Effect of a public health center-based nutrition education program for hypertension in women older than 50 years of age / 한국영양학회지

PURPOSE: The health risk of women increases after menopause. This study evaluated the effectiveness of a public health center-based nutrition education program for hypertension in women older than 50 years of age. METHODS: The program included 8-week nutrition education and 8-week follow-up with keeping a health diary and nutrition counseling. The program was evaluated three times: before and after the nutrition education, and after the follow-up. The subjects were classified into hypertensives (n = 44) or normotensives (n = 71). RESULTS: The rate of taking antihypertensive drugs in the hypertensive group was 86.4%. The systolic blood pressure decreased in the hypertensive and normotensive groups after nutrition education (p < 0.05). The body weight (p < 0.001), BMI (p < 0.001), waist circumference (p < 0.001), and percent body fat (p < 0.01) were also decreased after nutrition education in both groups. The hypertensive group showed an increase in HDL-cholesterol level (p < 0.001) and decreases in triglycerides (p < 0.01) and LDL-cholesterol (p < 0.05) levels after completion of the program. The normotensive group also displayed significant changes in HDL-cholesterol (p < 0.001) and triglycerides (p < 0.01). The dietary habits and nutrition knowledge on sodium and hypertension were improved in both groups (p < 0.001). The total score of dietary behavior related to the sodium intake was improved in the normotensive group (p < 0.001). The total score of the high sodium dish frequency questionnaire decreased in both groups after nutrition education and completion of the program compared to that before the program. Decreases in the consumption frequencies of noodles, pot stews and stews, Kimchi, and beverages were significant. The total self-efficacy score was increased in both groups by the program (p < 0.001). In particular, the hypertensive group showed improvement in all items. CONCLUSION: This public health center-based nutrition education program may contribute to the prevention and management of hypertension and chronic diseases in women over 50 years of age.

The Effects of Low-sodium Diet Education Program on Dietary Habits, Diet Quality and Obesity Index in Overweight and Obese Middle-aged Women / 대한지역사회영양학회지

OBJECTIVES: This study was conducted to investigate the effect of low sodium diet education program on dietary habits, diet quality, and measures of obesity in overweight or obese middle-aged women. METHODS: Subjects were 81 individuals aged 45 years or over, who completed an 8-week nutrition education. The subjects were divided into a normal group (N = 30) and an overweight-obese group (N = 51) according to the BMI. The effects were evaluated by anthropometric measurement, biochemical analysis, questionnaire, and diet records before and after the program. RESULTS: Overweight-obese group showed significant decreases in weight (p < 0.0001), BMI (p < 0.0001), percent of body fat (p = 0.0087), waist circumference (p < 0.0001), systolic (p = 0.0003) and diastolic blood pressure (p = 0.0261). Nutrients intakes were not different between the two groups and only sodium intake was decreased after education. Total score of general dietary habits, dietary behavior related to sodium intake, dietary diversity score (DDS), diet variety score (DVS), and diet quality index-international (DQI-I) were improved in both groups compared to the baseline. Overweight-obese group showed significant improvement in 'having fruits everyday', 'having fish everyday', 'trying to eat many kinds of food', 'eating less broth when eating soup, stew, and noodles', 'eating less kimchi and salt-fermented vegetable', and 'propensity to think that dishes should be pretty seasoned'. In addition, moderation of empty calories food (p = 0.0064) and macronutrient ratio (p = 0.0004) were improved in the overweigh-obese group, but in the normal group, the results did not reach statistical significance. CONCLUSIONS: These results suggested that low sodium diet education program may contribute to obesity management by improving diet quality and dietary habits in middle-aged women.

