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.

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.