6
• /
• pp.752-771
• /
• 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
• /
• v.10 no.6
• /
• pp.635-640
• /
• 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
• /
• v.50 no.5
• /
• pp.472-482
• /
• 2017

Purpose: This study examined the dietary behavior and the effects of nutrition education according to the stages of behavioral changes in sodium reduction of healthy male adults (20~69 years) in Gwangju Chonnam Regions. Methods: The research subjects were 200 male adults. Results: A significantly higher mean age was observed in the stage of Action Maintenance (A M) than in the stage of Precontemplation (PC) and stage of Contemplation Preparation (C P). Significant differences in the frequency of exercise, eating out, and preference for salty food, intake frequency of Udon, Ramen and Sundae according to the stages of behavior change in sodium reduction were observed. The dietary behavior scores and intake frequency-related dietary behavior scores of A M were significantly higher than PC and C P. Nutrition education for sodium reduction improved the dietary behavior score significantly in PC and C P, as well as the rate of correct answers of sodium-related nutrition knowledge in all stages. After the nutrition education, PC decreased greatly, and A M increased. Conclusion: Subjects in PC and C P had an undesirable propensity in dietary behavior, and nutrition knowledge compared to A M, but the nutrition education for sodium reduction greatly improved their dietary behavior and nutrition knowledge.

• Journal of the East Asian Society of Dietary Life
• /
• v.22 no.6
• /
• pp.734-743
• /
• 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.

• Korean Journal of Community Nutrition
• /
• v.28 no.4
• /
• pp.269-281
• /
• 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
• /
• v.55 no.1
• /
• pp.174-187
• /
• 2022

Purpose: This study was performed to evaluate an education program for housewives to reduce sodium intake based on the social cognitive theory. Methods: Housewives (n = 387) received 2 education sessions focused on food purchase and cooking, and completed a questionnaire on their perceptions of environmental, cognitive, and behavioral factors and the stages of behavioral change to reducing sodium intake both before and after the education program. Results: After the education program, the recognition of social efforts for sodium reduction and sodium labeling and experience with low-sodium products increased. Positive expectancies for the prevention of osteoporosis by the reduction of sodium were enhanced while the main barriers in practicing sodium reduction decreased, especially 'interrupting social relationships when dining with others', 'bad taste', 'preference for soup or stew', and 'limited knowledge and skills to practice'. In addition, cognition and nutrition knowledge related to reducing sodium intake were improved on all scores, but the effect on self-efficacy and dietary behavior was limited to only a few items. The percentage of participants in the pre-action stage (including pre-contemplation, contemplation, and preparation stages) for reducing sodium intake decreased from 43.2% before education to 21.5% after education, while that in the action stage increased from 19.6% before education to 43.5% after education (p < 0.001). The education program had the most significant impact on participants who were in the pre-action stage and showed improved scores in all sections. Conclusion: These results suggest that a customized education program for housewives could be an effective tool to reduce sodium intake by improving personal expectancies, cognition, and nutrition knowledge regarding sodium reduction and enabling a greater section of the population to move to the action stage of reducing sodium intake.