A Survey on the Salt Content of Kindergarten Lunch Meals and Meal Providers' Dietary Attitude to Sodium Intake in Gyeonggi-do Area / 대한지역사회영양학회지

Dietary habit of excess sodium consumption is formed mainly by excessive salt intake from the younger age and this may lead to hypertension, stroke, and stomach cancer. This study was performed to estimate the salt content in kindergarten meals and provide basic data on meal providers' dietary attitude to sodium intake for nutrition education. We collected data on161 food items from 16 institutions in Gyeonggi-do and salt content was calculated from salinity and weight of individual food items. The average salt content from lunch meals was 2.2 g, which was about daily adequate intake of sodium for children aged 3 to 5 years old. Greatest contributor to the salt content in a meal was soup and stew (47.8%). The most salty dishes were sauces and kimchi followed by stir-fried food, deep-fried food, braised food, and grilled food. The salt content was higher in soup and stew despite of low salinity, due to the large quantity per serving. The salt contents of soups and kimchi were 40.6% and 14.3%, respectively of the total salt content in dish groups. Staff members and caregivers at home who prepared food for the child showed preference for one-dish rice meal, dried fish and salted mackerel, and broth when eating soup, stew, and noodles. Caregivers showed higher sodium index score and had higher preference for processed food such as Ramen, canned food, and ham compared with staff members (p < 0.05). These results suggested that monitoring salt content of kindergarten meals and nutrition education for those prepare meals for children are needed to lower sodium intake in childhood.

Salt content of school meals and comparison of perception related to sodium intake in elementary, middle, and high schools

Excessive sodium intake leading to hypertension, stroke, and stomach cancer is mainly caused by excess use of salt in cooking. This study was performed to estimate the salt content in school meals and to compare differences in perceptions related to sodium intake between students and staffs working for school meal service. We collected 382 dishes for food from 24 schools (9 elementary, 7 middle, 8 high schools) in Gyeonggi-do and salt content was calculated from salinity and weight of individual food. The average salt content from elementary, middle, and high school meals were 2.44 g, 3.96 g, and 5.87 g, respectively. The amount of salt provided from the school lunch alone was over 80% of the recommended daily salt intake by WHO. Noodles, stews, sauces, and soups were major sources of salt intake at dish group level, while the most salty dishes were sauces, kimchies, and stir-fried foods. Dietary knowledge and attitude related to sodium intake and consumption frequency of the salty dishes were surveyed with questionnaire in 798 students and 256 staffs working for school meal service. Compared with the staffs, the students perceived school meals salty and the proportions of students who thought school meals were salty increased with going up from elementary to high schools (P < 0.001). Among the students, middle and high school students showed significant propensity for the preference to one-dish meal, processed foods, eating much broth and dipping sauce or seasoning compared with the elementary students, although they had higher nutrition knowledge scores. These results proposed that monitoring salt content of school meals and consideration on the contents and education methods in school are needed to lower sodium intake.

Analysis of Body Composition, Dietary Behaviors and Life style of 30~50 year old Women Living in Seoul / 대한지역사회영양학회지

This study was carried out to investigate the distribution of body composition, and to analyze its relationship to dietary behaviors and life style. The study subjects were divided into 3 age groups; 30' years (n = 78) 40' years (n = 71) and 50' years (n = 44). The data was collected by physical measurement (Inbody 230) and questionnaires. The rate of disease and general characteristics were higher in the 50 year old group than in the other groups. Average amount of body water, protein, mineral and body fat were 29.0 kg (50.4%), 7.7 kg (13.4%), 2.8 kg (4.8%), 18.7 kg (31.5%), respectively. The rate of menopause was significantly different with increasing age. Menopause was 1.3%, 9.1%, 79.6% by age respectively. Body fat percent was significantly increased and body water decreased with age (p < 0.01). The fat composition was higher and the mineral content was lower in 50' year old group. Dietary behavior scores of 30' year old group was significant lower than in the other two groups (p < 0.001). The means of salty eating, skipping meals, fruit intake and food habits total point were significantly higher in the 50 year old group than in the other groups. There were significant positive correlations between age, BMI, waist hip ratio respectively (p < 0.01). There were significant negative correlations between age and body water, body mineral, skeletal muscle (p < 0.01, p < 0.05, p < 0.01). The results of this study suggested that nutritional management and education for adult women differ by age group.

