Educating restaurant owners and cooks to lower their own sodium intake is a potential strategy for reducing the sodium contents of restaurant foods: a small-scale pilot study in South Korea

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.

The Relationship between Type D Personality and Heart Rate Variability in Community Mental Health Center Users

OBJECTIVE: Type D personality can be regarded as a promising cardiovascular risk marker that has been repeatedly linked to relevant indicators of mental health, quality of life, morbidity, and mortality in cardiac patients. Heart rate variability (HRV) is a non-invasive technology that can provide information regarding a patient's sympathetic/parasympathetic balance and the control mechanisms of the autonomic systems in the cardiovascular system. As both type D personality and HRV are parameters related to the cardiovascular system, we assumed a relationship between type D personality and HRV. This study set out to identify the relationship between type D and HRV and the differences in HRV variables between type D and non-type D personalities. METHODS: Patients who visited Guro Community Mental Health Center from January 2011 to December 2012 were surveyed. They were evaluated using both the Korean version of the Type D Personality-14 for type D personality and HRV. During the survey, those who reported major cardiovascular disease that can affect heart rate variability were excluded from the study. RESULTS: Our analysis included 559 participants, 249 of whom were classified as type D personality. No significant differences were found in the HRV variables between the type D group and the non-type D group. There were also no clinically meaningful correlations between HRV variables and type D total/subscale scores when controlled for patient age. CONCLUSION: A relationship between HRV and type D personality was not identified using short-term HRV measurements in non-clinical patients with no definitive cardiovascular disease. Further studies using long-term HRV measurements in patients with cardiovascular disease are necessary to conclude an association between HRV and type D personality.

Sputum Smear Conversion During mDOT (Modified Directly Observed Treatment) / 결핵

BACKGROUND: To assess the effects of mDOT implementation on sputum smear conversion for AFB (Acid fast bacilli) positive pulmonary tuberculosis patients, modified Directly Observed Treatment (mDOT) was started on October 8th 2001 at a health center in Seoul. mDOT was defined through weekly interviewing and supervising of a patient by a supervisor (doctor, nurse, or lay health worker). The sputum smear conversion of a mDOT group was compared with that of a self-medication (self) group. METHODS: This study included 52 AFB positive pulmonary tuberculosis patients registered at a health center in Seoul between October 8th 2001 and April 23rd 2002. 24 and 28 patients were enrolled in the mDOT and self medication groups, respectively. Paired (1:1) individual matching, by gender, extent of disease, relapse and age-matching variables, was performed between the two groups, resulting in 20 paired matches. This prospective study was planned as an unblinded, non-randomized quasi- experimental pilot project. Outcomes were identified from results of sputum smear examinations for AFB in both groups at 2 weeks, and 1 and 2 months. The paired matching data were analyzed using the SAS program version 8.1 by McNemar test. RESULTS: At the end of 2 weeks of treatment, the sputum smear conversion of the mDOT group was somewhat higher than that of the self medication group (78.57 vs. 50%, p-value=0.289), and after 1 month of treatment no statistically significant difference was shown between the two groups (83.33 vs. 50, p-value=0.125). At the end of 2 months of treatment (initial intensive phase), the sputum smear conversions of the mDOT and self groups were 95 and 75%, respectively (p-value=0.219). CONCLUSIONS: The implementation of mDOT did not result in clinically significant increases in the sputum smear conversion at 2 weeks, and 1 and 2 months compared with that of the self medication group. However, the increases experienced might contribute to diminishing the infectious period of AFB positive patients, and this approach may act as a guide for a specific group of patients. In this study, mDOT was performed for one hundred percent of the intensive treatment phase. It can also be an effective treatment for pulmonary tuberculosis patients, and may be useful for some high risk tuberculosis patients.