Development of Nutrition Education Program for Hypertension Based on Health Belief Model, Applying Focus Group Interview / 대한지역사회영양학회지

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.

Analysis of BMI, Body Composition, Weight Control, Dietary Behaviors of Adult Women / 대한지역사회영양학회지

This study was carried out to investigate distribution of obesity, body composition, weight control and dietary behaviors, and to analyze the relationship between Body Mass Index (BMI) and physical characteristics, body composition and dietary behaviors by anthropmetric measurement and questionnaires. The 199 study subjects were divided into 3 age groups; 30's (78), 40's (77) and 50's (44) and 4 groups by BMI ; under weight (4.5%), normal (51.3%), over weight (26.1%) and obese (18.1%). Amount of skeletal muscle, body water, mineral and body fat were significantly increased with BMI. There were especially significant increase skeletal muscle 5.3 kg (19.1 --> 23.5 kg), body water 5.3 kg (26.3 --> 31.6 kg) and fat 15.2 kg (11.2 --> 26.4 kg) from under weight to obesity group, respectively (p < 0.01). There were significantly decreased in the ratio of body water (10.3%), protein (2.7%) and body mineral (1.1%) from under weight to obesity, but significant increase 14.1% in body fat (p < 0.001). About 44.4% of under weight group and 40.1% of normal group and 50% of over and obesity group had dissatisfaction on their body images. Most of the women were concerned about their body images and experienced weight control. Dietary behavior scores of obesity group were significant lower than the other four groups (p < 0.001). There were significant positive correlation between BMI and body water (r = 0.62), protein (r = 0.52), skeletal muscle (r = 0.63), body fat (r = 0.91) and WH ratio (r = 0.91), respectively (p < 0.001). The correlation between BMI and body fat and WH ratio were much higher than the correlation between weight and fat and WH ratio.

Analysis of BMI Menopose, Blood Pressure and Dietary Habits Affecting Born Mineral Density of 30~60 Years Women / 대한지역사회영양학회지

Reducing women's bone mineral density (BMD) has close relationship to risk in osteoporosis. This study was carried out to identify bone density risk factors affecting women's BMD, and to analyze the relationship of age, between BMD and menopause, BMI, blood pressure lifestyle and dietary habits for bone health by physical measurement and questionnaires. The study subjects, 128 women living in Seoul, were divided into 4 age group; 30~39 years (17), 40~49 years (54) and 50~59 years (36) and 60~69 years (21). There were significant differences in mean height, BMI, systolic blood pressure, menache and menopause age and menopause ratio and BMD T-score among the 4 age groups. BHD was significantly decreased according to increasing age and BMI and menopause. The rate of BMD risk subjects was significantly different increasing with age and BMI. The rate of risk group were 0%, 13%, 22.2% and 71.4%, by age groups and 0%, 16.2%, 33.3% and 52.9% by BMI respectively. BMD of menopause groups was significantly decreased from 1.23 (40 years) to 1.34 (60 years). p < 0.001. Also systolic blood pressure were significantly increased from 116.5 mmHg (30 years) to 130.81 mmHg (60 years). The T-score of normal group also decreased significantly from 1.27 to 0.13 (60years) with age. There were significant negative correlation between BMD and age (r = -0.409) menopause (r = -0.346), BMI (r = -0.218) systolic blood pressure (r = -0.193), salty taste eating out (r = -0.185) (p < 0.05). There were significant positive correlation between BMD and meat fish and walking time. In conclusion, bone density decreased with age. Most of the 50 years' subjects were in risk group. BMI, menopause, systolic blood pressure, frequency alcohol consuming. To prevent osteoporosis, over 40 years needed to be educated to maintain normal weight and the improvement of eating and living habits.